In vivo cytometry: a spectrum of possibilities.
BACKGROUND
We investigate whether optical imaging can reliably detect abnormalities in tissue, in a range of specimens (live cells in vitro; fixed, fresh ex-vivo and in vivo tissue), without the use of added contrast agents, and review our promising spectral methods for achieving quantitative, real-time, high resolution intrasurgical optical diagnostics.


METHODS
We use reflectance, fluorescence, two-photon, and Mie scattering imaging, performed with instrumentation we developed or modified, to detect intrinsic tissue signatures. Emphasis is on spectral/hyperspectral imaging approaches allowing the equivalent of in vivo pathology.


RESULTS
With experimental focus on unstained specimens, we demonstrate the ability to segment tissue images for cancer detection. Spectral reflectance imaging, coupled with advanced analysis, typically yields 90% specificity and sensitivity. Autofluorescence is also shown to be diagnostically useful, with lymph nodes results highlighted here. Elastic scattering hyperspectral imaging endoscopy, using a new instrument we designed and built, shows promise in bronchoscopic detection of dysplasia and early cancer in patients.


CONCLUSIONS
The results demonstrate that advanced optical imaging can detect and localize cellular signatures of cancer in real-time, in vivo, without the use of contrast agents, in animals and humans. This is an important step towards tight spatio-temporal coupling between such detection and clinical intervention.
Minimally Invasive Surgical Technologies Institute and Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
Alice
A
Chung
Scott
S
Karlan
Erik
E
Lindsley
Sebastian
S
Wachsmann-Hogiu
Daniel L
DL
Farkas
D000818:Animals; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D019044:Image Cytometry / Q000295:instrumentation / Q000379:methods*; D007091:Image Processing, Computer-Assisted; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008856:Microscopy, Fluorescence / Q000379:methods; D008857:Microscopy, Interference / Q000379:methods; D009369:Neoplasms / Q000175:diagnosis* / Q000473:pathology; D013057:Spectrum Analysis / Q000379:methods