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Neurosurgical Flexible Probe Microscopy with Enhanced Architectural and Cytological Detail

Hany Osman1, Deena Elsahy2, Veronika Slivova3

  • 1Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

World Neurosurgery
|May 18, 2019
PubMed
Abstract

Insights

A new 3D-printed microscope with a flexible probe enhances in vivo neurosurgical imaging. This technology improves visualization of tumor cells at excision margins, potentially reducing recurrence and improving patient survival.

Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Biotechnology

Background:

  • Accurate tumor cell clearance at surgical margins is crucial for reducing recurrence and improving survival in neurosurgery.
  • In vivo fluorescence microscopy offers promising advancements for real-time intraoperative visualization.
  • Existing technologies require enhancement for detailed cellular and architectural imaging during procedures.

Purpose of the Study:

  • To develop and demonstrate a flexible fiberoptic epifluorescence microscope for enhanced in vivo neurosurgical imaging.
  • To achieve superior architectural and cytological detail during live surgical procedures.

Main Methods:

  • Procurement of 18 neurosurgical specimens.
  • Staining with acridine orange and imaging using a 3D-printed epifluorescent microscope with a flexible fiberoptic probe.
  • Image processing including frame alignment, signal projection, and pseudo-coloring for resolution and field-of-view enhancement.

Main Results:

  • The microscope produced images with excellent nuclear contrast and detailed architecture.
  • Specific tumor types like meningiomas and oligodendrogliomas showed characteristic cellular patterns.
  • High-grade tumors like glioblastomas exhibited significant nuclear pleomorphism and disarray, with visible mitoses and vascular proliferation.

Conclusions:

  • A 3D-printed, flexible probe microscope enables high-resolution in vivo microscopic imaging with enhanced architectural detail.
  • This advanced imaging capability can improve the detection and clearance of microscopic tumor burdens at surgical margins.
  • The technology holds potential to enhance neurosurgical outcomes by improving precision in tumor resection.
Keywords:
Ex vivoGliomaIn vivoMicroscopyNeurosurgeryOncology

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