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Stimulated Raman histology facilitates accurate diagnosis in neurosurgical patients: a one-to-one noninferiority study

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Abstract

Objective

Stimulated Raman histology (SRH) offers efficient and accurate intraoperative neuropathological tissue analysis without procedural alteration to the diagnostic specimen. However, there are limited data demonstrating one-to-one tissue comparisons between SRH and traditional frozen sectioning. This study explores the non-inferiority of SRH as compared to frozen section on the same piece of tissue in neurosurgical patients.

Methods

Tissue was collected over a 1-month period from 18 patients who underwent resection of central nervous system lesions. SRH and frozen section analyses were compared for diagnostic capabilities as well as assessed for quality and condition of tissue via a survey completed by pathologists.

Results

SRH was sufficient for diagnosis in 78% of specimens as compared to 94% of specimens by frozen section of the same specimen. A Fisher’s exact test determined there was no significant difference in diagnostic capability between the two groups. Additionally, both quality of SRH and condition of tissue after SRH were deemed to be non-inferior to frozen section.

Conclusions

This study provides further evidence for the non-inferiority of SRH techniques. It is also the first study to demonstrate SRH accuracy using one-to-one tissue analysis in neuropathological specimens.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Novis DA, Zarbo RJ (1997) Interinstitutional comparison of frozen section turnaround time a college of American pathologists Q-Probes study of 32868 frozen sections in 700 hospitals. Arch Pathol Lab Med 121(6):559–567

    CAS  PubMed  Google Scholar 

  2. Childers CP, Maggard-Gibbons M (2018) Understanding costs of care in the operating room. JAMA Surg 153(4):e176233. https://doi.org/10.1001/jamasurg.2017.6233

    Article  PubMed  PubMed Central  Google Scholar 

  3. Eichberg DG, Shah AH, Di L, Semonche AM, Jimsheleishvili G, Luther EM et al (2019) Stimulated Raman histology for rapid and accurate intraoperative diagnosis of CNS tumors: prospective blinded study. J Neurosurg. https://doi.org/10.3171/2019.9.Jns192075

    Article  PubMed  Google Scholar 

  4. Jaafar H (2006) Intra-operative frozen section consultation: concepts, applications and limitations. Malays J Med Sci 13(1):4–12

    PubMed  PubMed Central  Google Scholar 

  5. Cicerone MT, Camp CH (2017) Histological coherent Raman imaging: a prognostic review. Analyst 143(1):33–59. https://doi.org/10.1039/c7an01266g

    Article  CAS  PubMed  Google Scholar 

  6. Shi L, Fung AA, Zhou A (2021) Advances in stimulated Raman scattering imaging for tissues and animals. Quant Imaging Med Surg 11(3):1078–1101. https://doi.org/10.21037/qims-20-712

    Article  PubMed  PubMed Central  Google Scholar 

  7. Brustlein S, Ferrand P, Walther N, Brasselet S, Billaudeau C, Marguet D et al (2011) Optical parametric oscillator-based light source for coherent Raman scattering microscopy: practical overview. J Biomed Opt 16(2):021106. https://doi.org/10.1117/1.3533311

    Article  PubMed  Google Scholar 

  8. Fu D, Lu FK, Zhang X, Freudiger C, Pernik DR, Holtom G et al (2012) Quantitative chemical imaging with multiplex stimulated Raman scattering microscopy. J Am Chem Soc 134(8):3623–3626. https://doi.org/10.1021/ja210081h

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Fu Y, Huff TB, Wang HW, Wang H, Cheng JX (2008) Ex vivo and in vivo imaging of myelin fibers in mouse brain by coherent anti-stokes Raman scattering microscopy. Opt Express 16(24):19396–19409. https://doi.org/10.1364/oe.16.019396

    Article  CAS  PubMed  Google Scholar 

  10. Freudiger CW, Pfannl R, Orringer DA, Saar BG, Ji M, Zeng Q et al (2012) Multicolored stain-free histopathology with coherent Raman imaging. Lab Invest 92(10):1492–1502. https://doi.org/10.1038/labinvest.2012.109

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Hollon T, Lewis S, Freudiger CW, Sunney Xie X, Orringer DA (2016) Improving the accuracy of brain tumor surgery via Raman-based technology. Neurosurg Focus 40(3):E9. https://doi.org/10.3171/2015.12.Focus15557

    Article  PubMed  PubMed Central  Google Scholar 

  12. Orringer DA, Pandian B, Niknafs YS, Hollon TC, Boyle J, Lewis S et al (2017) Rapid intraoperative histology of unprocessed surgical specimens via fibre-laser-based stimulated Raman scattering microscopy. Nat Biomed Eng 1(2):0027. https://doi.org/10.1038/s41551-016-0027

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hollon TC, Lewis S, Pandian B, Niknafs YS, Garrard MR, Garton H et al (2018) Rapid intraoperative diagnosis of pediatric brain tumors using stimulated Raman histology. Cancer Res 78(1):278–289. https://doi.org/10.1158/0008-5472.Can-17-1974

    Article  CAS  PubMed  Google Scholar 

  14. Ji M, Lewis S, Camelo-Piragua S, Ramkissoon SH, Snuderl M, Venneti S et al (2015) Detection of human brain tumor infiltration with quantitative stimulated Raman scattering microscopy. Sci Transl Med 7(309):309. https://doi.org/10.1126/scitranslmed.aab0195

    Article  CAS  Google Scholar 

  15. Bae K, Zheng W, Lin K, Lim SW, Chong YK, Tang C et al (2018) Epi-detected hyperspectral stimulated Raman scattering microscopy for label-free molecular subtyping of glioblastomas. Anal Chem 90(17):10249–10255. https://doi.org/10.1021/acs.analchem.8b01677

    Article  CAS  PubMed  Google Scholar 

  16. Sarri B, Poizat F, Heuke S, Wojak J, Franchi F, Caillol F et al (2019) Stimulated Raman histology: one to one comparison with standard hematoxylin and eosin staining. Biomed Opt Express 10(10):5378–5384. https://doi.org/10.1364/BOE.10.005378

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Freudiger CW, Yang W, Holtom GR, Peyghambarian N, Xie XS, Kieu KQ (2014) Stimulated Raman scattering microscopy with a robust fibre laser source. Nat Photonics 8(2):153–159. https://doi.org/10.1038/nphoton.2013.360

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Hollon TC, Pandian B, Adapa AR, Urias E, Save AV, Khalsa SSS et al (2020) Near real-time intraoperative brain tumor diagnosis using stimulated Raman histology and deep neural networks. Nat Med 26(1):52–58. https://doi.org/10.1038/s41591-019-0715-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Funding

The authors declare that no funds, Grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Neurosurgery, Lenox Hill Hospital/Donald, Barbara Zucker School of Medicine at Hofstra, New York, NY, USA

    Evan H. Einstein, Faina Ablyazova, Ashley Rosenberg, Jason A. Ellis, John A. Boockvar, David J. Langer & Randy S. D’Amico

  2. Department of Pathology, Lenox Hill Hospital/Donald, Barbara Zucker School of Medicine at Hofstra, New York, NY, USA

    Manju Harshan & Samuel Wahl

  3. Department of Otolaryngology-Head and Neck Surgery, Lenox Hill Hospital/Donald, Barbara Zucker School of Medicine at Hofstra, New York, NY, USA

    Gady Har-El & Peter D. Constantino

Authors
  1. Evan H. Einstein
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  2. Faina Ablyazova
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  3. Ashley Rosenberg
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  4. Manju Harshan
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  5. Samuel Wahl
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  6. Gady Har-El
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  7. Peter D. Constantino
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  8. Jason A. Ellis
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  9. John A. Boockvar
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  10. David J. Langer
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  11. Randy S. D’Amico
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Contributions

All authors contributed to the preparation of this manuscript. EHE, AR and FA: literature search was conducted. EHE, AR, FA, RSA and MH: primary writing of the body of the manuscript was performed. MH, SW, GH, PDC, JAE, JAB, DJL, RSA and FA: data collection was conducted. EHE and MH: figures were created. All authors were involved in the editing and revision of this manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Evan H. Einstein.

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Einstein, E.H., Ablyazova, F., Rosenberg, A. et al. Stimulated Raman histology facilitates accurate diagnosis in neurosurgical patients: a one-to-one noninferiority study. J Neurooncol 159, 369–375 (2022). https://doi.org/10.1007/s11060-022-04071-y

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  • DOI: https://doi.org/10.1007/s11060-022-04071-y

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