Three-dimensional assessments are necessary to determine the true, spatially resolved composition of tissues

Methods for spatially resolved cellular profiling of tissue sections enable in-depth study of inter- and intra-sample heterogeneity but often profile small regions, requiring evaluation of many samples to compensate for limited assessment. Recent advances in three-dimensional (3D) tissue mapping offer deeper insights; however, attempts to quantify the information gained in transitioning to 3D remains limited. Here, to compare inter- and intra-sample tissue heterogeneity, we analyze >100 pancreas samples as cores, whole-slide images (WSIs), and cm³-sized 3D samples. We show that tens of WSIs and hundreds of tissue microarrays are needed to approximate the compositional tissue heterogeneity of tumors. Additionally, spatial correlations of pancreatic structures decay significantly within microns, demonstrating that isolated two-dimensional (2D) sections poorly represent their surroundings. Through 3D simulations, we determined the number of slides necessary to accurately measure tumor burden. These results quantify the power of 3D mapping and establish sampling methods for biological studies prioritizing composition or incidence.