Abstract
Simple SummaryFluorescence confocal microscopy (FCM) is a novel micro-imaging technique providing optical sections of native tissue. The method is increasingly used for the routine diagnosis of tumors and inflammatory lesions of the skin and shows promising results for the diagnosis of other organ tumors. Very few publications exist about examinations of liver tissue thus far. In this study, we compare findings of FCM-examinations of biopsies and surgical specimens of the liver with the final diagnoses from conventional histology.Ex vivo Fluorescence Confocal Microscopy (FCM) is a technique providing high-resolution images of native tissues. The method is increasingly used in surgical settings in areas of dermatology and urology. Only a few publications exist about examinations of tumors and non-neoplastic lesions of the liver. We report on the application of FCM in biopsies, surgical specimens and autopsy material (33 patients, 39 specimens) of the liver and compare the results to conventional histology. Our preliminary examinations indicated a perfect suitability for tumor diagnosis (ĸ = 1.00) and moderate/good suitability for the assessment of inflammation (ĸ = 0.4–0.6) with regard to their severity and localization. Macro-vesicular steatosis was reliably detected, micro-vesicular steatosis tended to be underestimated. Cholestasis and eosinophilic granules in granulocytes were not represented in the scans. The tissue was preserved as native material and maintained its quality for downstream histological, immunohistological and molecular examinations. In summary, FCM is a material sparing method that provides rapid feedback to the clinician about the presence of tumor, the degree of inflammation and structural changes. This can lead to faster therapeutic decisions in the management of liver tumors, treatment of hepatitis or in liver transplant medicine.
Highlights
Introduction distributed under the terms andConventional histology is the gold standard for the diagnosis of liver diseases
We previously demonstrated that DNA content was not significantly diminished after pre-treatment for Fluorescence Confocal Microscopy (FCM) [32]
Our preliminary work demonstrated that FCM allows histological examinations of unfixed liver samples within half an hour after biopsy acquisition
Summary
Introduction distributed under the terms andConventional histology is the gold standard for the diagnosis of liver diseases. Several microscopic methods have been developed for the examinations of unfixed tissue based on modifications of illumination, fluorescence techniques and digital image processing [2,3,4,5]. These new imaging technologies allow for the timely examinations in living patients without tissue removal (in vivo microscopy) or in freshly excised tissue (ex vivo microscopy). Due to their tremendous potential for clinical impact in a wide variety of applications, there has been much effort in recent years to integrate these approaches into pathology practice [6,7,8,9]
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