E1608. Principles of Tissue Sampling, Handling, and Processing: A Primer for Procedural Radiologists
  1. Alice Shieh; University of Washington
  2. Bahar Mansoori; University of Washington
  3. Brian Mau; University of Washington
  4. Jose Mantilla; University of Washington
  5. Firoozeh Zadeh; University of Washington
  6. Christine Rehwald; University of Washington
  7. Majid Chalian; University of Washington
Radiology and pathology are both essential in diagnosis and guiding patient management. However, these two disciplines are more often than not separated and isolated from one another, with little overlap between daily workflows. Several publications have highlighted the benefits of improved integration between radiology and pathology across various settings, which can lead to improved patient care, research and innovation, and development of a common database to assist with research efforts. This educational project will bridge radiologists’ knowledge gap on pathology processes to learn not only what happens to samples after they are sent to the lab, but also understand the pathology report. Additionally, we provide a brief background on image-guided tissue sampling and handling techniques to optimize yield and enhance the pathologist’s ability to provide an accurate diagnosis.

Educational Goals / Teaching Points
The educational goals are to provide a broad overview of pathology to demystify subdivisions and associated protocols and procedures. Best practices for tissue sampling and handling, based on organ system (including thyroid, breast, lung, liver, kidney, bone, and musculoskeletal soft tissue) will be discussed. The audience will be familiarized with different sample media, their functions, and indications and learn about common histopathology artifacts and mitigation strategies. Additionally, the exhibit will cover how to implement clinical and imaging findings to sample adequately and handle tissue appropriately.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The overall workflows of anatomic and clinical pathology will be reviewed to provide a basic understanding and appreciation of the interplay between radiology and pathology. The audience will learn about general best practices for ultrasound- and CT-guided tissue sampling, by an organ-based approach. Different methods and solutions for specimen handling and processing will be discussed as well as strategies on how to increase yield and minimize inadequate samples. The information in this educational exhibit includes input from practicing pathologists at our institution based on their experiences analyzing specimens obtained by radiologists.

Through this educational exhibit, radiologists including those in training and those who are seasoned proceduralists will receive a primer on best practices for various sampling/biopsy procedures. Additionally, they will learn about downstream pathology processes after sample acquisition. We aim for this project to show others how further integrating radiology and pathology workflows is beneficial for each department and also for patient care.