1. Evaluation and Implementation of Machine-assisted Slide Processing Charlotte Gregory South-East Scotland Cytogenetics Service Western General Edinburgh

2. Time Consuming Labour Intensive Inconsistent Messy Slide Processing Genetix SL-120 Metaphase Finder/Analysis Transgenomics Hanabi Automatic Harvester

3. Aims of the Project Integrate new equipment (Set up/Programming/SOPS/Training) Compare quality and consistency to manual method Time, Space, financial implications

4. Thermotron (Fisher) Environmental Chamber Controlled Environment Gives Consistency Facilitates Spreading Optimum values?

5. Temperature O C Relative Humidity % %Metaphase ≥ QA5 B F Average Crossovers 23.8 Control in Hood 4523 278 7 2050 9 6 2550 49 565 6 30 50 339 8 Variables 20, 25, 30 o C 20, 30, 40, 50,60% RH for each temperature as above

6. Varistain Gemini (Shandon) Automatic Stainer Robotic arm/troughs Multiple Samples Accurate Timing Heat/Running Water

7. Postnatal Pre- treatment Hot Plate/ Peroxide Time1hr/ 30mins Trypsin Concentration 1/10 Time50s PBS wash5s + agitation Leishman’s Concentration 1/4 Time2.5m Gurr’s Wash 5 secs +agitation Postnatal Prenatal Tissue Haematology Tumour Adapted from Manual Protocol

8. video

9. Picture of reagent screen

10. 1m 5m Load Trypsin PBS Stain Gurr’s Store 1 rack every 8 minutes(32 minutes for 4) Previous Version

11. Updated Version LoadStoreTrypsin PBS Stain Gurr’s Store 1m 5m 4 racks at same time(11 minutes for 4)

12. Picture of sample screen

13. Clearvue (Shandon) Automatic Coverslipper Daily maintenance Preloaded Coverslips Humid atmosphere No pressure

14. video

15. Methods% Cells ≥ QA5 SpreadingBanding Thermo/Man67OKOK/ S. Under Thermo/Gem62OK Man/Gem56ThickS. Over Man/Man53OKOK pale Pattern consistent in all cases Pattern consistent for all users Thermo/Man best quality due to not batch banding Thermo/Gemini good, quicker, more consistent

18. SIZE M 2 Per Unit Total SIZE M 2 Per Unit Total Monoair Hood 0.965 x2 1.93 Clearvue H 500 D 575 W 645 0.37 +hood 0.965 Sensair Hood 0.82 x2 1.64 Thermotron H 1425 D 715 W 1095 0.78 X2 1.56 Worktop 0.57 x4 2.28 Varistain H 880 D 710 W 720 0.51 + bench 1.12 Total5.853.65

19. ManualMachine TimeWalk awayTimeWalk away Mon 3h301h3h301h30 Tues 7h201h3h201h55 Wed 6h251h6h201h35 Thur 6h1h2h052h Fri 4h551h4h251h45 TIME29h105h19h408h45 TOTAL24h1010h55

20. PBS ml ManAuto Blood Fluid Oncology 299 200 390 380 Total Litres 2.51.9 Cost£2.08£1.57 Gurr's Leishman's Trypsin Coverslip Mountant Automatic method costs ~£80 more, per year

21. £ Saving: 689 MTO hours per year Extra cost: Machines + Extra Reagent + Maintenance Overall Saving £6000 a year

22. QA66 Crossovers85 Space Needed5.85m 2 3.65m 2 Time taken4.72mins2.11mins Cost£1.76£1.52 Conclusion Statistics on an average slide basis

23. Acknowledgements Eddy Maher Clive Dixon All at South East Scotland Cytogenetics Service.