[1893] Multiphoton Microscopy: A Potential “Optical Biopsy” Tool for Real-Time Evaluation of Lung Tumors without the Need for Exogenous Contrast Agents

Manu Jain, Navneet Narula, Amit Aggarwal, Nasser Altorki, Sushmita Mukherjee. Weill Medical College of Cornell University, New York, NY

Background: Multiphoton microscopy (MPM), an optical imaging technique that generates subcellular-resolution images from unprocessed and unstained tissue. While miniaturization of MPM for in vivo use is in progress, here we assess its diagnostic potential in fresh ex vivo human lung tissue, utilizing a bench-top system.
Design: Fresh sections from tumor and adjacent non-neoplastic lung {n = 20 lobectomy specimens} were imaged with MPM and then compared with corresponding hematoxylin and eosin (H&E) slides.
Results: Alveoli, bronchi, blood vessels, pleura, smokers' macrophages and lymphocytes were readily identified with MPM in non-neoplastic tissue. Atypical adenomatous hyperplasia / adenocarcinoma in situ (a preinvasive lesion) was identified in tissue adjacent to the tumor in one case. Out of 20 tumor sections imaged, 2 were non-diagnostic due to extensive necrosis and elastosis, confirmed later on H&E and Verhoeff's stain, respectively. Of the remaining 18 cases, all adenocarcinoma (16/16), were correctly diagnosed on MPM, along with their histological patterns. Of the 2 cases of squamous cell carcinoma, 1 was correctly diagnosed, whereas the second was misdiagnosed as adenocarcinoma due to pseudo-gland formation. Increase in collagen was noticed in invasive adenocarcinomas, particularly with acinar and solid patterns.




Conclusions: Our study demonstrates the utility of MPM for differentiating neoplastic from non-neoplastic lung tissue and identifying the histological subtype of tumor. We foresee future real-time applications using miniaturized instruments for directing lung biopsies, assessing their adequacy for subsequent histopathological analysis and intraoperatively for evaluating surgical margins in limited lung resections.
Category: Pulmonary

Tuesday, March 5, 2013 1:00 PM

Poster Session IV # 302, Tuesday Afternoon

 

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