Stony Brook University (SUNY) Department of Biomedical Engineering, Stony Brook, NY, USA.
Anal Cell Pathol (Amst). 2011;34(3):81-98. doi: 10.3233/ACP-2011-011.
Advances in optical designs are enabling the development of miniature microscopes that can examine tissue in situ for early anatomic and molecular indicators of disease, in real time, and at cellular resolution. These new devices will lead to major changes in how diseases are detected and managed, driving a shift from today's diagnostic paradigm of biopsy followed by histopathology and recommended therapy, to non-invasive point-of-care diagnosis with possible same-session definitive treatment. This shift may have major implications for the training requirements of future physicians to enable them to interpret real-time in vivo microscopic data, and will also shape the emerging fields of telepathology and telemedicine. Implementation of new technologies into clinical practice is a complex process that requires bridging gaps between clinicians, engineers and scientists. This article provides a forward-looking discussion of these issues, with a focus on malignant and pre-malignant lesions, by first highlighting some of the clinical areas where point-of-care in vivo microscopy could address unmet needs, and then by reviewing the technological challenges that are being addressed, or need to be addressed, for in vivo microscopy to become a standard clinical tool.
光学设计的进步正在推动微型显微镜的发展，这些显微镜可以实时、以细胞分辨率原位检查组织中疾病的早期解剖学和分子指标。这些新设备将导致疾病检测和管理方式的重大变化，从当今的活检后进行组织病理学和推荐治疗的诊断模式，转变为非侵入性的即时护理诊断，并可能在同一时段进行明确的治疗。这一转变可能对未来医生的培训要求产生重大影响，使他们能够解释实时体内显微镜数据，并将塑造远程病理学和远程医疗等新兴领域。将新技术应用于临床实践是一个复杂的过程，需要在临床医生、工程师和科学家之间架起桥梁。本文通过首先强调即时护理体内显微镜可以解决未满足需求的一些临床领域，然后回顾正在解决或需要解决的技术挑战，前瞻性地讨论了这些问题，以实现体内显微镜成为标准的临床工具。
