title: Multiphoton microscopy for structure identification in human prostate and periprostatic tissue: implications in prostate cancer surgery.
abstract: OBJECTIVE
  • To test whether multiphoton microscopy (MPM) might allow identification of prostatic and periprostatic structures with magnification and resolution similar to gold standard histopathology.
  
  
  METHODS
  • The present study included 95 robotic radical prostatectomy patients who consented to participate in an Institutional Review Board-approved study starting in 2007. • The types of specimens used for imaging were excised surgical margins and biopsies, and sections obtained from the excised prostate. • The specimens were imaged with a custom-built MPM system. • All images were compared with haematoxylin/eosin histopathology of the same specimen.
  
  
  RESULTS
  • MPM of freshly excised, unprocessed and unstained tissue can identify all relevant prostatic and periprostatic structures, such as nerves, blood vessels, capsule, underlying acini and also pathological changes, including prostate cancer. • Histological confirmation and correlation of these structures and pathologies have validated the findings of MPM.
  
  
  CONCLUSIONS
  • MPM shows great promise as a tool for real-time intra-surgical histopathology without needing excision or administration of contrast agents. • The results will, however, need to be confirmed in true surgical settings using a miniaturized MPM microendoscope.
authors: Lefrak Center of Robotic Surgery and Prostate Cancer Institute, James Buchanan Brady Foundation, Weill Cornell Medical College, New York, USA. smukherj@med.cornell.edu
authors: Ashutosh K
authors: AK
authors: Tewari
authors: Maria M
authors: MM
authors: Shevchuk
authors: Joshua
authors: J
authors: Sterling
authors: Sonal
authors: S
authors: Grover
authors: Michael
authors: M
authors: Herman
authors: Rajiv
authors: R
authors: Yadav
authors: Kumaran
authors: K
authors: Mudalair
authors: Abhishek
authors: A
authors: Srivastava
authors: Mark A
authors: MA
authors: Rubin
authors: Warren R
authors: WR
authors: Zipfel
authors: Frederick R
authors: FR
authors: Maxfield
authors: Chris
authors: C
authors: Xu
authors: Watt W
authors: WW
authors: Webb
authors: Sushmita
authors: S
authors: Mukherjee
mesh_terms: D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D036641:Microscopy, Fluorescence, Multiphoton / Q000379:methods*; D011446:Prospective Studies; D011467:Prostate / Q000294:innervation / Q000473:pathology* / Q000601:surgery; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D015203:Reproducibility of Results