Fluorescence confocal microscopy for pathologists.

Area of Science:

• Pathology
• Medical Imaging
• Optical Microscopy

Background:

• Confocal microscopy provides non-invasive optical imaging of untreated tissue, mimicking traditional histology.
• Reflectance and fluorescence confocal microscopy are available imaging systems.
• Current clinical use aims to reduce the need for excision biopsies and subsequent pathological examination.

Purpose of the Study:

• To evaluate fluorescence confocal microscopy on various surgical specimens (breast, lymph node, thyroid, colon).
• To correlate confocal images with histological sections for morphologic comparison.
• To identify limitations and applications in surgical pathology.

Main Methods:

• Testing fluorescence confocal microscopy on surgical specimens.
• Comparing confocal images with corresponding hematoxylin and eosin stained histological sections.
• Assessing diagnostic capability from a pathologist's perspective.

Main Results:

• Neoplastic tissues were clearly distinguished from normal structures and reactive processes.
• Fluorescence enhanced contrast and image quality without affecting histologic evaluation.
• Adipose tissue imaging was accurate, avoiding frozen-section artifacts.

Conclusions:

• Fluorescence confocal microscopy can be an alternative to frozen sections for margin assessment in specific cases.
• The technology requires training for image interpretation due to black and white output.
• This study is the first to assess fluorescent confocal microscopy on non-skin surgical specimens for diagnostic capability.