Our study suggests that voxel-based WL enhancement parameters provide only a slight improvement over single ROI-based enhancement techniques in differentiating between ccRCC and renal oncocytoma.
imaging technique used for the rapid histological diagnosis of renal cell carcinoma on percutaneous biopsy.METHODS: After institutional board approval, 50 total percutaneous biopsies were obtained from 20 patients undergoing either partial or radical nephrectomy from resected renal tissue after specimen removal. Biopsy specimens were sprayed with a dual topical fluorescent stain, and VR-SIM images obtained using a 4.2 megapixel, high-speed CMOS camera with fast ferroelectric spatial light modulators. Biopsy specimens were subsequently fixed and analyzed using standard hematoxylin and eosin (H&E) histopathologic methods. One blinded pathologist reviewed all VR-SIM images and H&E specimens. The presence of cancer was correlated between the two modalities and final standard pathology result.RESULTS: Of the 50 biopsy specimens, fourteen were determined to be malignant on H&E, while 36 represented benign renal tissue. Thirteen of the 14 malignant specimens were diagnosed by VR-SIM, with 1 specimen being assessed as indeterminant. Sensitivity and specificity of VR-SIM were 93% and 100%, respectively.CONCLUSIONS: VR-SIM is a promising and practical method for point of care renal biopsy assessment. This may translate into the ability to rapidly assess sufficiency of biopsy specimens and enable immediate diagnostic capability to aid in counseling patients regarding management options.
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