Real-time optical diagnosis for surgical margin in low rectal cancer using multiphoton microscopy

Area of Science:

• Biomedical Optics
• Surgical Pathology
• Gastroenterology

Background:

• Multiphoton microscopy (MPM) leverages nonlinear optics and femtosecond lasers for real-time imaging of live tissue.
• MPM provides detailed insights into tissue architecture and cell morphology.

Purpose of the Study:

• To evaluate the feasibility of using MPM for real-time optical diagnosis of surgical margins in low rectal cancers.
• To compare MPM findings with traditional histopathology.

Main Methods:

• Thirty fresh, unfixed, low rectal cancer surgical margins were examined using MPM.
• MPM images were acquired using autofluorescence and second harmonic generation (SHG) channels.
• MPM results were compared against intraoperative frozen sections and routine pathology (hematoxylin-eosin staining).

Main Results:

• MPM successfully differentiated between negative and positive surgical margins.
• Negative margins showed regular architecture, typical foveolar patterns, and collagen SHG signals.
• Positive margins exhibited irregular structures, cellular pleomorphism, and reduced SHG signals, consistent with cancer.
• MPM images demonstrated high comparability with H-E stained images.

Conclusions:

• MPM is feasible for real-time optical diagnosis of surgical margins in low rectal cancer.
• Further development with integrated colonoscopy or probes could enable noninvasive, real-time margin assessment in clinical settings.