Comparing histologic evaluation of prostate tissue using nonlinear microscopy and paraffin H&E: a pilot study
Lucas C Cahill1,2, James G Fujimoto2, Michael G Giacomelli2
1Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School and Massachusetts Institute of Technology, Cambridge, MA, USA.
Summary
Nonlinear microscopy (NLM) allows rapid, whole-mount prostate tissue imaging without sectioning, aiding intraoperative consultations. This technique closely resembles standard histology, enabling quick assessment of prostate cancer and benign conditions.
Area of Science:
- Pathology
- Medical Imaging
- Oncology
Background:
- Intraoperative consultation for prostate cancer requires rapid histological assessment of large tissue areas.
- Current methods like frozen sections are time-consuming and involve tissue preparation.
Purpose of the Study:
- To demonstrate rapid histological imaging of unsectioned prostate cancer surgical specimens using nonlinear microscopy (NLM).
- To compare NLM features of prostate pathology with standard paraffin-embedded Hematoxylin and Eosin (H&E) histology.
- To evaluate NLM's potential for intraoperative consultation.
Main Methods:
- Fresh or formalin-fixed prostate specimens were stained with fluorescent dyes (2.5 min).
- NLM (two-photon excitation) generated real-time images of unsectioned tissues.
- NLM images were compared to subsequent standard paraffin-embedded H&E histology by genitourinary pathologists.
Main Results:
- NLM images closely resembled H&E slides, enabling interpretation with minimal training.
- NLM visualized benign glands, stroma, vasculature, inflammatory changes, and cancer.
- NLM identified adenocarcinoma, Gleason patterns, perineural invasion, and extraprostatic extension.
Conclusions:
- NLM provides rapid histological assessment of large prostate tissue areas without sectioning.
- NLM is a promising technique for intraoperative consultation, offering speed and detail comparable to traditional methods.
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