High-Resolution Rapid Diagnostic Imaging of Whole Prostate Biopsies Using Video-Rate Fluorescence Structured Illumination Microscopy
High-Resolution Rapid Diagnostic Imaging of Whole Prostate Biopsies Using Video-Rate Fluorescence Structured Illumination Microscopy
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DOI：
10.1158/0008-5472.can-14-3806
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发表时间：
2015-10-01
期刊：
影响因子：
11.2
通讯作者：
Brown, J. Quincy
中科院分区：
文献类型：
--
作者：
Wang, Mei;Kimbrell, Hillary Z.;Brown, J. Quincy
在手术时快速评估前列腺核心活检病理学可以为各种临床情况带来益处。即使采用先进的经直肠超声引导和饱和活检方案，多达一半的初始活检程序也可能会漏掉前列腺癌。此外，由于无法粗略地识别前列腺癌，肿瘤产量低，阻碍了用于下游组织学、分子和遗传分析的肿瘤样本的收集。然而，当前的手术点病理学方案，例如冰冻切片分析（FSA），具有破坏性，并且过于耗时和劳力密集，不切合实际或经济。对切除的标本进行离体显微镜检查，并用快速作用的荧光组织学染料染色，可能是 FSA 的一种有吸引力的非破坏性替代方案。在这项工作中，我们报告了视频速率结构照明显微镜（VR-SIM）的首次演示，用于在现实的手术时间范围内对前列腺活检进行快速高分辨率诊断成像。用吖啶橙染色的前列腺活检的大马赛克图像可在几秒钟内呈现，并且包含出色的对比度和细节，与相应的苏木精和伊红组织学表现出密切的相关性。两名独立病理学家对 34 个未固定和未切割的前列腺核心活检的 VR-SIM 图像进行了临床相关审查，得出受试者手术曲线下面积 (AUC) 为 0.82-0.88，敏感性范围为 63% 至 88%，特异性范围为 78% 至 89%。当活检组织中肿瘤含量超过 5% 时，敏感性提高至 75% 至 92%。 VR-SIM 的图像质量、速度、最低的复杂性和易用性可能被证明是有利于在手术时采用作为破坏性病理学替代方案的特征。 (C) 2015 年 AACR。
Rapid assessment of prostate core biopsy pathology at the point-of-procedure could provide benefit in a variety of clinical situations. Even with advanced transrectal ultrasound guidance and saturation biopsy protocols, prostate cancer can be missed in up to half of all initial biopsy procedures. In addition, collection of tumor specimens for downstream histologic, molecular, and genetic analysis is hindered by low tumor yield due to inability to identify prostate cancer grossly. However, current point-of-procedure pathology protocols, such as frozen section analysis (FSA), are destructive and too time-and labor-intensive to be practical or economical. Ex vivo microscopy of the excised specimens, stained with fast-acting fluorescent histology dyes, could be an attractive nondestructive alternative to FSA. In this work, we report the first demonstration of video-rate structured illumination microscopy (VR-SIM) for rapid high-resolution diagnostic imaging of prostate biopsies in realistic point-of-procedure timeframes. Large mosaic images of prostate biopsies stained with acridine orange are rendered in seconds and contain excellent contrast and detail, exhibiting close correlation with corresponding hematoxylin and eosin histology. A clinically relevant review of VR-SIM images of 34 unfixed and uncut prostate core biopsies by two independent pathologists resulted in an area under the receiver operative curve (AUC) of 0.82-0.88, with a sensitivity ranging from 63% to 88% and a specificity ranging from 78% to 89%. When biopsies contained more than 5% tumor content, the sensitivity improved to 75% to 92%. The image quality, speed, minimal complexity, and ease of use of VR-SIM could prove to be features in favor of adoption as an alternative to destructive pathology at the point-of-procedure. (C) 2015 AACR.