Multiphoton microscopy for rapid histopathological evaluation of kidney tumours

Abstract

ObjectiveTo explore the potential of multiphoton microscopy (MPM) for rapid evaluation and triaging of ex vivo kidney tissue. Materials and MethodsFresh neoplastic and non-neoplastic tissues from nephrectomy specimens (n = 40) were imaged with MPM and later submitted for routine histopathology. ResultsOn MPM, normal kidney architecture was evident and clearly distinguishable from tumour. Forty malignant tumours (20 clear-cell renal cell carcinomas [RCCs], 10 papillary RCCs, five chromophobe RCCs and five papillary urothelial carcinomas [UCs], as diagnosed by haematoxylin and eosin staining) were imaged and subtyped as non-papillary and papillary, based on their architecture. Non-papillary tumours were further classified based on their unique cytoplasmic signatures. Clear-cell RCCs had a predominant population of cells with fat droplets in cytoplasm. Chromophobe RCCs had cells with non-fatty/homogeneous cytoplasm and distinct intra-cytoplasmic granules. Papillary RCCs had single-celllined papillae with often abundant histiocytes in their core, whereas PUC had multi-layered urothelium-lined papillae. The diagnostic accuracy of tumour subtyping by two independent uropathologists was 95%. ConclusionsWe showed that MPM can reliably differentiate neoplastic from non-neoplastic kidney tissue and subtype kidney tumours in fresh, unprocessed tissue, MPM might therefore be useful as a rapid real-time diagnostic tool for the evaluation of kidney biopsies, and surgical margins in partial nephrectomies, to improve overall patient management.

A component‐by‐component characterisation of high‐risk atherosclerotic plaques by multiphoton microscopic imaging

“…The various components of the atherosclerotic plaques were defined based on their morphological features (similar to that seen on H&E) as well as their well-known autofluorescence or SHG signals on MPM (Denk et al, 1990;Zipfel et al, 2003;Tewari et al, 2011;Jain et al, 2014;Jain et al, 2015;Jain et al, 2016). All the H&E images shown in the figures correspond to the samples imaged with MPM.…”

Multiphoton Microscopic Study of the Renal Cell Carcinoma Pseudocapsule: Implications for Tumour Enucleation

“…In their study, it distinguished RCC histological subtypes based on their tissue architecture, with a diagnostic accuracy of 95%. 20 It was suggested that MPM may potentially be used for real time unstained kidney tissue biopsy diagnosis and surgical margin assessment in future. 20 The findings in our report support the other reports that the presence and integrity of RCC pseudocapsules are known to vary between tumours.…”

Exploring Multiphoton Microscopy as a Novel Tool to Differentiate Chromophobe Renal Cell Carcinoma From Oncocytoma in Fixed Tissue Sections

“…Multiphoton microscopy has been used in research to differentiate neoplastic from nonneoplastic tissue and to characterize various tumors. [15][16][17][18] Further, Jain et al 19 have characterized various malignant kidney tumors on MPM and have achieved a high diagnostic accuracy of 98% in subtyping these tumors. Although this study included few cases of chRCC, it lacked oncocytoma cases.…”

“…13,14 It has been used to image fresh and fixed human tissues for differentiating neoplastic from nonneoplastic lesions and to characterize various tumor types, including kidney tumors. [15][16][17][18][19] The purpose of the current study was to explore MPM as a potential alternative and rapid diagnostic tool for differen-tiating oncocytoma from chRCC. Because this was a proofof-concept study, typical cases (readily diagnosed with H&E) of oncocytoma and chRCC were included, with the aim of characterizing unique MPM signatures of each tumor type that could aid in their differential diagnosis.…”