Application of a Novel Miniaturized Histopathologic Microscope for Ex Vivo Identifying Cerebral Glioma Margins
Weichi Wu1, Baoshu Xie1, Xiaowei Zhang1
1Department of Neurosurgery, Institute of Precision Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Brain Function and Disease, Sun Yat-sen University, Guangzhou, Guangdong, China.
Purpose:
The purpose of our study is to assess the clinical performance of the DiveScope, a novel handheld histopathologic microscope in rapidly differentiating glioma from normal brain tissue during neurosurgery.
Methods:
Thirty-two ex vivo specimens from 18 patients were included in the present study. The excised suspicious tissue was sequentially stained with sodium fluorescein and methylene blue and scanned with DiveScope during surgery. The adjacent tissue was sent to the department of pathology for frozen section examination. They would eventually be sent to the pathology department later for hematoxylin and eosin staining for final confirmation. The positive likelihood ratio, negative likelihood ratio, sensitivity, specificity, and area under the curve of the device were calculated. In addition, the difference in time usage between DiveScope and frozen sections was compared for the initial judgment.
Results:
The sensitivity and specificity of the DiveScope after analyzing hematoxylin and eosin -staining sections, were 88.29% and 100%, respectively. In contrast, the sensitivity and specificity of the frozen sections histopathology were 100% and 75%, respectively. The area under the curve of the DiveScope and the frozen sections histopathology was not significant ( P =0.578). Concerning time usage, DiveScope is significantly much faster than the frozen sections histopathology no matter the size of tissue.
Conclusion:
Compared with traditional pathological frozen sections, DiveScope was faster and displayed an equal accuracy for judging tumor margins intraoperatively.
Insights
The DiveScope, a handheld histopathologic microscope, offers faster and equally accurate intraoperative glioma margin assessment compared to traditional frozen sections. This novel device aids neurosurgeons in differentiating brain tumors from normal tissue efficiently.
Area of Science:
- Neurosurgery
- Histopathology
- Medical Devices
Background:
- Accurate intraoperative margin assessment is crucial for glioma resection.
- Traditional frozen section analysis can be time-consuming.
- Novel tools are needed to improve surgical decision-making.
Purpose of the Study:
- To evaluate the clinical performance of the DiveScope, a handheld histopathologic microscope.
- To assess its ability to differentiate glioma from normal brain tissue during neurosurgery.
- To compare its accuracy and speed against frozen section analysis.
Main Methods:
- Ex vivo analysis of 32 specimens from 18 patients.
- Tissue staining with sodium fluorescein and methylene blue, followed by DiveScope scanning.
- Comparison with adjacent tissue examined by frozen section and subsequent H&E staining.
- Calculation of sensitivity, specificity, likelihood ratios, and AUC; time usage comparison.
Main Results:
- DiveScope demonstrated 88.29% sensitivity and 100% specificity (vs. H&E).
- Frozen sections showed 100% sensitivity and 75% specificity.
- No significant difference in AUC between DiveScope and frozen sections (P=0.578).
- DiveScope was significantly faster than frozen sections for initial judgment.
Conclusions:
- DiveScope provides comparable accuracy to frozen sections for intraoperative tumor margin judgment.
- The device offers a significant speed advantage over traditional methods.
- DiveScope is a promising tool for rapid intraoperative histopathologic assessment in neurosurgery.
