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Xu Z, Xie X, Li R, Yu K, Lish SR, Xu M. Information entropy of quantitative chemometric endogenous fluorescence improves photonic lung cancer diagnosis. APPLIED OPTICS 2022; 61:478-484. [PMID: 35200886 DOI: 10.1364/ao.439458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
Quantitative chemometric widefield endogenous fluorescence microscopy (CFM) maps the endogenous absolute chromophore concentration and spatial distribution in cells and tissue sections label-free from fluorescence color images under broadband excitation and detection. By quantifying the endogenous chromophores, including tryptophan, elastin, reduced nicotinamide adenine dinucleotide [NAD(P)H], and flavin adenine dinucleotide (FAD), CFM reveals the biochemical environment and subcellular structure. Here we show that the chromophore information entropy, marking its spatial distribution pattern of quantitative chemometric endogenous fluorescence at the microscopic scale, improves photonic lung cancer diagnosis with independent diagnostic power to the cellular metabolism biomarker. NAD(P)H and FAD's information entropy is found to decrease from normal to perilesional to cancerous tissue, whereas the information entropy for the redox ratios [FAD/tryptophan and FAD/NAD(P)H] is smaller for the normal tissue than both perilesional and cancerous tissue. CFM imaging of the specimen's inherent biochemical and structural properties eliminates the dependence on measurement details and facilitates robust, accurate diagnosis. The synergy of quantifying absolute chromophore concentration and information entropy achieves high accuracies for a three-class classification of lung tissue into normal, perilesional, and cancerous ones and a three-class classification of lung cancers into grade 1, grade 2, and grade 3 using a support vector machine, outperforming the chromophore concentration biomarkers.
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Multiphoton Microscopic Study of the Renal Cell Carcinoma Pseudocapsule: Implications for Tumour Enucleation. Urology 2020; 144:249-254. [PMID: 32681916 DOI: 10.1016/j.urology.2020.06.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To utilize Multiphoton Microscopy (MPM) as a novel imaging technique to characterize and quantify collagen at the Renal Cell Carcinoma Pseudocapsule, to assess for both intra-tumoral and inter-tumoral variation of collagen characteristics. MPM combines Second Harmonic Generation and Two Photon Excitation Fluorescence to image extracellular matrix architecture. METHODS Twenty partial nephrectomy specimen tissues were retrieved, cut into 5-micron sections, mounted on slides and deparaffinized. The pseudocapsules (PCs) were imaged with 2X and 20X objective at selected Regions of Interest. Corresponding clinical information was retrieved. PC thickness was determined. Collagen parameters measured included quantification by the Collagen Area Ratio, and qualitative measurements by the Collagen Fiber Density and Collagen Reticulation Index. RESULTS The boundaries between tumor, PC and normal renal parenchyma were distinguished by MPM without need for staining. In the thickest areas of the PC, collagen content and density were quantitatively higher compared to the thinnest areas. Median Collagen Area Ratio was higher in the thickest compared to the thinnest areas of the PC (P = .01). Clear Cell RCC specimens had a consistently higher Collagen Fiber Density in both the thickest and thinnest areas compared to non-Clear Cell RCC specimens (P = .02). CONCLUSIONS We demonstrated the ability of MPM to quantify collagen characteristics of PCs without fluorescent labeling. Tumor enucleation for Renal Cell Carcinoma along its PC remains debatable with regards to oncological safety. Even with a complete and intact PC, the PC is not a homogenous structure, and varies in its thickness and its collagen characteristics within, and between tumors.
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Zhao S, Todorov MI, Cai R, -Maskari RA, Steinke H, Kemter E, Mai H, Rong Z, Warmer M, Stanic K, Schoppe O, Paetzold JC, Gesierich B, Wong MN, Huber TB, Duering M, Bruns OT, Menze B, Lipfert J, Puelles VG, Wolf E, Bechmann I, Ertürk A. Cellular and Molecular Probing of Intact Human Organs. Cell 2020; 180:796-812.e19. [PMID: 32059778 PMCID: PMC7557154 DOI: 10.1016/j.cell.2020.01.030] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 12/04/2019] [Accepted: 01/22/2020] [Indexed: 12/16/2022]
Abstract
Optical tissue transparency permits scalable cellular and molecular investigation of complex tissues in 3D. Adult human organs are particularly challenging to render transparent because of the accumulation of dense and sturdy molecules in decades-aged tissues. To overcome these challenges, we developed SHANEL, a method based on a new tissue permeabilization approach to clear and label stiff human organs. We used SHANEL to render the intact adult human brain and kidney transparent and perform 3D histology with antibodies and dyes in centimeters-depth. Thereby, we revealed structural details of the intact human eye, human thyroid, human kidney, and transgenic pig pancreas at the cellular resolution. Furthermore, we developed a deep learning pipeline to analyze millions of cells in cleared human brain tissues within hours with standard lab computers. Overall, SHANEL is a robust and unbiased technology to chart the cellular and molecular architecture of large intact mammalian organs.
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Affiliation(s)
- Shan Zhao
- Insititute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Zentrum München, 85764 Neuherberg, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilian University of Munich (LMU), 81377 Munich, Germany; Munich Medical Research School (MMRS), 80336 Munich, Germany
| | - Mihail Ivilinov Todorov
- Insititute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Zentrum München, 85764 Neuherberg, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilian University of Munich (LMU), 81377 Munich, Germany; Graduate School of Neuroscience (GSN), 82152 Munich, Germany
| | - Ruiyao Cai
- Insititute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Zentrum München, 85764 Neuherberg, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilian University of Munich (LMU), 81377 Munich, Germany
| | - Rami Ai -Maskari
- Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilian University of Munich (LMU), 81377 Munich, Germany; Department of Computer Science, Technical University of Munich (TUM), 81675 Munich, Germany; Center for Translational Cancer Research (TranslaTUM) of the TUM, 80798 Munich, Germany; Graduate School of Bioengineering, Technical University of Munich (TUM), 85748 Munich, Germany
| | - Hanno Steinke
- Institute of Anatomy, University of Leipzig, 04109 Leipzig, Germany
| | - Elisabeth Kemter
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, Ludwig Maximilian University of Munich (LMU), 81377 Munich, Germany; Center for Innovative Medical Models (CiMM), 85764 Oberschleißheim, Germany; German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Hongcheng Mai
- Insititute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Zentrum München, 85764 Neuherberg, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilian University of Munich (LMU), 81377 Munich, Germany
| | - Zhouyi Rong
- Insititute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Zentrum München, 85764 Neuherberg, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilian University of Munich (LMU), 81377 Munich, Germany
| | - Martin Warmer
- Helmholtz Pioneer Campus, Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Karen Stanic
- Insititute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Oliver Schoppe
- Department of Computer Science, Technical University of Munich (TUM), 81675 Munich, Germany; Center for Translational Cancer Research (TranslaTUM) of the TUM, 80798 Munich, Germany
| | - Johannes Christian Paetzold
- Department of Computer Science, Technical University of Munich (TUM), 81675 Munich, Germany; Center for Translational Cancer Research (TranslaTUM) of the TUM, 80798 Munich, Germany; Graduate School of Bioengineering, Technical University of Munich (TUM), 85748 Munich, Germany
| | - Benno Gesierich
- Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilian University of Munich (LMU), 81377 Munich, Germany
| | - Milagros N Wong
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Tobias B Huber
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilian University of Munich (LMU), 81377 Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany
| | - Oliver Thomas Bruns
- Helmholtz Pioneer Campus, Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Bjoern Menze
- Department of Computer Science, Technical University of Munich (TUM), 81675 Munich, Germany; Center for Translational Cancer Research (TranslaTUM) of the TUM, 80798 Munich, Germany; Graduate School of Bioengineering, Technical University of Munich (TUM), 85748 Munich, Germany
| | - Jan Lipfert
- Department of Physics and Center for Nanoscience, Ludwig Maximilian University of Munich (LMU), 80799 Munich, Germany
| | - Victor G Puelles
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; Department of Nephrology, Monash Health, and Center for Inflammatory Diseases, Monash University, Melbourne VIC 3168, Australia
| | - Eckhard Wolf
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, Ludwig Maximilian University of Munich (LMU), 81377 Munich, Germany; Center for Innovative Medical Models (CiMM), 85764 Oberschleißheim, Germany; German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Ingo Bechmann
- Institute of Anatomy, University of Leipzig, 04109 Leipzig, Germany
| | - Ali Ertürk
- Insititute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Zentrum München, 85764 Neuherberg, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilian University of Munich (LMU), 81377 Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany.
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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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Krishnamurthy S, Brown JQ, Iftimia N, Levenson RM, Rajadhyaksha M. Ex Vivo Microscopy: A Promising Next-Generation Digital Microscopy Tool for Surgical Pathology Practice. Arch Pathol Lab Med 2019; 143:1058-1068. [PMID: 31295016 PMCID: PMC7365575 DOI: 10.5858/arpa.2019-0058-ra] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
CONTEXT.— The rapid evolution of optical imaging modalities in recent years has opened the opportunity for ex vivo tissue imaging, which has significant implications for surgical pathology practice. These modalities have promising potential to be used as next-generation digital microscopy tools for examination of fresh tissue, with or without labeling with contrast agents. OBJECTIVE.— To review the literature regarding various types of ex vivo optical imaging platforms that can generate digital images for tissue recognition with potential for utilization in anatomic pathology clinical practices. DATA SOURCES.— Literature relevant to ex vivo tissue imaging obtained from the PubMed database. CONCLUSIONS.— Ex vivo imaging of tissues can be performed by using various types of optical imaging techniques. These next-generation digital microscopy tools have a promising potential for utilization in surgical pathology practice.
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Affiliation(s)
- Savitri Krishnamurthy
- From the Department of Pathology and Laboratory Medicine, The University of Texas, MD Anderson Cancer Center, Houston (Dr Krishnamurthy); Biomedical Engineering, Tulane University, New Orleans, Louisiana (Dr Brown); Physical Sciences Inc, Andover, Massachusetts (Dr Iftimia); the Department of Pathology and Laboratory Medicine, University of California Davis, Davis (Dr Levenson); and Dermatology Section, Memorial Sloan Kettering Cancer Center, New York, New York (Dr Rajadhyaksha)
| | - Jonathan Quincy Brown
- From the Department of Pathology and Laboratory Medicine, The University of Texas, MD Anderson Cancer Center, Houston (Dr Krishnamurthy); Biomedical Engineering, Tulane University, New Orleans, Louisiana (Dr Brown); Physical Sciences Inc, Andover, Massachusetts (Dr Iftimia); the Department of Pathology and Laboratory Medicine, University of California Davis, Davis (Dr Levenson); and Dermatology Section, Memorial Sloan Kettering Cancer Center, New York, New York (Dr Rajadhyaksha)
| | - Nicusor Iftimia
- From the Department of Pathology and Laboratory Medicine, The University of Texas, MD Anderson Cancer Center, Houston (Dr Krishnamurthy); Biomedical Engineering, Tulane University, New Orleans, Louisiana (Dr Brown); Physical Sciences Inc, Andover, Massachusetts (Dr Iftimia); the Department of Pathology and Laboratory Medicine, University of California Davis, Davis (Dr Levenson); and Dermatology Section, Memorial Sloan Kettering Cancer Center, New York, New York (Dr Rajadhyaksha)
| | - Richard M Levenson
- From the Department of Pathology and Laboratory Medicine, The University of Texas, MD Anderson Cancer Center, Houston (Dr Krishnamurthy); Biomedical Engineering, Tulane University, New Orleans, Louisiana (Dr Brown); Physical Sciences Inc, Andover, Massachusetts (Dr Iftimia); the Department of Pathology and Laboratory Medicine, University of California Davis, Davis (Dr Levenson); and Dermatology Section, Memorial Sloan Kettering Cancer Center, New York, New York (Dr Rajadhyaksha)
| | - Milind Rajadhyaksha
- From the Department of Pathology and Laboratory Medicine, The University of Texas, MD Anderson Cancer Center, Houston (Dr Krishnamurthy); Biomedical Engineering, Tulane University, New Orleans, Louisiana (Dr Brown); Physical Sciences Inc, Andover, Massachusetts (Dr Iftimia); the Department of Pathology and Laboratory Medicine, University of California Davis, Davis (Dr Levenson); and Dermatology Section, Memorial Sloan Kettering Cancer Center, New York, New York (Dr Rajadhyaksha)
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Goedeke J, Schreiber P, Seidmann L, Li G, Birkenstock J, Simon F, König J, Muensterer OJ. Multiphoton microscopy in the diagnostic assessment of pediatric solid tissue in comparison to conventional histopathology: results of the first international online interobserver trial. Cancer Manag Res 2019; 11:3655-3667. [PMID: 31118788 PMCID: PMC6503203 DOI: 10.2147/cmar.s195470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/06/2019] [Indexed: 12/17/2022] Open
Abstract
Purpose: Clear resection margins are paramount for good outcome in children undergoing solid tumor resections. Multiphoton microscopy (MPM) can provide high-resolution, real-time, intraoperative microscopic images of tumor tissue. Objective: This prospective international multicenter study evaluates the diagnostic accuracy, feasibility, and interobserver congruence of MPM in diagnosing solid pediatric tissue and tumors for the first time. Material and methods: Representative fresh sections from six different neonatal solid tissues (liver, lung, kidney, adrenal gland, heart muscle, testicle) and two types of typical pediatric solid tumors (neuroblastoma, rhabdomyosarcoma) with adjacent nonneoplastic tissue were imaged with MPM and then presented online with corresponding H&E stained slides of the exact same tissue region. Both image sets of each tissue type were interpreted by 38 randomly selected international attending pediatric pathologists via an online evaluation software. Results: The quality of MPM was sufficient to make the diagnosis of all normal tissue types except cardiac muscle in >94% of assessors with high interobserver congruence and 95% sensitivity. Heart muscle was interpreted as skeletal muscle in 55% of cases. Based on MPM imaging, participating pathologists diagnosed the presented pediatric neoplasms with 100% specificity, although the sensitivity reached only about 50%. Conclusion: Even without prior training, pathologists are able to diagnose normal pediatric tissues with valuable accuracy using MPM. While current MPM imaging protocols are not yet sensitive enough to reliably rule out neuroblastoma or rhabdomyosarcoma, they seem to be specific and therefore useful to confirm a diagnosis intraoperatively. We are confident that improved algorithms, specific training, and more experience with the method will make MPM a valuable future alternative to frozen section analysis. Registration: The trial was registered at www.researchregistry.com, registration number 2967.
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Affiliation(s)
- Jan Goedeke
- Department of Pediatric Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, 55131Mainz, Germany
| | - Peter Schreiber
- Department of Pediatric Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, 55131Mainz, Germany
| | - Larissa Seidmann
- Institute for Pathology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131Mainz, Germany
| | - Geling Li
- Department of Pediatric Pathology, Childrens Hospital of Alabama, University of Alabama at Birmingham, Birmingham, AL35233, USA
| | - Jérôme Birkenstock
- Forschungszentrum für Translationale Neurowissenschaften, University Medical Center of the Johannes Gutenberg-University Mainz, 55131Mainz, Germany
| | - Frank Simon
- Department of Pediatric Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, 55131Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, 55131Mainz, Germany
| | - Oliver J Muensterer
- Department of Pediatric Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, 55131Mainz, Germany
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Wang M, Tulman DB, Sholl AB, Mandava SH, Maddox MM, Lee BR, Brown JQ. Partial nephrectomy margin imaging using structured illumination microscopy. JOURNAL OF BIOPHOTONICS 2018; 11:10.1002/jbio.201600328. [PMID: 28834287 PMCID: PMC5821599 DOI: 10.1002/jbio.201600328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 05/19/2017] [Accepted: 08/17/2017] [Indexed: 06/07/2023]
Abstract
Partial nephrectomy (PN) is the recommended procedure over radical nephrectomy (RN) for patients with renal masses less than 4 cm in diameter (Stage T1a). Patients with less than 4 cm renal masses can also be treated with PN, but have a higher risk for positive surgical margins (PSM). PSM, when present, are indicative of poor clinical outcomes. The current gold-standard histopathology method is not well-suited for the identification of PSM intraoperatively due to processing time and destructive nature. Here, video-rate structured illumination microscopy (VR-SIM) was investigated as a potential tool for PSM detection during PN. A clinical image atlas assembled from ex vivo renal biopsies provided diagnostically useful images of benign and malignant kidney, similar to permanent histopathology. VR-SIM was then used to image entire parenchymal margins of tumor resection covering up to >1800× more margin surface area than standard histology. Aided by the image atlas, the study pathologist correctly classified all parenchymal margins as negative for PSM with VR-SIM, compared to standard postoperative pathology. The ability to evaluate large surgical margins in a short time frame with VR-SIM may allow it to be used intraoperatively as a "safety net" for PSM detection, allowing more patients to undergo PN over RN.
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Affiliation(s)
- Mei Wang
- Department of Biomedical Engineering, Tulane University, New Orleans, LA 70118
| | - David B. Tulman
- Bioinnovation Program, Tulane University, New Orleans, LA 70118
| | - Andrew B. Sholl
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA 70112
| | - Sree H. Mandava
- Department of Urology, Tulane University School of Medicine, New Orleans, LA 70112
| | - Michael M. Maddox
- Department of Urology, Tulane University School of Medicine, New Orleans, LA 70112
| | - Benjamin R. Lee
- Division of Urology, University of Arizona College of Medicine, Tucson, AZ 85724
| | - J. Quincy Brown
- Department of Biomedical Engineering, Tulane University, New Orleans, LA 70118
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Jain M, Robinson BD, Wu B, Khani F, Mukherjee S. Exploring Multiphoton Microscopy as a Novel Tool to Differentiate Chromophobe Renal Cell Carcinoma From Oncocytoma in Fixed Tissue Sections. Arch Pathol Lab Med 2017; 142:383-390. [DOI: 10.5858/arpa.2017-0056-oa] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
Distinguishing chromophobe renal cell carcinoma (chRCC), especially in the presence of eosinophilic cytoplasm, from oncocytoma on hematoxylin-eosin can be difficult and often requires time-consuming ancillary procedures that ultimately may not be informative.
Objective.—
To explore the potential of multiphoton microscopy (MPM) as an alternative and rapid diagnostic tool in differentiating oncocytoma from chRCC at subcellular resolution without tissue processing.
Design.—
Unstained, deparaffinized tissue sections from 27 tumors (oncocytoma [n = 12], chRCC [n = 12], eosinophilic variant of chRCC [n = 1], and atypical oncocytic renal neoplasm [n = 2]) were imaged with MPM. Morphologic evaluation and automated quantitative morphometric analysis were conducted to distinguish between chRCC and oncocytoma.
Results.—
The typical cases of oncocytomas (12 of 12) and chRCC (12 of 12) could be readily differentiated on MPM based on the morphologic features similar to hematoxylin-eosin. The most striking MPM signature of both of the tumors was the presence of autofluorescent intracytoplasmic granules, which are not seen on hematoxylin-eosin–stained slides. Although we saw these granules in both types of tumors, they appeared distinct, based on their size, shape, cytoplasmic distribution, and autofluorescence wavelengths, and were valuable in arriving at a definitive diagnosis. For oncocytomas and chRCC, high diagnostic accuracies of 100% and 83.3% were achieved on blinded MPM and morphometric analysis, respectively.
Conclusions.—
To the best of our knowledge, this is the first demonstration of MPM to distinguish chRCC from oncocytoma in fixed tissues. Our study was limited by small sample size and only a few variants of oncocytic tumors. Prospective studies are warranted to assess the utility of MPM as a diagnostic aid in oncocytic renal tumors.
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Affiliation(s)
| | | | | | | | - Sushmita Mukherjee
- From the Departments of Pathology and Laboratory Medicine (Drs Jain, Robinson, and Khani), Urology (Drs Robinson and Khani), and Biochemistry (Drs Wu and Mukherjee), Weill Cornell Medical College, New York, New York; the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York (Dr Jain); and the Physics Department and CSCU Center for Nanotechnology, Southern Connecticut
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Jain M, Wu B, Pisapia D, Salvatore S, Mukherjee S, Narula N. A component-by-component characterisation of high-risk atherosclerotic plaques by multiphoton microscopic imaging. J Microsc 2017; 268:39-44. [PMID: 28556893 DOI: 10.1111/jmi.12584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/03/2017] [Accepted: 04/28/2017] [Indexed: 12/17/2022]
Abstract
AIMS Atherosclerotic plaques vulnerable to rupture are almost always inflamed, and carry a large lipid core covered by a thin fibrous cap. The other components may include neovascularisation, intraplaque haemorrhage and spotty calcification. In contrast, stable plaques are characterised by a predominance of smooth muscle cells and collagen, and lipid core is usually deep seated or absent. This study is a proof of principle experiment to evaluate the feasibility of multiphoton microscopy (MPM) to identify aforementioned plaque components. METHODS AND RESULTS MPM is a nonlinear optical technique that allows imaging based on intrinsic tissue signals including autofluorescence and higher-order scattering. In our study, MPM imaging was performed on morphologically diverse aortic and coronary artery plaques obtained during autopsy. Various histologically verified plaque components including macrophages, cholesterol crystals, haemorrhage, collagen and calcification were recognised by MPM. CONCLUSIONS Recognition of the distinct signatures of various plaque components suggests that MPM has the potential to offer next-generation characterisation of atherosclerotic plaques. The higher lateral resolution (comparable to histology) images generated by MPM for identifying plaque components might complement larger field of view and greater imaging depth currently available with optical coherence tomography imaging. As the next step MPM would need to be evaluated for intact vessel imaging ex vivo and in vivo.
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Affiliation(s)
- M Jain
- Department of Dermatology, Memorial Sloan Kettering Cancer Center, NY, U.S.A.,Department of Pathology, Weill Cornell Medical College, NY, U.S.A
| | - B Wu
- Department of Biochemistry, Weill Cornell Medical College, NY, U.S.A.,Department of Physics, Southern Connecticut State University, New Haven, CT, U.S.A
| | - D Pisapia
- Department of Pathology, Weill Cornell Medical College, NY, U.S.A
| | - S Salvatore
- Department of Pathology, Weill Cornell Medical College, NY, U.S.A
| | - S Mukherjee
- Department of Biochemistry, Weill Cornell Medical College, NY, U.S.A
| | - N Narula
- Department of Pathology, Weill Cornell Medical College, NY, U.S.A
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