Adjunct Assistant Profesor UC Davis, Department of Pathology Sacramento, California, United States
Introduction:: Anatomic pathology, still the gold standard for tissue-based disease diagnosis, is centered on interpretation of H&E-stained sections on glass slides, a process that has remained largely unchanged for at least a century. Current methods require labor-intensive and time-consuming specimen processing steps that are ill-suited for providing rapid intraoperative guidance and margin assessment, especially for breast surgeries, and are not capable of generating high-quality, histological (not cytological) rapid onsite evaluation of core needle biopsies. Current approaches for bypassing slide-based imaging have encompassed a variety of technologies, including confocal, multiphoton, and other optical methods, but these have yet to have significant impact in the field due to challenges posed by cost and complexity issues.
Materials and Methods:: We propose a simple, clinically relevant solution, termed FIBI (fluorescence imitating brightfield imaging), for directly creating diagnostic-quality images from unsectioned, fresh or fixed tissue specimens. FIBI can generate full-color histology-grade images within minutes using inexpensive components making it suitable for intraoperative guidance and cancer margin assessment, especially for breast surgeries.
Results, Conclusions, and Discussions:: Our proposed methodology uses conventional epi-illumination and rapidly stained tissue surfaces to produce digital images that immediately resemble standard histology, are suitable for diagnosis or other evaluation purposes, and are amenable to AI-based analysis and telepathology applications. We have demonstrated the validity of this method by collecting 50 tissue samples from various organs and pathologies and comparing the diagnosis obtained using FIBI images with those determined from adjacent, conventionally prepared H&E-stained slides, demonstrating 97% concordance.
