Abstract
Lung cancer is one of the most prevalent and lethal cancers. To improve health outcomes while reducing health care burden, it becomes crucial to move toward early detection and cost-effective workflows. Currently, there is no method for the on-site rapid histologic feedback on biopsies taken in diagnostic, endoscopic, or surgical procedures. Higher harmonic generation (HHG) microscopy is a laser-based technique that provides images of unprocessed tissue. In this study, we report the feasibility of an HHG portable microscope in the clinical workflow in terms of acquisition time, image quality, and diagnostic accuracy in suspected pulmonary and pleural malignancy. One hundred nine biopsies of 47 patients were imaged and a biopsy overview image was provided within a median acquisition time of 6 minutes after excision. The assessment by pathologists and an artificial intelligence algorithm showed that image quality was sufficient for a malignancy or nonmalignancy diagnosis in 97% of the biopsies, and 87% of the HHG images were correctly scored by the pathologists. HHG is therefore an excellent candidate to provide a rapid pathology outcome on biopsy samples, enabling immediate diagnosis and (local) treatment.
| Original language | English |
|---|---|
| Article number | 100633 |
| Journal | Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc |
| Volume | 38 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 16 Oct 2024 |
Bibliographical note
Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.Funding
The authors thank Frank van Mourik (Flash Pathology B.V.) for the technical support and the nursing team of the Behandelkamer at Amsterdam University Medical Center for their help with logistics and acquisition of biopsies. This publication is part of the project InstantPathology (project number: 15825) of the research program Applied and Engineering Sciences, which is (partly) financed by the Dutch Research Council. Furthermore, this project has received funding from the European Union's Horizon 2020 research and innovation program under grants 654148 and 871124 (Laserlab-Europe). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. L.M.G.v.H. M.B. J.M.A.D. J.T.A. and M.L.G. conceived and designed the study. L.M.G.v.H. performed project administration. L.M.G.v.H. M.B. T.R. and J.H.v.d.T. performed data acquisition. L.M.G.v.H. and M.B. performed development of methodology, data analysis, interpretation of data, and writing of the original draft. J.M.A.D. T.R. J.H.v.d.T. M.V. J.T.A. and M.L.G. performed review and revision of the paper. J.M.A.D. J.T.A. and M.L.G. provided material support. J.T.A. and M.L.G. provided supervision. M.L.G. provided funding acquisition. All authors read and approved the final paper. The data, model, and code files that support the findings of this study are available from the DataverseNL database (accession number: DOI:10.34894/ZZYU9M). This publication is part of the project InstantPathology (project number: 15825) of the research program Open Technology by the domain which is (partly) financed by the Dutch Research Council (Applied and Engineering Sciences) and Horizon 2020 Framework Program grants 654148 and 871124. M.L.G. declares to have indirect interest in Flash Pathology B.V. L.M.G.v.H. received technical support from Flash Pathology. Flash Pathology was not involved in the design of the study and data acquisition and analysis. Other authors have no conflict of interest. The Medical Ethics Review Committee of the VU University Medical Centre confirmed that this study did not fall within the scope of the Medical Research Involving Human Subjects Act, as the diagnostic procedures were performed for clinical purposes (2020.223). The study is in line with Dutch license procedures and the declaration of Helsinki. Written consent was provided by all included patients. This publication is part of the project Instant Pathology (with project number 15825) of the research program Open Technology, by the domain which is (partly) financed by the Dutch Research Council (NWO- Applied and Engineering Sciences) and Horizon 2020 Framework Program grants 654148 and 871124. This publication is part of the project InstantPathology (with project number 15825) of the research program Applied and Engineering Sciences which is (partly) financed by the Dutch Research Council (NWO). Furthermore, this project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement no 654148 and 871124 Laserlab-Europe. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
| Funders | Funder number |
|---|---|
| Horizon 2020 | |
| Nederlandse Organisatie voor Wetenschappelijk Onderzoek | |
| Horizon 2020 Framework Programme | 654148, 871124 |
| VU University Medical Centre | 2020.223 |
Keywords
- Humans
- Lung Neoplasms/pathology
- Artificial Intelligence
- Biopsy
- Microscopy/methods
- Pleural Neoplasms/pathology
- Female
- Male
- Aged
- Middle Aged
- Lung/pathology