Fluorescence In Vivo Endomicroscopy


Figure 6: Intraoperative ex vivo FIVE system fluorescein imaging of glioblastoma showing the neuronavigation locations of imaging. FIVE images at locations reveal the (A) aggressive tissue characteristics and (B) irregular capillaries within the malignant tumor mass (arrows). Used with permission from Barrow Neurological Institute, Phoenix, Arizona.


tissue fragments obtained from 16 breast, 18 lung, 14 kidney, and 7 liver surgical excision specimens, stained them with 0.6 mM acridine orange for 6 seconds, and imaged with FIVE before performing standard H&E staining. Acridine orange offered sharp contrast between the nucleus and cytoplasm, recapitulating tissue architecture. Within 5 to 10 minutes,


high-quality images were obtained, allowing recognition of the cytomorphologic details for categorization of the imaged tissue similar to histologic examination of H&E tissue sec- tions. Due to its speed, ease of acquisition, and resolution, authors suggested FIVE’s potential in surgical pathology practice.


Figure 7: In vivo selective antibody imaging (GFP and FITC-EGFR fluorescence) of an experimental GL261 murine malignant glioma. The FIVE system reveals images that closely compare to imaging from a Zeiss 710 benchtop confocal system. An invading peninsula of tumor cells are seen (delineated by arrows) and com- pared to the H&E-stained histology section. Images obtained from tumor border. (A) In vivo confocal endomicroscope image demonstrates tumor cells aligned along a blood vessel progressing out from the main tumor mass (arrows). (B) Ex vivo bench-top confocal. (C) H&E section (×20) from the same region of interest shows similar histologic features (arrows). Scale bars=100 µm. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.


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