Molecular imaging can identify the location to perform a frozen biopsy during intraoperative frozen section consultation

Background Intraoperative frozen section (FS) consultation is an important tool in surgical oncology that suffers from sampling error because the pathologist does not always know where to perform a biopsy of the surgical specimen. Intraoperative molecular imaging is a technology used in the OR to visualize lesions during surgery. We hypothesized that molecular imaging can address this pathology challenge in FS by visualizing the cancer cells in the specimen in the pathology suite. Here, we report the development and validation of a molecular-imaging capable cryostat called Smart-Cut. Methods A molecular imaging capable cryostat prototype was developed and tested using a murine model. Tumors grown in mice were targeted with a NIR contrast agent, indocyanine green (ICG), via tail vein injection. Tumors and adjacent normal tissue samples were frozen sectioned with Smart-Cut. Fluorescent sections and non-fluorescent sections were prepared for H&E and fluorescent microscopy. Fluorescent signal was quantified by tumor-to-background ratio (TBR). NIR fluorescence was tested in one patient enrolled in a clinical trial. Results The Smart-Cut prototype has a small footprint and fits well in the pathology suite. Fluorescence imaging with Smart-Cut identified cancerous tissue in the specimen in all 12 mice. No false positives or false negatives were seen, as confirmed by H&E. The mean TBR in Smart-Cut positive tissue sections was 6.8 (SD±3.8). In a clinical application in the pathology suite, NIR imaging identified two lesions in a pulmonary resection specimen, where traditional grossing only identified one. Conclusion Molecular imaging can be integrated into the pathology suite via the Smart-Cut device, and can detect cancer in frozen tissue sections using molecular imaging in a murine model.

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Rapid brain structure and tumour margin detection on whole frozen tissue sections by fast multiphotometric mid-infrared scanning

Scientific Reports ◽

10.1038/s41598-021-90777-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tim Kümmel ◽

Björn van Marwick ◽

Miriam Rittel ◽

Carina Ramallo Guevara ◽

Felix Wühler ◽

...

Keyword(s):

Imaging System ◽

Frozen Section ◽

Computational Effort ◽

Primary Hepatocellular Carcinoma ◽

Measuring System ◽

Sufficient Information ◽

Tissue Samples ◽

Mid Infrared ◽

Tissue Sections ◽

Frozen Tissue

AbstractFrozen section analysis is a frequently used method for examination of tissue samples, especially for tumour detection. In the majority of cases, the aim is to identify characteristic tissue morphologies or tumour margins. Depending on the type of tissue, a high number of misdiagnoses are associated with this process. In this work, a fast spectroscopic measurement device and workflow was developed that significantly improves the speed of whole frozen tissue section analyses and provides sufficient information to visualize tissue structures and tumour margins, dependent on their lipid and protein molecular vibrations. That optical and non-destructive method is based on selected wavenumbers in the mid-infrared (MIR) range. We present a measuring system that substantially outperforms a commercially available Fourier Transform Infrared (FT-IR) Imaging system, since it enables acquisition of reduced spectral information at a scan field of 1 cm2 in 3 s, with a spatial resolution of 20 µm. This allows fast visualization of segmented structure areas with little computational effort. For the first time, this multiphotometric MIR system is applied to biomedical tissue sections. We are referencing our novel MIR scanner on cryopreserved murine sagittal and coronal brain sections, especially focusing on the hippocampus, and show its usability for rapid identification of primary hepatocellular carcinoma (HCC) in mouse liver.

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Accuracy of Frozen Section with Histopathological Report in an Institute

Journal of Nepal Medical Association ◽

10.31729/jnma.3545 ◽

2018 ◽

Vol 56 (210) ◽

pp. 572-577

Author(s):

Purbesh Adhikari ◽

Paricha Upadhyaya ◽

Smriti Karki ◽

Chandra Shekhar Agrawal ◽

Shyam Thapa Chhetri ◽

...

Keyword(s):

Predictive Value ◽

Sampling Error ◽

Frozen Section ◽

Cross Sectional Study ◽

Histopathological Diagnosis ◽

Cross Sectional ◽

Tissue Samples ◽

Organ Systems ◽

Discordance Rate ◽

Frozen Section Diagnosis

Introduction: Frozen section helps in rapid intra-operative diagnosis. It is commonly used during surgical procedures to detect malignancy so that modifications of surgery can be decided at the time of surgery on the table. Frozen section is also performed for evaluation of surgical margins and detection of lymph node metastasis. In addition it is applied for detection of unknown pathological processes.The objective of this study was to assess the accuracy of frozen section diagnosis in comparison to gold standard histopathological diagnosis and to find concordance and discordance rate of frozen section with histopathological report.Methods: This was a cross sectional study of 41 frozen section samples done in the department of pathology of BP Koirala Institute of Health Sciences from September 2014 to August 2015. All frozen section samples with their permanent tissue samples sent for final histopathological evaluation were included in the study.Results: The overall accuracy of frozen section diagnosis was 97%. The sensitivity was 94%, specificity was 87%, positive predictive value was 90% and negative predictive value was 93%. The concordance rate was 90.2% and the discordance rate was 9.8%.Conclusions: The results of frozen section varied in different organ systems and the common cause of discrepancy in our study were the gross sampling error and the interpretational error.

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Role of Intraoperative Frozen Section Diagnosis in the Management of Patients with CNS Lesions: Evaluation of 60 Consecutive Intraoperative Frozen Sections from 1991 to 1993

McGill Journal of Medicine ◽

10.26443/mjm.v1i1.403 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Seyed Mirsattari ◽

Fraser W. Saunders

Keyword(s):

Frozen Section ◽

Imaging Techniques ◽

Frozen Sections ◽

Tissue Samples ◽

Tissue Sections ◽

Intraoperative Management ◽

Clinical Diagnoses ◽

Cns Lesions

To determine the role of intraoperative frozen sections (FSs) in the management of patients with central nervous system (CNS) lesions, 60 consecutive intraoperative clinical diagnoses of CNS lesions were presented and compared with concomitantly obtained FS diagnoses. Clinical diagnoses were established byhistory, physical examination, imaging techniques, and gross appearance of the abnormal tissue in situ. Tissue samples were obtained intraoperatively and processed for FS diagnoses. The findings of the FS diagnoses were reported to the operating room and compared with the clinical diagnoses. The remainingbiopsy samples were used to prepare paraffin-embedded tissue sections from which the definitive diagnoses were made. Comparison of the clinical and FS diagnoses, using paraffin-embedded tissue as the true diagnosis, shows that FS diagnosis has a limited contribution to intraoperative patient management by the neurosurgeon. The rate of diagnostic failures between the two techniques was very similar; clinical diagnoses and FSs were misinterpreted in 12 and 11 of the 60 cases, respectively. Compared to a clinical diagnosis, the intraoperative FS technique provided no significant improvement in diagnosis and management; it altered the intraoperative management of the patients in 2 of 60 cases.

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Discovery of intracellular 2,8 dihydroxyadenine crystals in bovine lymphatic and hepatic cells

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010012881x ◽

1987 ◽

Vol 45 ◽

pp. 906-907

Author(s):

W. E. Rigsby ◽

D. M. Hinton ◽

V. J. Hurst ◽

P. C. McCaskey

Keyword(s):

Polarized Light ◽

Paraffin Sections ◽

Tissue Samples ◽

Whole Cells ◽

Tissue Sections ◽

Hepatic Cells ◽

Slaughter House ◽

Mammalian Tissues ◽

Carbon Coated ◽

Cellular Components

Crystalline intracellular inclusions are rarely seen in mammalian tissues and are often difficult to positively identify. Lymph node and liver tissue samples were obtained from two cows which had been rejected at the slaughter house due to the abnormal appearance of these organs in the animals. The samples were fixed in formaldehyde and some of the fixed material was embedded in paraffin. Examination of the paraffin sections with polarized light microscopy revealed the presence of numerous crystals in both hepatic and lymph tissue sections. Tissue sections were then deparaffinized in xylene, mounted, carbon coated, and examined in a Phillips 505T SEM equipped with a Tracor Northern X-ray Energy Dispersive Spectroscopy (EDS) system. Crystals were obscured by cellular components and membranes so that EDS spectra were only obtainable from whole cells. Tissue samples which had been fixed but not paraffin-embedded were dehydrated, embedded in Spurrs plastic, and sectioned.

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RESEARCH ON VALUE OF INTRAOPERATIVE FROZEN SECTION EXAMINATION OF THE COMMON TUMORS AT HUE UNIVERSITY HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.6.8 ◽

2011 ◽

pp. 67-73

Author(s):

Cong Thuan Dang ◽

Thi Thu Thao Le

Keyword(s):

Sensitivity And Specificity ◽

Frozen Section ◽

Analysis Data ◽

Poor Quality ◽

University Hospital ◽

Frozen Sections ◽

Intraoperative Frozen Section ◽

Frozen Section Examination ◽

Incorrect Diagnosis ◽

The Common

Background: To evaluate the accuracy and the pitfalls of frozen section examination in diagnosis the common tumors at Hue University Hospital. Materials and method: A retrospective analysis data of 99 consecutive patients from 2007 to 2009 were evaluated and analyzed the major pitfalls. In our 99 patients, 100% cases we compared histological diagnosis on frozen sections with those on paraffin sections. Results: The majority of frozen section examinations were the thyroid lesions 37.4%, breast lesions 25.2%, lymph nodes 16.1%, ovary 9.1% and less common in other diseases (12.1%). The accuracy, sensitivity and specificity of the intraoperative frozen section examination were 93.9%, 89.1% and 98.1% respectively. The main factors causing incorrect diagnosis in frozen section are: Misinterpretation, poor quality of frozen sections, improper sampling in sectioning and difficult to result interpretation. Conclusion: The frozen section analysis of suspect lesions displays good sensitivity and specificity characteristics.

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