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Wang S, Pan J, Zhang X, Li Y, Liu W, Lin R, Wang X, Kang D, Li Z, Huang F, Chen L, Chen J. Towards next-generation diagnostic pathology: AI-empowered label-free multiphoton microscopy. LIGHT, SCIENCE & APPLICATIONS 2024; 13:254. [PMID: 39277586 PMCID: PMC11401902 DOI: 10.1038/s41377-024-01597-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 08/04/2024] [Accepted: 08/21/2024] [Indexed: 09/17/2024]
Abstract
Diagnostic pathology, historically dependent on visual scrutiny by experts, is essential for disease detection. Advances in digital pathology and developments in computer vision technology have led to the application of artificial intelligence (AI) in this field. Despite these advancements, the variability in pathologists' subjective interpretations of diagnostic criteria can lead to inconsistent outcomes. To meet the need for precision in cancer therapies, there is an increasing demand for accurate pathological diagnoses. Consequently, traditional diagnostic pathology is evolving towards "next-generation diagnostic pathology", prioritizing on the development of a multi-dimensional, intelligent diagnostic approach. Using nonlinear optical effects arising from the interaction of light with biological tissues, multiphoton microscopy (MPM) enables high-resolution label-free imaging of multiple intrinsic components across various human pathological tissues. AI-empowered MPM further improves the accuracy and efficiency of diagnosis, holding promise for providing auxiliary pathology diagnostic methods based on multiphoton diagnostic criteria. In this review, we systematically outline the applications of MPM in pathological diagnosis across various human diseases, and summarize common multiphoton diagnostic features. Moreover, we examine the significant role of AI in enhancing multiphoton pathological diagnosis, including aspects such as image preprocessing, refined differential diagnosis, and the prognostication of outcomes. We also discuss the challenges and perspectives faced by the integration of MPM and AI, encompassing equipment, datasets, analytical models, and integration into the existing clinical pathways. Finally, the review explores the synergy between AI and label-free MPM to forge novel diagnostic frameworks, aiming to accelerate the adoption and implementation of intelligent multiphoton pathology systems in clinical settings.
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Affiliation(s)
- Shu Wang
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, 350108, China
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, China
| | - Junlin Pan
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, 350108, China
| | - Xiao Zhang
- College of Computer and Data Science, Fuzhou University, Fuzhou, 350108, China
| | - Yueying Li
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, 350108, China
| | - Wenxi Liu
- College of Computer and Data Science, Fuzhou University, Fuzhou, 350108, China
| | - Ruolan Lin
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Xingfu Wang
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China
| | - Deyong Kang
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Zhijun Li
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, China
| | - Feng Huang
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, 350108, China.
| | - Liangyi Chen
- New Cornerstone Laboratory, State Key Laboratory of Membrane Biology, Beijing Key Laboratory of Cardiometabolic Molecular Medicine, Institute of Molecular Medicine, National Biomedical Imaging Center, School of Future Technology, Peking University, Beijing, 100091, China.
| | - Jianxin Chen
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, 350007, China.
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Stanciu SG, König K, Song YM, Wolf L, Charitidis CA, Bianchini P, Goetz M. Toward next-generation endoscopes integrating biomimetic video systems, nonlinear optical microscopy, and deep learning. BIOPHYSICS REVIEWS 2023; 4:021307. [PMID: 38510341 PMCID: PMC10903409 DOI: 10.1063/5.0133027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/26/2023] [Indexed: 03/22/2024]
Abstract
According to the World Health Organization, the proportion of the world's population over 60 years will approximately double by 2050. This progressive increase in the elderly population will lead to a dramatic growth of age-related diseases, resulting in tremendous pressure on the sustainability of healthcare systems globally. In this context, finding more efficient ways to address cancers, a set of diseases whose incidence is correlated with age, is of utmost importance. Prevention of cancers to decrease morbidity relies on the identification of precursor lesions before the onset of the disease, or at least diagnosis at an early stage. In this article, after briefly discussing some of the most prominent endoscopic approaches for gastric cancer diagnostics, we review relevant progress in three emerging technologies that have significant potential to play pivotal roles in next-generation endoscopy systems: biomimetic vision (with special focus on compound eye cameras), non-linear optical microscopies, and Deep Learning. Such systems are urgently needed to enhance the three major steps required for the successful diagnostics of gastrointestinal cancers: detection, characterization, and confirmation of suspicious lesions. In the final part, we discuss challenges that lie en route to translating these technologies to next-generation endoscopes that could enhance gastrointestinal imaging, and depict a possible configuration of a system capable of (i) biomimetic endoscopic vision enabling easier detection of lesions, (ii) label-free in vivo tissue characterization, and (iii) intelligently automated gastrointestinal cancer diagnostic.
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Affiliation(s)
- Stefan G. Stanciu
- Center for Microscopy-Microanalysis and Information Processing, University Politehnica of Bucharest, Bucharest, Romania
| | | | | | - Lior Wolf
- School of Computer Science, Tel Aviv University, Tel-Aviv, Israel
| | - Costas A. Charitidis
- Research Lab of Advanced, Composite, Nano-Materials and Nanotechnology, School of Chemical Engineering, National Technical University of Athens, Athens, Greece
| | - Paolo Bianchini
- Nanoscopy and NIC@IIT, Italian Institute of Technology, Genoa, Italy
| | - Martin Goetz
- Medizinische Klinik IV-Gastroenterologie/Onkologie, Kliniken Böblingen, Klinikverbund Südwest, Böblingen, Germany
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Wang X, Zhang D, Zhang X, Xing Y, Wu J, Sui X, Huang X, Chang G, Li L. Application of Multiphoton Microscopic Imaging in Study of Gastric Cancer. Technol Cancer Res Treat 2022; 21:15330338221133244. [PMID: 36379591 PMCID: PMC9676310 DOI: 10.1177/15330338221133244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2024] Open
Abstract
Multiphoton microscopy (MPM) imaging relies on the nonlinear interaction between ultrashort optical pulses and the samples to achieve image contrast. Featuring larger penetration depth, less phototoxicity, 3-dimensional sectioning capability, no need for labeling, MPM become a powerful medical imaging technique that can identify structural characteristics of tissues at the cellular and subcellular levels. In this review paper, we introduce the working principle of MPM imaging, present the current results of MPM imaging applied to the study of gastric tumors, and discuss the future prospects of this interdisciplinary research field.
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Affiliation(s)
- Xiaoying Wang
- Strategic Support Force Medical Center, Beijing, China
| | - Di Zhang
- Ningxia Jingyuan County People's Hospital, Ningxia, China
| | - Xiaochun Zhang
- General Hospital of Ningxia Medical University, Ningxia, China
| | - Yuting Xing
- Institute of Physics, Chinese Academy of Sciences, Beijing, China
| | - Jihua Wu
- Strategic Support Force Medical Center, Beijing, China
| | - Xinke Sui
- Strategic Support Force Medical Center, Beijing, China
| | - Xin Huang
- Strategic Support Force Medical Center, Beijing, China
| | - Guoqing Chang
- Institute of Physics, Chinese Academy of Sciences, Beijing, China
| | - Lianyong Li
- Strategic Support Force Medical Center, Beijing, China
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Chen HY, Ning SB, Yin X, Li BR, Zhang J, Jin XW, Sun T, Xia ZB, Zhang XP. Balloon-assisted endoscopic submucosal dissection for treating small intestinal lipomas: Report of two cases. World J Clin Cases 2021; 9:1631-1638. [PMID: 33728306 PMCID: PMC7942049 DOI: 10.12998/wjcc.v9.i7.1631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/21/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Most small intestinal lipomas are treated surgically, and some require repeated surgeries for multiple lipomas. However, application of endoscopic submucosal dissection (ESD) technology in the deep small intestine is rarely reported owing to the special anatomical structure of the small intestine, medical equipment limitations, and the lack of relevant experience among endoscopists.
CASE SUMMARY Two patients with small intestinal lipomas treated at the Air Force Medical Center from November 2015 to September 2019 were selected to undergo balloon-assisted ESD to treat the lipomas and explore the technical feasibility and safety of ESD for treating small intestinal lipomas. The two patients successfully underwent balloon-assisted ESD to treat four small intestinal lipomas, with a complete resection rate of 100% (4/4), without intraoperative or postoperative bleeding, perforation, or other complications. After 3-6 mo of postoperative follow-up, the clinical symptoms caused by the lipomas were significantly relieved or disappeared after treatment.
CONCLUSION Balloon-assisted ESD is a safe and reliable new method for treating deep intestinal lipomas and shows good clinical feasibility.
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Affiliation(s)
- Hong-Yu Chen
- Department of Gastroenterology, Air Force Medical Center, PLA of China, Beijing 100142, China
| | - Shou-Bin Ning
- Department of Gastroenterology, Air Force Medical Center, PLA of China, Beijing 100142, China
| | - Xin Yin
- Department of Gastroenterology, Air Force Medical Center, PLA of China, Beijing 100142, China
| | - Bai-Rong Li
- Department of Gastroenterology, Air Force Medical Center, PLA of China, Beijing 100142, China
| | - Jing Zhang
- Department of Gastroenterology, Air Force Medical Center, PLA of China, Beijing 100142, China
| | - Xiao-Wei Jin
- Department of Gastroenterology, Air Force Medical Center, PLA of China, Beijing 100142, China
| | - Tao Sun
- Department of Gastroenterology, Air Force Medical Center, PLA of China, Beijing 100142, China
| | - Zhi-Bo Xia
- Department of Gastroenterology, Air Force Medical Center, PLA of China, Beijing 100142, China
| | - Xiao-Peng Zhang
- Department of Gastroenterology, Air Force Medical Center, PLA of China, Beijing 100142, China
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Sahu SP, Liu Q, Prasad A, Hasan SMA, Liu Q, Rodriguez MXB, Mukhopadhyay O, Burk D, Francis J, Mukhopadhyay S, Fu X, Gartia MR. Characterization of fibrillar collagen isoforms in infarcted mouse hearts using second harmonic generation imaging. BIOMEDICAL OPTICS EXPRESS 2021; 12:604-618. [PMID: 33520391 PMCID: PMC7818962 DOI: 10.1364/boe.410347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/14/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
Abstract
We utilized collagen specific second harmonic generation (SHG) signatures coupled with correlative immunofluorescence imaging techniques to characterize collagen structural isoforms (type I and type III) in a murine model of myocardial infarction (MI). Tissue samples were imaged over a four week period using SHG, transmitted light microscopy and immunofluorescence imaging using fluorescently-labeled collagen antibodies. The post-mortem cardiac tissue imaging using SHG demonstrated a progressive increase in collagen deposition in the left ventricle (LV) post-MI. We were able to monitor structural morphology and LV remodeling parameters in terms of extent of LV dilation, stiffness and fiber dimensions in the infarcted myocardium.
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Affiliation(s)
- Sushant P Sahu
- Department of Chemistry, University of Louisiana at Lafayette, Lafayette, LA 70504, USA
| | - Qianglin Liu
- LSU AgCenter, School of Animal Sciences, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Alisha Prasad
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Syed Mohammad Abid Hasan
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Qun Liu
- Department of Computer Science, Louisiana State University, Baton Rouge, LA 70803, USA
| | | | | | - David Burk
- Shared Instrumentation Facility and Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Joseph Francis
- Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Supratik Mukhopadhyay
- Department of Computer Science, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Xing Fu
- LSU AgCenter, School of Animal Sciences, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Manas Ranjan Gartia
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge, LA 70803, USA
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Wang G, Sun Y, Chen Y, Gao Q, Peng D, Lin H, Zhan Z, Liu Z, Zhuo S. Rapid identification of human ovarian cancer in second harmonic generation images using radiomics feature analyses and tree-based pipeline optimization tool. JOURNAL OF BIOPHOTONICS 2020; 13:e202000050. [PMID: 32500634 DOI: 10.1002/jbio.202000050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/15/2020] [Accepted: 05/28/2020] [Indexed: 06/11/2023]
Abstract
Ovarian cancer is currently one of the most common cancers of the female reproductive organs, and its mortality rate is the highest among all types of gynecologic cancers. Rapid and accurate classification of ovarian cancer plays an important role in the determination of treatment plans and prognoses. Nevertheless, the most commonly used classification method is based on histopathological specimen examination, which is time-consuming and labor-intensive. Thus, in this study, we utilize radiomics feature extraction methods and the automated machine learning tree-based pipeline optimization tool (TOPT) for analysis of 3D, second harmonic generation images of benign, malignant and normal human ovarian tissues, to develop a high-efficiency computer-aided diagnostic model. Area under the receiver operating characteristic curve values of 0.98, 0.96 and 0.94 were obtained, respectively, for the classification of the three tissue types. Furthermore, this approach can be readily applied to other related tissues and diseases, and has great potential for improving the efficiency of medical diagnostic processes.
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Affiliation(s)
- Guangxing Wang
- School of Science, Jimei University, Xiamen, Fujian, China
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education & Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, Fujian, China
| | - Yang Sun
- Department of Gynecology, Fujian Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Youting Chen
- Department of Hepatopancreatobiliary Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Qiqi Gao
- Department of Gynecology, Fujian Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Dongqing Peng
- School of Science, Jimei University, Xiamen, Fujian, China
| | - Hongxin Lin
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education & Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, Fujian, China
| | - Zhenlin Zhan
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education & Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, Fujian, China
| | - Zhiyi Liu
- State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou Zhejiang, China
| | - Shuangmu Zhuo
- School of Science, Jimei University, Xiamen, Fujian, China
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education & Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, Fujian, China
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König TT, Goedeke J, Muensterer OJ. Multiphoton microscopy in surgical oncology- a systematic review and guide for clinical translatability. Surg Oncol 2019; 31:119-131. [PMID: 31654957 DOI: 10.1016/j.suronc.2019.10.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/02/2019] [Accepted: 10/13/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Multiphoton microscopy (MPM) facilitates three-dimensional, high-resolution functional imaging of unlabeled tissues in vivo and ex vivo. This systematic review discusses the diagnostic value, advantages and challenges in the practical use of MPM in surgical oncology. METHOD AND FINDINGS A Medline search was conducted in April 2019. Fifty-three original research papers investigating MPM compared to standard histology in human patients with solid tumors were identified. A qualitative synopsis and meta-analysis of 14 blinded studies was performed. Risk of bias and applicability were evaluated. MPM can image fresh, frozen or fixed tissues up to a depth 1000 μm in the z-plane. Best results including functional imaging and virtual histochemistry are obtained by in vivo imaging or scanning fresh tissue immediately after excision. Two-photon excited fluorescence by natural fluorophores of the cytoplasm and second harmonic generation signals by fluorophores of the extracellular matrix can be scanned simultaneously, providing high resolution optical histochemistry comparable to standard histology. Functional parameters like fluorescence lifetime imaging or optical redox ratio provide additional objective information. A major concern is inability to visualize the nucleus. However, in a subpopulation analysis of 440 specimens, MPM yielded a sensitivity of 94%, specificity of 96% and accuracy of 95% for the detection of malignant tissue. CONCLUSION MPM is a promising emerging technique in surgical oncology. Ex vivo imaging has high sensitivity, specificity and accuracy for the detection of tumor cells. For broad clinical application in vivo, technical challenges need to be resolved.
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Affiliation(s)
| | - Jan Goedeke
- Universitätsmedizin Mainz, Department of Pediatric Surgery, Mainz, Germany
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