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Bishop KW, Hu B, Vyawhare R, Yang Z, Liang DC, Gao G, Baraznenok E, Han Q, Lan L, Chow SSL, Sanai N, Liu JTC. Miniature line-scanned dual-axis confocal microscope for versatile clinical use. BIOMEDICAL OPTICS EXPRESS 2023; 14:6048-6059. [PMID: 38021137 PMCID: PMC10659777 DOI: 10.1364/boe.503478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
A miniature optical-sectioning fluorescence microscope with high sensitivity and resolution would enable non-invasive and real-time tissue inspection, with potential use cases including early disease detection and intraoperative guidance. Previously, we developed a miniature MEMS-based dual-axis confocal (DAC) microscope that enabled video-rate optically sectioned in vivo microscopy of human tissues. However, the device's clinical utility was limited due to a small field of view, a non-adjustable working distance, and a lack of a sterilization strategy. In our latest design, we have made improvements to achieve a 2x increase in the field of view (600 × 300 µm) and an adjustable working distance range of 150 µm over a wide range of excitation/emission wavelengths (488-750 nm), all while maintaining a high frame rate of 15 frames per second (fps). Furthermore, the device is designed to image through a disposable sterile plastic drape for convenient clinical use. We rigorously characterize the performance of the device and show example images of ex vivo tissues to demonstrate the optical performance of our new design, including fixed mouse skin and human prostate, as well as fresh mouse kidney, mouse intestine, and human head and neck surgical specimens with corresponding H&E histology. These improvements will facilitate clinical testing and translation.
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Affiliation(s)
- Kevin W. Bishop
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Bingwen Hu
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Rajat Vyawhare
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Zelin Yang
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - David C. Liang
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Gan Gao
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Elena Baraznenok
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Qinghua Han
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Lydia Lan
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
- Department of Biology, University of Washington, Seattle, Washington 98195, USA
| | - Sarah S. L. Chow
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
| | - Nader Sanai
- Ivy Brain Tumor Center, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix 85013, AZ, USA
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix 85013, AZ, USA
| | - Jonathan T. C. Liu
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
- Department of Laboratory Medicine & Pathology, University of Washington, Seattle, WA 98195, USA
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Villarreal PP, Pal R, Qiu S, Coblens O, Villasante-Tezanos A, Resto V, McCammon S, Vargas G. Label-Free Imaging and Histo-Optical Evaluation of Head and Neck Cancers with Multiphoton Autofluorescence Microscopy. Cancers (Basel) 2023; 15:1302. [PMID: 36831646 PMCID: PMC9953923 DOI: 10.3390/cancers15041302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/30/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Depth-resolved label-free optical imaging by the method of multiphoton autofluorescence microscopy (MPAM) may offer new ways to examine cellular and extracellular atypia associated with epithelial squamous cell carcinoma (SCC). MPAM was evaluated for its ability to identify cellular and microstructural atypia in head and neck tissues from resected discarded tumor tissue. Three-dimensional image volumes were obtained from tissues from the floor of the mouth, tongue, and larynx, and were then processed for histology. MPAM micrographs were evaluated for qualitative metrics of cell atypia and quantitative measures associated with nuclear pleomorphism. Statistical analyses correlated MPAM endpoints with histological grade from each imaged site. Cellular overcrowding, discohesion, anisonucleosis, and multinucleated cells, as observed through MPAM, were found to be statistically associated with dysplasia and SCC grading, but not in histologically benign regions. A quantitative measure of the coefficient of variance in nuclear size in SCC and dysplasia was statistically elevated above histologically benign regions. MPAM also allowed for the identification of cellular heterogeneity across transitional areas and other features, such as inflammatory infiltrates. In the future, MPAM could be evaluated for the non-invasive detection of neoplasia, possibly as an adjunct to traditional conventional examination and biopsy.
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Affiliation(s)
- Paula Patricia Villarreal
- The Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Rahul Pal
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Suimin Qiu
- Department of Pathology, Division of Surgical Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Orly Coblens
- Department of Otolaryngology, Head & Neck Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Alejandro Villasante-Tezanos
- Department of Biostatistics and Data Science, School for Public and Population Health, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Vicente Resto
- Department of Otolaryngology, Head & Neck Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Susan McCammon
- Department of Otolaryngology, Head & Neck Surgery Oncology Division, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Gracie Vargas
- Department of Neurobiology, University of Texas Medical Branch, Galveston, TX 77555, USA
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Rapid and label-free histological imaging of unprocessed surgical tissues via dark-field reflectance ultraviolet microscopy. iScience 2022; 26:105849. [PMID: 36647380 PMCID: PMC9839964 DOI: 10.1016/j.isci.2022.105849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/04/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022] Open
Abstract
Routine examination for intraoperative histopathologic assessment is lengthy and laborious. Here, we present the dark-field reflectance ultraviolet microscopy (DRUM) that enables label-free imaging of unprocessed and thick tissues with subcellular resolution and a high signal-to-background ratio. To the best of our knowledge, DRUM provides image results for pathological assessment with the shortest turnaround time (2-3 min in total from sample preparation to tissue imaging). We also proposed a virtual staining process to convert DRUM images into pseudo-colorized images and enhance the image familiarity of pathologists. By imaging various tissues, we found DRUM can resolve cell nuclei and some extranuclear features, which are comparable to standard H&E images. Furthermore, the essential diagnostic features of intraoperatively excised tumor tissues also can be revealed by DRUM, demonstrating its potential as an additional aid for intraoperative histopathology.
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Bishop KW, Maitland KC, Rajadhyaksha M, Liu JTC. In vivo microscopy as an adjunctive tool to guide detection, diagnosis, and treatment. JOURNAL OF BIOMEDICAL OPTICS 2022; 27:JBO-220032-PER. [PMID: 35478042 PMCID: PMC9043840 DOI: 10.1117/1.jbo.27.4.040601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/05/2022] [Indexed: 05/05/2023]
Abstract
SIGNIFICANCE There have been numerous academic and commercial efforts to develop high-resolution in vivo microscopes for a variety of clinical use cases, including early disease detection and surgical guidance. While many high-profile studies, commercialized products, and publications have resulted from these efforts, mainstream clinical adoption has been relatively slow other than for a few clinical applications (e.g., dermatology). AIM Here, our goals are threefold: (1) to introduce and motivate the need for in vivo microscopy (IVM) as an adjunctive tool for clinical detection, diagnosis, and treatment, (2) to discuss the key translational challenges facing the field, and (3) to propose best practices and recommendations to facilitate clinical adoption. APPROACH We will provide concrete examples from various clinical domains, such as dermatology, oral/gastrointestinal oncology, and neurosurgery, to reinforce our observations and recommendations. RESULTS While the incremental improvement and optimization of IVM technologies should and will continue to occur, future translational efforts would benefit from the following: (1) integrating clinical and industry partners upfront to define and maintain a compelling value proposition, (2) identifying multimodal/multiscale imaging workflows, which are necessary for success in most clinical scenarios, and (3) developing effective artificial intelligence tools for clinical decision support, tempered by a realization that complete adoption of such tools will be slow. CONCLUSIONS The convergence of imaging modalities, academic-industry-clinician partnerships, and new computational capabilities has the potential to catalyze rapid progress and adoption of IVM in the next few decades.
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Affiliation(s)
- Kevin W. Bishop
- University of Washington, Department of Bioengineering, Seattle, Washington, United States
- University of Washington, Department of Mechanical Engineering, Seattle, Washington, United States
| | - Kristen C. Maitland
- Texas A&M University, Department of Biomedical Engineering, College Station, Texas, United States
| | - Milind Rajadhyaksha
- Memorial Sloan Kettering Cancer Center, Dermatology Service, New York, New York, United States
| | - Jonathan T. C. Liu
- University of Washington, Department of Bioengineering, Seattle, Washington, United States
- University of Washington, Department of Mechanical Engineering, Seattle, Washington, United States
- University of Washington, Department of Laboratory Medicine and Pathology, Seattle, Washington, United States
- Address all correspondence to Jonathan T.C. Liu,
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Kulkarni N, Masciola A, Nishant A, Kim KJ, Choi H, Gmitro A, Freeman EE, Semeere A, Nakalembe M, Kang D. Low-cost, chromatic confocal endomicroscope for cellular imaging in vivo. BIOMEDICAL OPTICS EXPRESS 2021; 12:5629-5643. [PMID: 34692205 PMCID: PMC8515984 DOI: 10.1364/boe.434892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/29/2021] [Accepted: 08/01/2021] [Indexed: 05/06/2023]
Abstract
We have developed a low-cost, chromatic confocal endomicroscope (CCE) that can image a cross-section of the tissue at cellular resolution. In CCE, a custom miniature objective lens was used to focus different wavelengths into different tissue depths. Therefore, each tissue depth was encoded with the wavelength. A custom miniature spectrometer was used to spectrally-disperse light reflected from the tissue and generate cross-sectional confocal images. The CCE prototype had a diameter of 9.5 mm and a length of 68 mm. Measured resolution was high, 2 µm and 4 µm for lateral and axial directions, respectively. Effective field size was 468 µm. Preliminary results showed that CCE can visualize cellular details from cross-sections of the tissue in vivo down to the tissue depth of 100 µm.
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Affiliation(s)
- Nachiket Kulkarni
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Andrew Masciola
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| | - Abhinav Nishant
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Kyung-Jo Kim
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Heejoo Choi
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Arthur Gmitro
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| | - Esther E. Freeman
- Department of Dermatology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Aggrey Semeere
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA 94143, USA
| | - Miriam Nakalembe
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Dongkyun Kang
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
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Fujita Y, Wei L, Cimino PJ, Liu JTC, Sanai N. Video-Mosaicked Handheld Dual-Axis Confocal Microscopy of Gliomas: An ex vivo Feasibility Study in Humans. Front Oncol 2020; 10:1674. [PMID: 32974207 PMCID: PMC7482651 DOI: 10.3389/fonc.2020.01674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/29/2020] [Indexed: 01/07/2023] Open
Abstract
Background Intraoperative confocal microscopy can enable high-resolution cross-sectional imaging of intact tissues as a non-invasive real-time alternative to gold-standard histology. However, all current means of intraoperative confocal microscopy are hindered by a limited field of view (FOV), presenting a challenge for evaluating gliomas, which are highly heterogeneous. Objective This study explored the use of image mosaicking with handheld dual-axis confocal (DAC) microscopy of fresh human glioma specimens. Methods In this preliminary technical feasibility study, fresh human glioma specimens from 6 patients were labeled with a fast-acting topical stain (acridine orange) and imaged using a newly developed DAC microscope prototype. Results In comparison to individual image frames with small fields of view, mosaicked images from a DAC microscope correlate better with gold-standard H&E-stained histology images, including the ability to visualize gradual transitions from areas of dense cellularity to sparse cellularity within the tumor. Conclusion LS-DAC microscopy provides high-resolution, high-contrast images of glioma tissues that agree with corresponding H&E histology. Compared with individual image frames, mosaicked images provide more accurate representations of the overall cytoarchitecture of heterogeneous glioma tissues. Further investigation is needed to evaluate the ability of high-resolution mosaicked microscopy to improve the extent of glioma resection and patient outcomes.
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Affiliation(s)
- Yoko Fujita
- Ivy Brain Tumor Center, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Linpeng Wei
- Department of Mechanical Engineering, University of Washington, Seattle, WA, United States
| | - Patrick J Cimino
- Department of Pathology, University of Washington, Seattle, WA, United States
| | - Jonathan T C Liu
- Department of Mechanical Engineering, University of Washington, Seattle, WA, United States.,Department of Pathology, University of Washington, Seattle, WA, United States.,Department of Bioengineering, University of Washington, Seattle, WA, United States
| | - Nader Sanai
- Ivy Brain Tumor Center, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States.,Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
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Yin C, Wei L, Kose K, Glaser AK, Peterson G, Rajadhyaksha M, Liu JT. Real-time video mosaicking to guide handheld in vivo microscopy. JOURNAL OF BIOPHOTONICS 2020; 13:e202000048. [PMID: 32246558 PMCID: PMC7969124 DOI: 10.1002/jbio.202000048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/16/2020] [Accepted: 03/24/2020] [Indexed: 05/05/2023]
Abstract
Handheld and endoscopic optical-sectioning microscopes are being developed for noninvasive screening and intraoperative consultation. Imaging a large extent of tissue is often desired, but miniature in vivo microscopes tend to suffer from limited fields of view. To extend the imaging field during clinical use, we have developed a real-time video mosaicking method, which allows users to efficiently survey larger areas of tissue. Here, we modified a previous post-processing mosaicking method so that real-time mosaicking is possible at >30 frames/second when using a device that outputs images that are 400 × 400 pixels in size. Unlike other real-time mosaicking methods, our strategy can accommodate image rotations and deformations that often occur during clinical use of a handheld microscope. We perform a feasibility study to demonstrate that the use of real-time mosaicking is necessary to enable efficient sampling of a desired imaging field when using a handheld dual-axis confocal microscope.
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Affiliation(s)
- Chengbo Yin
- University of Washington, Department of Mechanical Engineering, Seattle, WA, 98195, USA
| | - Linpeng Wei
- University of Washington, Department of Mechanical Engineering, Seattle, WA, 98195, USA
| | - Kivanc Kose
- Memorial Sloan-Kettering Cancer Center, Dermatology Service, New York, NY, 10021, USA
| | - Adam K. Glaser
- University of Washington, Department of Mechanical Engineering, Seattle, WA, 98195, USA
| | - Gary Peterson
- Memorial Sloan-Kettering Cancer Center, Dermatology Service, New York, NY, 10021, USA
| | - Milind Rajadhyaksha
- Memorial Sloan-Kettering Cancer Center, Dermatology Service, New York, NY, 10021, USA
| | - Jonathan T.C. Liu
- University of Washington, Department of Mechanical Engineering, Seattle, WA, 98195, USA
- University of Washington School of Medicine, Department of Pathology, Seattle, WA 98195, USA
- University of Washington, Department of Bioengineering, Seattle, WA 98195, USA
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