Dye-Enhanced Multimodal Confocal Imaging Apparatus and Method
OHSU # 1353
Several surgical procedures to remove tumors involve detection of aberrations of cell morphology that are impossible to discern with the unaided eye. In such circumstances, surgeons perform successive incremental excisions and each sample of excised tissue is subjected to histological examination to determine the remaining extent of the tumor.
This procedure for preparing the histology sections is tedious and time consuming, often exceeding 30 minutes per section. In turn, surgical procedures that rely on such histology sections can extend to two hours and more, increasing the exposure of the patient to infection and undesirable consequences of surgery, and limiting the availability of surgeons for other procedures.
Confocal microscopy is capable of directly observing, in real time, very small structures and can directly observe tumors in excised tissue. However, confocal images are in grayscale and lack the tissue structure specific color contrast that is conventionally provided by hematoxylin and eosin (H&E) staining of tissue samples. This technology addresses the grayscale issue by employing multimodal confocal imagery based on luminescence to approximate H&E absorption stain, and takes five minutes or less. This is achieved through the combination of enhanced sample fixation techniques, modifications to currently used confocal instruments, superior mosaicing of images, and the conversion of luminous information to pigment based images.
Surgical procedures that involve viewing histology in incremental excisions include Mohs surgery for the removal of basal cell carcinoma (BCC) in skin, removal of oral mucosal lesions, thyroid nodules, parathyroid glands and bone, needle core biopsies and lumpectomies of the breast and inter-operative biopsies of the liver and bladder.
Competitive Advantage (over conventional H&E staining)
1) 80% reduction in time required for staining and acquisition.
2) Comparable field of view.
3) Minimal resources required – no limitation due to hematoxylin availability, lower reagent costs,
less manpower required.
4) Pathologists can analyze images (like H&E sections). No need for confocal expertise.
Patent application filed.
- Dan Gareau, SM.Biomedical Engineering
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Technology Development Manager