Partial nephrectomy margin imaging using structured illumination microscopy

Mei Wang, David B. Tulman, Andrew B. Sholl, Sree H. Mandava, Michael M. Maddox, Benjamin R. Lee, J. Quincy Brown

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Partial nephrectomy (PN) is the recommended procedure over radical nephrectomy (RN) for patients with renal masses less than 4 cm in diameter (Stage T1a). Patients with less than 4 cm renal masses can also be treated with PN, but have a higher risk for positive surgical margins (PSM). PSM, when present, are indicative of poor clinical outcomes. The current gold-standard histopathology method is not well-suited for the identification of PSM intraoperatively due to processing time and destructive nature. Here, video-rate structured illumination microscopy (VR-SIM) was investigated as a potential tool for PSM detection during PN. A clinical image atlas assembled from ex vivo renal biopsies provided diagnostically useful images of benign and malignant kidney, similar to permanent histopathology. VR-SIM was then used to image entire parenchymal margins of tumor resection covering up to >1800× more margin surface area than standard histology. Aided by the image atlas, the study pathologist correctly classified all parenchymal margins as negative for PSM with VR-SIM, compared to standard postoperative pathology. The ability to evaluate large surgical margins in a short time frame with VR-SIM may allow it to be used intraoperatively as a “safety net” for PSM detection, allowing more patients to undergo PN over RN.

Original languageEnglish (US)
Article numbere201600328
JournalJournal of Biophotonics
Volume11
Issue number3
DOIs
StatePublished - Mar 2018
Externally publishedYes

Keywords

  • cancer
  • margin imaging
  • partial nephrectomy
  • renal cell carcinoma
  • structured illumination microscopy

ASJC Scopus subject areas

  • Chemistry(all)
  • Materials Science(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Engineering(all)
  • Physics and Astronomy(all)

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  • Cite this

    Wang, M., Tulman, D. B., Sholl, A. B., Mandava, S. H., Maddox, M. M., Lee, B. R., & Quincy Brown, J. (2018). Partial nephrectomy margin imaging using structured illumination microscopy. Journal of Biophotonics, 11(3), [e201600328]. https://doi.org/10.1002/jbio.201600328