Partial nephrectomy margin imaging using structured illumination microscopy.
Partial nephrectomy margin imaging using structured illumination microscopy.
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DOI：
10.1002/jbio.201600328
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发表时间：
2018-03
影响因子：
2.8
通讯作者：
Quincy Brown J
中科院分区：
文献类型：
--
作者：
Wang M;Tulman DB;Sholl AB;Mandava SH;Maddox MM;Lee BR;Quincy Brown J
对于直径< 4 cm的肾脏肿块（T1 a期）患者，推荐采用肾部分切除术（PN）而非根治性肾切除术（RN）。肾肿块> 4 cm的患者也可以接受PN治疗，但手术切缘阳性的风险较高。手术切缘阳性（PSM），如果存在，则表明临床结局较差。由于处理时间和破坏性，目前的金标准组织病理学方法不适合术中识别PSM。在这里，视频速率结构照明显微镜（VR-SIM）进行了研究，作为一个潜在的工具，在PN的PSM检测。一个临床图像图谱组装从离体肾活检提供诊断有用的图像的良性和恶性肾脏，类似于永久的组织病理学。然后使用VR-SIM对肿瘤切除的整个实质边缘进行成像，覆盖的边缘表面积比标准组织学多1，800倍。在图像图谱的帮助下，与标准术后病理学相比，研究病理学家正确地将所有实质边缘分类为VR-SIM PSM阴性。VR-SIM在短时间内评估大手术切缘的能力可使其在术中用作PSM检测的“安全网”，使更多患者接受PN而不是RN。在接受肾部分切除术（PN）治疗的患者中，手术切缘阳性（PSM）很少见，但PSM可能会导致不良的临床结局。我们证明了视频速率结构照明显微镜（VR-SIM）作为一种潜在的工具，在机器人肾部分切除术中检测PSM。我们证明了能够在15-30分钟的时间范围内以显微镜分辨率从新鲜的未切割PN标本中捕获完整的实质边缘表面。
Partial nephrectomy (PN) is the recommended procedure over radical nephrectomy (RN) for patients with renal masses < 4 cm in diameter (Stage T1a). Patients with > 4 cm renal masses can also be treated with PN, but have a higher risk for positive surgical margins. Positive surgical margins (PSM), when present, are indicative of poor clinical outcomes. The current gold-standard histopathology method is not well-suited for the identification of PSM intra-operatively 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 >1,800× 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 post-operative pathology. The ability to evaluate large surgical margins in a short timeframe with VR-SIM may allow it to be used intra-operatively as a “safety net” for PSM detection, allowing more patients to undergo PN over RN. Positive surgical margins (PSM) are rare in patients treated with partial nephrectomy (PN), but PSM potentially result in poor clinical outcomes. We demonstrate video-rate structured illumination microscopy (VR-SIM) as a potential tool to detect PSM intra-operatively during robotic partial nephrectomy. We demonstrated the ability to capture the full parenchymal margin surface from fresh uncut PN specimens with microscopic resolution within a 15–30-minute timeframe.
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影响因子：
3.2
作者：
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通讯作者：
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影响因子：
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作者：
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DOI：
10.1016/j.juro.2011.09.149
发表时间：
2012-02
期刊：
The Journal of urology
影响因子：
--
作者：
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通讯作者：
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影响因子：
6.6
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