Abstract
Confocal microscopy is an emerging technology for rapid imaging of freshly excised tissue without the need for frozen- or fixed-section processing. Initial studies have described imaging of breast tissue using fluorescence confocal microscopy with small regions of interest, typically 750 × 750 ?? ? m 2 . We present exploration with a microscope, termed confocal strip-mosaicking microscope (CSM microscope), which images an area of 2 × 2 ?? cm 2 of tissue with cellular-level resolution in 10 min of excision. Using the CSM microscope, we imaged 34 fresh, human, large breast tissue specimens from 18 patients, blindly analyzed by a board-certified pathologist and subsequently correlated with the corresponding standard fixed histopathology. Invasive tumors and benign tissue were clearly identified in CSM strip-mosaic images. Thirty specimens were concordant for image-to-histopathology correlation while four were discordant.
Highlights
IntroductionThere are several imaging modalities being studied to guide surgical oncology.[1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19] Confocal microscopy is an emerging technology for rapid imaging of freshly excised tissue without the need for frozen- or fixed-section processing
We present the development and testing of an emulated pathology examination-like approach and exploration with a microscope, termed the confocal stripmosaicking microscope (CSM microscope), which images an area of 2 × 2 cm[2] of tissue with cellular-level resolution in 10 min of excision
The 34 mosaics that were created for comparison to histology demonstrate reproducibility of the tissue fixturing and mosaicking algorithm
Summary
There are several imaging modalities being studied to guide surgical oncology.[1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19] Confocal microscopy is an emerging technology for rapid imaging of freshly excised tissue without the need for frozen- or fixed-section processing. The regions of interest (ROIs) used in the analysis were user-selected and small (typically 750 × 750 μm[2]) These important findings open exploration into rapid pathology, integrating confocal microscopy into a pathology reading setting will require examination of large specimens in a blinded fashion. We present the development and testing of an emulated pathology examination-like approach and exploration with a microscope, termed the confocal stripmosaicking microscope (CSM microscope), which images an area of 2 × 2 cm[2] of tissue with cellular-level resolution in 10 min of excision
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