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Multiscale nonlinear microscopy and widefield white light imaging enables rapid histological imaging of surgical specimen margins
Name
boe-9-5-2457.pdf
Description
Published version
Size
4.87 MB
Format
Adobe PDF
Checksum (MD5)
0be1b9b084e35ca732c6fbbf68d04bdd
Author(s)
Giacomelli, Michael G
Yoshitake, Tadayuki
Cahill, Lucas C
Vardeh, Hilde
Quintana, Liza M
Faulkner-Jones, Beverly E
Brooker, Jeff
Connolly, James L
Fujimoto, James G
Date Issued
2018
Journal
Biomedical Optics Express
Publisher
The Optical Society
Version
Final published version
Abstract
© 2018 Optical Society of America under the terms of the OSA Open Access Publishing Agreement. The ability to histologically assess surgical specimens in real-time is a longstanding challenge in cancer surgery, including applications such as breast conserving therapy (BCT). Up to 40% of women treated with BCT for breast cancer require a repeat surgery due to postoperative histological findings of close or positive surgical margins using conventional formalin fixed paraffin embedded histology. Imaging technologies such as nonlinear microscopy (NLM), combined with exogenous fluorophores can rapidly provide virtual H&E imaging of surgical specimens without requiring microtome sectioning, facilitating intraoperative assessment of margin status. However, the large volume of typical surgical excisions combined with the need for rapid assessment, make comprehensive cellular resolution margin assessment during surgery challenging. To address this limitation, we developed a multiscale, real-time microscope with variable magnification NLM and real-time, co-registered position display using a widefield white light imaging system. Margin assessment can be performed rapidly under operator guidance to image specific regions of interest located using widefield imaging. Using simulated surgical margins dissected from human breast excisions, we demonstrate that multi-centimeter margins can be comprehensively imaged at cellular resolution, enabling intraoperative margin assessment. These methods are consistent with pathology assessment performed using frozen section analysis (FSA), however NLM enables faster and more comprehensive assessment of surgical specimens because imaging can be performed without freezing and cryo-sectioning. Therefore, NLM methods have the potential to be applied to a wide range of intra-operative applications.
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DOI of Published Version
10.1364/BOE.9.002457
