Michael Christopher Montalto

Highly multiplexed single-cell analysis of formalin-fixed, paraffin-embedded cancer tissue

Limitations on the number of unique protein and DNA molecules that can be characterized microscopically in a single tissue specimen impede advances in understanding the biological basis of health and disease. Here we present a multiplexed fluorescence microscopy method (MxIF) for quantitative, single-cell, and subcellular characterization of multiple analytes in formalin-fixed paraffin-embedded tissue. Chemical inactivation of fluorescent dyes after each image acquisition round allows reuse of common dyes in iterative staining and imaging cycles. The mild inactivation chemistry is compatible with total and phosphoprotein detection, as well as DNA FISH. Accurate computational registration of sequential images is achieved by aligning nuclear counterstain-derived fiducial points. Individual cells, plasma membrane, cytoplasm, nucleus, tumor, and stromal regions are segmented to achieve cellular and subcellular quantification of multiplexed targets. In a comparison of pathologist scoring of diaminobenzidine staining of serial sections and automated MxIF scoring of a single section, human epidermal growth factor receptor 2, estrogen receptor, p53, and androgen receptor staining by diaminobenzidine and MxIF methods yielded similar results. Single-cell staining patterns of 61 protein antigens by MxIF in 747 colorectal cancer subjects reveals extensive tumor heterogeneity, and cluster analysis of divergent signaling through ERK1/2, S6 kinase 1, and 4E binding protein 1 provides insights into the spatial organization of mechanistic target of rapamycin and MAPK signal transduction. Our results suggest MxIF should be broadly applicable to problems in the fields of basic biological research, drug discovery and development, and clinical diagnostics.

The relative distribution of membranous and cytoplasmic met is a prognostic indicator in stage I and II colon cancer.

Purpose: The association hepatocyte growth factor receptor (Met) tyrosine kinase with prognosis and survival in colon cancer is unclear, due in part to the limitation of detection methods used. In particular, conventional chromagenic immunohistochemistry (IHC) has several limitations including the inability to separate compartmental measurements. Measurement of membrane, cytoplasm, and nuclear levels of Met could offer a superior approach to traditional IHC. Experimental Design: Fluorescent-based IHC for Met was done in 583 colon cancer patients in a tissue microarray format. Using curvature and intensity-based image analysis, the membrane, nuclear, and cytoplasm were segmented. Probability distributions of Met within each compartment were determined, and an automated scoring algorithm was generated. An optimal score cutpoint was calculated using 500-fold crossvalidation of a training and test data set. For comparison with conventional IHC, a second array from the same tissue microarray block was 3,3′-diaminobenzidine immunostained for Met. Results: In crossvalidated and univariate Cox analysis, the membrane relative to cytoplasm Met score was a significant predictor of survival in stage I (hazard ratio, 0.16; P = 0.006) and in stage II patients (hazard ratio, 0.34; P ≤ 0.0005). Similar results were found with multivariate analysis. Met in the membrane alone was not a significant predictor of outcome in all patients or within stage. In the 3,3′-diaminobenzidine–stained array, no associations were found with Met expression and survival. Conclusions: These data indicate that the relative subcellular distribution of Met, as measured by novel automated image analysis, may be a valuable biomarker for estimating colon cancer prognosis.

Fibrillar and Oligomeric β‐Amyloid as Distinct Local Biomarkers for Alzheimer's Disease

Abstract:  β‐amyloid is a key component of Alzheimers disease (AD) pathology. Researchers in both academic and industry are actively pursuing the development of imaging tracers and techniques to noninvasively measure local levels of β‐amyloid in the Alzheimers brain. This presentation summarizes recent data and discusses the opportunities and challenges of imaging plaques containing fibrillar β‐amyloid for the early diagnosis and therapeutic monitoring of amyloid targeted therapies. Further, the value and feasibility of measuring the recently described soluble oligomeric form of β‐amyloid as an alternative noninvasive biomarker is also discussed.

Multi-modal imaging of histological tissue sections

Two common imaging modalities for histological sections are brightfield and fluorescence microscopy imaging. Hematoxylin-Eosin (H&E) based brightfield microscopy has been the traditional imaging technique for imaging morphology, while an epi-fluorescent microscope is used for immunofluorescent staining of specific proteins or fluorescent in situ hybridization (FISH) for genetic based analysis of DNA. Simultaneous imaging of both microscopy modalities has been difficult due to optical and chemical effects of the H&E dyes. We present a novel sequential imaging and registration technique that enables brightfield and fluorescent imaging on the same tissue section, hence combining the traditional anatomic pathology with the newly emerging field of molecular pathology. First the tissue is labeled with fluorescent biomarkers, and imaged through a fluorescence microscope, and then the tissue is re-labeled with H&E dyes, and imaged again with traditional brightfield. Our robust registration algorithms achieve 99.8% registration success rate on tissue micro array (TMA) sections.

A Computational Positron Emission Tomography Simulation Model for Imaging β-Amyloid in Mice

PurposeWe aimed to develop a computational simulation model for β-amyloid (Aβ) positron emission tomography (PET) imaging.ProceduresModel parameters were set to reproduce levels of Aβ within the PDAPP mouse. Pharmacokinetic curves of virtual tracers were computed and a PET detector simulator was configured for a commercially available preclinical PET-imaging system.ResultsWe modeled the effects of Aβ therapy and tracer affinity on the ability to differentiate Aβ levels by PET. Varying affinity had a significant effect on the ability to quantitate Aβ. Further, PET tracers for Aβ monomers were more sensitive to the therapeutic reduction in Aβ levels than total brain amyloid. Following therapy, the decrease in total brain Aβ corresponded to the slow rate of change in total amyloid load as expected.ConclusionsWe have developed a first proof-of-concept Aβ-PET simulation model that will be a useful tool in the interpretation of preclinical Aβ imaging data and tracer development.

Relationship between magnification and resolution in digital pathology systems

Many pathology laboratories are implementing digital pathology systems. The image resolution and scanning (digitization) magnification can vary greatly between these digital pathology systems. In addition, when digital images are compared with viewing images using a microscope, the cellular features can vary in size. This article highlights differences in magnification and resolution between the conventional microscopes and the digital pathology systems. As more pathologists adopt digital pathology, it is important that they understand these differences and how they ultimately translate into what the pathologist can see and how this may impact their overall viewing experience.

An industry perspective: An update on the adoption of whole slide imaging.

This manuscript is an adaptation of the closing keynote presentation of the Digital Pathology Association Pathology Visions Conference 2015 in Boston, MA, USA. In this presentation, analogies are drawn between the adoption of whole slide imaging (WSI) and other mainstream digital technologies, including digital music and books. In doing so, it is revealed that the adoption of seemingly similar digital technologies does not follow the same adoption profiles and that understanding the unique aspects of value for each customer segment is critical. Finally, a call to action is given to academia and industry to study the value that WSI brings to the global healthcare community.