Fluorescence In Vivo Endomicroscopy
Figure 5: Intraoperative ex vivo fluorescein imaging with the FIVE system of meningioma, high-grade glioma, pituitary adenoma, and choroid plexus papilloma, showing the neuronavigation location of FIVE imaging and correlating H&E-stained tissue biopsy. Also shown is the post-processed volumetric imaging based on FIVE depth images. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.
revealed liver details similar to those found with traditional histopathology techniques, with the accuracy to predict the presence of steatosis and fibrosis. FIVE has been success- fully employed in a study of a murine model of hepatocyte apoptosis. Single hepatocytes were observed for up to 6 hours within the intact liver in a living mouse. Tis study showed that cells that undergo apoptosis initially swell rather than shrink in the initial phase of apoptosis. Authors also followed cytoplasmic vesicle formation, nuclear condensation, cellular disintegration, and macrophage infiltration. Such procedures and dynamic imaging of cells in their natural environment is not possible ex vivo. FIVE imaging of other tissues. In a study at Melbourne Royal Women’s Hospital, Tan imaged patients undergoing
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colposcopy for the treatment of low- or high-grade cervical epithelial neoplasia [57]. Different histoarchitectural features of cervix, including squamo-columnar junctions, dermal papillae, endocervical glands, and squamous epithelia were reported. Tis study also developed a novel scoring system based on the cellular architecture of the tissue and compared the efficiency of FIVE with conventional histology. Based on this scoring system, FIVE was 97% effective in detecting neo- plastic changes in squamous epithelium, 80% effective in pre- dicting low-grade neoplasia, and 93% specific in predicting medium- to high-grade neoplasia. Krishnamurthy developed a simple ex vivo FIVE stain-
ing method and yielded results comparable to conventional histopathological examination [58]. Tis group stained 55
www.microscopy-today.com • 2021 May
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