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Real-time 3D Optical Diagnosis of Colorectal Cancer Using Three-photon Imaging

Dexin Chen, Wei Jiang, Zhangyuanzhu Liu, Kai Li, Weisheng Chen, Xiumin LIu, Jun Yan. Department of General Surgery, Nanfang Hospital, Southern Medical University

Background: Three-photon imaging(TPI), which was based on the field of nonlinear optics and femtosecond lasers, has been proved to be able to provide the 3-dimensional (3D) morphological feature of living tissues without the administration of exogenous contrast agents. The purpose of this study is to investigate whether TPI could make a real-time histological 3D diagnosis for colorectal cancer compared with the gold standard hematoxylin-eosin (H-E).

Methods: This study was conducted between January 2017 and August 2017. A total of 30 patients diagnosed as colon or rectum carcinoma by preoperative colonoscopy were included. All patients received radical surgery. The fresh, unfixed and unstained full-thickness cancerous and the corresponding normal specimens in the same patient, were immediately prepared to receive TPI after surgery. For 3D visualization, the z-stacks were reconstructed. All tissue went through routine histological procedures. TPI images were compared with H-E by the same attending pathologist.

Results: The schematic diagram of TPI is shown in Fig. 1A. Peak TPI signal intensity excited at 1300nm was detected in living tissues. The field of view (FOV) was 500×500μm and the imaging deep was 200μm in each specimen. In normal specimens, glands lined regularly and characterized as a typical foveolar, which was comparable to H-E images (Fig. 1B and 1D). In cancerous specimens, irregular tissue architecture and shape were identified by TPI, which was also validated by corresponding H-E images (Fig. 1C and 1E). TPI images can be acquired with a view of 3D visualization. Based on rates of correlation with pathological diagnosis, the accuracy, sensitivity, specificity, positive predictive value, negative predictive value were 95%, 90%, 100%, 100%, 90.9%, respectively.

Conclusions: It is feasible to use TPI to make a real-time 3D optical diagnosis for colorectal cancer. With the miniaturization and integration of colonoscopy, TPI has the potential to make a real-time histological 3D diagnosis for colorectal cancer in the future, especially in low rectal cancer.

 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87400

Program Number: P280

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

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