Fang Na, Wu Zanyi, Chen Rong, Chen Zhongjiang, Zheng Limei, Yang Tingqi, Wang Ling, Wang Xingfu, Kang Dezhi, Chen Jianxin
Fujian Medical University, Department of Ophthalmology and Optometry, Fuzhou, China.
The First Affiliated Hospital of Fujian Medical University, Department of Neurosurgery, Fuzhou, China.
Neurophotonics. 2023 Jul;10(3):035006. doi: 10.1117/1.NPh.10.3.035006. Epub 2023 Jul 10.
To prevent meningioma recurrence, it is necessary to detect and remove all corresponding tumors intraoperatively, including those in the adjacent dura mater.
Currently, the removal of meningiomas from the dura mater depends solely on cautious visual identification of lesions by a neurosurgeon. Inspired by the requirements for resection, we propose multiphoton microscopy (MPM) based on two-photon-excited fluorescence and second-harmonic generation as a histopathological diagnostic paradigm to assist neurosurgeons in achieving precise and complete resection.
Seven fresh normal human dura mater samples and 10 meningioma-infiltrated dura mater samples, collected from 10 patients with meningioma, were acquired for this study. First, multi-channel mode and lambda mode detection were utilized in the MPM to characterize the architectural and spectral features of normal and meningioma-infiltrated dura mater, respectively. Three imaging algorithms were then employed to quantify the architectural differences between the normal and meningioma-infiltrated dura mater through calculations of the collagen content, orientation, and alignment. Finally, MPM was combined with another custom-developed imaging algorithm to locate the meningioma within the dura mater and further delineate the tumor boundary.
MPM not only detected meningioma cells in the dura mater but also revealed the morphological and spectral differences between normal and meningioma-infiltrated dura mater, providing quantitative information. Furthermore, combined with a self-developed image-processing algorithm, the precise borders of meningiomas in the dura mater could be accurately delineated.
MPM can automatically detect meningiomas in the dura mater label-free. With the development of advanced multiphoton endoscopy, MPM combined with image analysis can provide decision-making support for histopathological diagnosis, as well as offer neurosurgeons more precise intraoperative resection guidance for meningiomas.
为防止脑膜瘤复发，有必要在术中检测并切除所有相应肿瘤，包括相邻硬脑膜中的肿瘤。
目前，从硬脑膜切除脑膜瘤完全依赖于神经外科医生对病变进行谨慎的视觉识别。受切除要求的启发，我们提出基于双光子激发荧光和二次谐波产生的多光子显微镜（MPM）作为一种组织病理学诊断模式，以协助神经外科医生实现精确和完整的切除。
本研究采集了7个新鲜的正常人类硬脑膜样本和10个来自10例脑膜瘤患者的脑膜瘤浸润硬脑膜样本。首先，在MPM中采用多通道模式和λ模式检测，分别表征正常和脑膜瘤浸润硬脑膜的结构和光谱特征。然后采用三种成像算法，通过计算胶原蛋白含量、方向和排列来量化正常和脑膜瘤浸润硬脑膜之间的结构差异。最后，将MPM与另一种定制开发的成像算法相结合，在硬脑膜内定位脑膜瘤并进一步描绘肿瘤边界。
MPM不仅检测到硬脑膜中的脑膜瘤细胞，还揭示了正常和脑膜瘤浸润硬脑膜之间的形态和光谱差异，提供了定量信息。此外，结合自行开发的图像处理算法，可以准确描绘硬脑膜中脑膜瘤的精确边界。
MPM可以自动无标记地检测硬脑膜中的脑膜瘤。随着先进的多光子内窥镜的发展，MPM与图像分析相结合可为组织病理学诊断提供决策支持，并为神经外科医生提供更精确的脑膜瘤术中切除指导。
