Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure
CPT4 code
Name of the Procedure:
Morphometric Analysis, In Situ Hybridization (Quantitative or Semi-Quantitative), Multiplex Probe Stain
Summary
Morphometric analysis using in situ hybridization (ISH) with multiplex probe stains is an advanced technique that allows for the detailed study of cells and tissues. It involves tagging specific DNA or RNA sequences with fluorescent or chromogenic probes and analyzing these signals using computer-assisted technology to quantify and localize genetic material within a specimen.
Purpose
Morphometric analysis using ISH is primarily used for diagnosing and studying genetic and molecular features of various conditions, such as cancers, genetic disorders, and infectious diseases. The goal is to provide precise information on the presence and amount of specific genetic materials within tissues, helping to guide diagnosis, treatment, and research.
Indications
- Suspicion of cancer or tumors based on initial imaging or biopsy results.
- Genetic disorders where specific gene alterations need to be identified.
- Certain infections that can be better identified by their genetic markers.
- Research studies requiring detailed cellular and molecular analysis.
Preparation
- Patients may need to stop certain medications that could interfere with tissue sampling.
- Pre-procedure imaging studies or biopsies are typically required to locate and sample the tissue.
- Fasting is usually not required unless combined with other procedures.
Procedure Description
- Tissue Sampling: A biopsy is obtained of the tissue needing evaluation.
- Tissue Preparation: The specimen is prepared and treated in the lab.
- Probe Application: Specific DNA/RNA probes are applied to the tissue sample.
- Hybridization: Probes hybridize with their complementary sequences in the tissue.
- Staining: Probes are visualized with fluorescent or chromogenic stains.
- Imaging: The stained specimen is examined under a microscope.
- Quantification and Analysis: Computer-assisted technology measures and analyzes the signals.
Duration
Typically takes 2-4 hours, depending on the complexity and sample size.
Setting
Performed in specialized laboratory settings or medical research facilities, sometimes as a part of hospital pathology departments.
Personnel
- Pathologists or molecular biologists
- Laboratory technicians experienced in molecular techniques
- Data analysts for computer-assisted image analysis
Risks and Complications
- Risk of biopsy-related complications such as bleeding or infection.
- Rarely, false negatives or positives due to technical errors.
- Minimal risk from the procedure itself since it is largely lab-based.
Benefits
- Precise and detailed genetic and molecular information.
- Helps in accurate diagnosis, prognosis, and personalized treatment planning.
- High sensitivity and specificity for genetic abnormalities.
Recovery
- Recovery mainly pertains to the tissue sampling (biopsy) if performed.
- Minimal to no physical recovery time required for the analysis part.
- Follow-up appointments might be necessary to discuss results and subsequent steps.
Alternatives
- Polymerase Chain Reaction (PCR) for specific genetic testing.
- Immunohistochemistry for protein expression studies.
- Next-Generation Sequencing (NGS) for broad genetic analysis.
- Each alternative has differing sensitivities, specificities, and costs.
Patient Experience
- The biopsy procedure might cause discomfort or pain, managed with local anesthesia.
- The lab-based ISH analysis is non-invasive and does not directly affect the patient.
- Detailed discussions with the healthcare provider help understand the process and alleviate any concerns.