Abstract. Blom H, Brismar H (Royal Institute of Technology, Stockholm, Sweden). STED microscopy: increased resolution for medical research? (Review). J Intern Med 2014;276: 560-578.Optical imaging is crucial for addressing fundamental problems in all areas of life science. With the use of confocal and two-photon fluorescence microscopy, complex dynamic structures and functions in a plethora of tissue and cell types have been visualized. However, the resolution of 'classical' optical imaging methods is poor due to the diffraction limit and does not allow resolution of the cellular microcosmos. On the other hand, the novel stimulated emission depletion (STED) microscopy technique, because of its targeted on/ off-switching of fluorescence, is not hampered by a diffraction-limited resolution barrier. STED microscopy can therefore provide much sharper images, permitting nanoscale visualization by sequential imaging of individual-labelled biomolecules, which should allow previous findings to be reinvestigated and provide novel information. The aim of this review is to highlight promising developments in and applications of STED microscopy and their impact on unresolved issues in biomedical science.Keywords: fluorescence, nanoscale imaging, STED, stimulated emission depletion microscopy, superresolution.
Challenges in medical optical imagingFluorescence microscopy is a tool with superb sensitivity that allows individual-labelled biomolecules to be detected by the absorption of light and the reemission of fluorescent photons. In the last decade, the technique has provided new experimental possibilities to decipher several biochemical questions related to the heterogeneous cellular world [1]. Why is this 'impressive' optical tool not applied in the routine clinical setting, in the same way as other imaging methods such as X-ray radiography, magnetic resonance imaging, ultrasonography and positron emission tomography? The main physical disadvantage of this method, which hampers clinical applications, is light scattering, which generates 'poor' penetration depth of human tissue. A diffuse image is often the final result with fluorescence microscopy when trying to visualize deep within dense cellular material whilst attempting to enable both excitation light to enter and emission light to exit the sample and achieving targeted labelling of the area of interest. Internal imaging by microscopy avoids the problem of optical penetration by placing the tool in the vicinity of the studied objects as in endoscopy. The only opportunities for human optical microscopy are dermatological surface layer investigations (e.g. glucose measurement) and ophthalmological investigations of the visual sensory system (e.g. assessment of a damaged cornea), to specify two clinical examples. However, longer wavelength (near-infrared) microscopy has been developed and applied since the early 1990s to allow a better penetration depth into cellular structures, thus enabling imaging of several hundred micrometres into the highly scattering medium of ti...