Multiphoton microscopy for structure identification in human prostate and periprostatic tissue: implications in prostate cancer surgery

Abstract

Objective To test whether multiphoton microscopy (MPM) might allow identification of prostatic and periprostatic structures with magnification and resolution similar to gold standard histopathology. Material and Methods The present study included 95 robotic radical prostatectomy patients who consented to participate in an Institutional Review Board-approved study starting in 2007. The types of specimens used for imaging were excised surgical margins and biopsies, and sections obtained from the excised prostate. The specimens were imaged with a custom-built MPM system. All images were compared with haematoxylin/eosin histopathology of the same specimen. Results MPM of freshly excised, unprocessed and unstained tissue can identify all relevant prostatic and periprostatic structures, such as nerves, blood vessels, capsule, underlying acini and also pathological changes, including prostate cancer. Histological confirmation and correlation of these structures and pathologies have validated the findings of MPM. Conclusions MPM shows great promise as a tool for real-time intra-surgical histopathology without needing excision or administration of contrast agents. The results will, however, need to be confirmed in true surgical settings using a miniaturized MPM microendoscope.

Advances and challenges in label-free nonlinear optical imaging using two-photon excitation fluorescence and second harmonic generation for cancer research

“…Later on, Yan et al was able to provide cyto-structural details that could identify normal and gastric cancer samples [66]. Similarly good correlation was demonstrated between ex vivo label-free NLOI and HE stained slides in various other organs such as oral cavity [14], lungs [67][68][69], breast [70], ovaries [29,71,72], prostate [10], colon [73,74], rectum (as shown in Fig. 4) [75] and bladder [76][77][78].…”

“…Technological innovations and research have steadily progressed in trying to develop NLOI as a diagnostic tool for the patient in a clinical environment [1][2][3][4][5][6][7]. Simultaneously NLOI based research has also been able to provide fundamental researchers with new perspectives in cancer research, especially with regard to studying pathogenesis of cancer and drug development for cancer therapy [8][9][10][11][12][13][14]. Numerous NLOI studies have given deep insights about cancer progression and the steps involved in angiogenesis and metastasis [8,9,[15][16][17][18][19][20][21][22][23][24][25][26].…”

Navigierte urologische Chirurgie

“…Tewari et al [16] integrieren ein Multiphotonenmikroskop in das Kameramodul des daVinci®-Systems. Durch Aussenden von Photonen unterschiedlicher Frequenz und deren unterschiedlicher Absorption auch in tieferen Gewebeschichten können histologische Unterschiede detektiert werden.…”

Visualization of prostatic nerves by polarization-sensitive optical coherence tomography

“…An electrophysiological testing method such as electromyographic (EMG) stimulation [11][12][13] and various imaging methods have been developed and are under investigation to provide better identification of CNs [14][15][16][17]. The imaging methods are transrectal ultrasound (TRUS) [18][19][20][21], dye-based fluorescence imaging [22][23][24][25][26][27][28][29][30], multiphoton microscopy (MPM) [31,32], coherent anti-Stokes Raman scattering (CARS) microscopy [33], and photoacoustic microscopy (PAM) [34,35]. However, these imaging methods have their own limitations as far as their use for the surgery.…”