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© College of American Pathologists
Sandra Camelo-Piragua, MD October 29, 2019
Stimulating Raman Histology
A novel technology to image
fresh tissues in real-time
© College of American Pathologists
Sandra Camelo-Piragua, MD
• Clinical Associate
Professor of Pathology
at the University of
Michigan
• Specializes in
neuropathology with a
clinical practice in
surgical and autopsy
neuropathology
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© College of American Pathologists
Disclaimer
• The CAP does not permit reproduction of any substantial
portion of the material in this Webinar without its written
authorization. The CAP hereby authorizes attendees of the
CAP Webinar to use the PDF presentation solely for
educational purposes within their own institutions. The CAP
prohibits use of the material in the Webinar – and any
unauthorized use of the CAP’s name or logo – in connection
with promotional efforts by marketers of laboratory
equipment, reagents, materials, or services.
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© College of American Pathologists
Disclaimer
• Opinions expressed by the speaker are the speaker’s own
and do not necessarily reflect an endorsement by the CAP of
any organizations, equipment, reagents, materials, or
services used by participating laboratories.
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© College of American Pathologists
• I have no conflicts of interests related to this
presentation.
Disclosures
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© College of American Pathologists
Objectives:
1. Understand the principles of stimulating Raman
scattering microcopy
2. Compare and contrast the images acquired in
stimulated Raman Histology versus standard HE
3. Discuss the current and potential future applications
of this technology in surgical pathology
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© College of American Pathologists
Stimulated Raman Scattering (SRS)
Microscopy
LIPID
PROT/DNA
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© College of American Pathologists
In-vivo SRS Mouse Brain Tumor Imaging
500mm 500mm
Ji et al Sci Trans Med 2013
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© College of American Pathologists
SRS Mouse Neuroanatomy and Tumors
Ji et al Sci Trans Med 2013
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© College of American Pathologists
Stimulated Raman Histology (SRH)
Orringer, et al. Nature Biomedical
Engineering 1,0027 (2017)
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© College of American Pathologists
SRS Evolution
Harvard Medical School
Professor Xie
V1 University of
Michigan V2 University of
Michigan
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© College of American Pathologists
SRH: Normal Cortex
Orringer, et al. Nature Biomedical
Engineering 1,0027 (2017)
100um
Conventional H&E (CHE): Normal Cortex
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© College of American Pathologists
100um
SRH: Gliosis
Orringer, et al. Nature Biomedical
Engineering 1,0027 (2017)
CHE: Gliosis
Frozen GFAP
Smear
Frozen
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© College of American Pathologists
SRH: Macrophages
Orringer, et al. Nature Biomedical
Engineering 1,0027 (2017)
100um
CHE: Macrophages
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© College of American Pathologists
Diffuse Infiltrating Astrocytoma, WHO grade II
Frozen FFPESRH
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© College of American Pathologists
Oligodendroglioma, WHO grade II
CHE: Frozen Section SRH CHE: FFPE
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© College of American Pathologists
SRH: Glioblastoma, WHO grade IV
Hypercellularity Nuclear atypia
Mitosis
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© College of American Pathologists
Microvascular Proliferation Necrosis
SRH: Glioblastoma, WHO grade IV
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© College of American Pathologists
Pilocytic Astrocytoma, WHO grade I
Frozen Section SRH Rosenthal Fibers
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© College of American Pathologists
Ependymoma, WHO grade II
Frozen Section SRH
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© College of American Pathologists
SRH: Meningioma, WHO grade I
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© College of American Pathologists
SRH
Medulloblastoma,
WHO grade IV
Lymphoma Metastatic carcinoma
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© College of American Pathologists
Frozen SRH
Chordoma
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© College of American Pathologists
Germinoma
Prominent nucleoliMixed population
Smear Frozen
CHESRH
F
F
P
E
SRH CHE
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© College of American Pathologists
Is SRH imaged tissue suitable for standard
histopathologic analysis?
GFAP
Ki67 ATRX
IDH1
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© College of American Pathologists
Concordance
Lesional vs.
Non-Lesional
Glial vs.
Non-GlialDiagnosis
Orringer, et al. Nature Biomedical
Engineering 1,0027 (2017)
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© College of American Pathologists
Workflow: Conventional Histology vs SRH
Time: 2 minutes in a 3 x 3 mm
piece of tissue27
© College of American Pathologists
SRH PACS integration
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© College of American Pathologists
SRH Cloud Based System
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© College of American Pathologists
SRH Cloud Based System
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© College of American Pathologists
AI using SRH images to predict diagnosis
AI: CNN
Image
Acquisition Image Processing
Image Prediction
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© College of American Pathologists
Multiclass Confusion Matrices
Diagnostic
accuracy: CH:95.8% vs. SRH+CNN: 93%
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© College of American Pathologists
t-SNE plot of internal CNN feature
representations SRH+CNN
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© College of American Pathologists
Applications in Surgical Pathology
• Fast imaging of fresh, unable, unfrozen,
unprocessed tissue for small specimens.
• SRH images resemble conventional histology
• Tissue used for SRH is suitable for standard
histopathologic examination
• Can be used to screen and select tissue for banking,
molecular testing and research
• Imaging can be integrated in PACS or in the future
Access in a cloud for consultation by experts
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© College of American Pathologists
Limitations and Future Applications
• Requires a specific instrument not yet widely available
• Larger specimens (>3 x 3x 3 mm) require longer image
acquisition time
• As any new testing modality, pathologists need to get familiar
with imaging characteristics
• Additional non-CNS tissue imaging is in progress and will
determine utility in other areas of pathology (e.g. cytology,
renal, transplants, head and neck, etc.)
• AI algorithms can be used in the future to guide pathologists
that lack on-site expertise in certain areas.
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© College of American Pathologists
Stimulating Raman Histology
Sandra
Camelo-Piragua, MD
Associate Professor of
Pathology
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© College of American Pathologists
IVM Resources at CAP
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© College of American Pathologists
The CAP In Vivo Microscopy Resource Guide – see handout
• The IVM resource guide highlights current IVM articles and
other resources that assist in understanding and potentially
adopting IVM and EVM
o Printed guides are available for members ($39) and non-members ($69)
o The digital copies of all four Resource Guides are a complimentary member
benefit
o Access them www.cap.org > Resources and Publications
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© College of American Pathologists
IVM Short Presentations on Emerging
Concepts (SPECs) – see handout
• IVM SPECs are:o Short PowerPoints, created for
pathologists
o Useful for educating colleagues about
IVM and GI specialist on the role and
value of pathologists in IVM
• IVM SPEC Topics: o In Vivo Microscopy (IVM): A New Role for
Pathologists
o IVM of the GI Tract
o Ex Vivo Microscopy (EVM): A New Tool
for Pathologists
o Access them www.cap.org > Resources
and Publications
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© College of American Pathologists
IVM Topic Center Page on CAP.ORG
• Check the IVM Topic Center for continued updates and for all your IVM resources
www.cap.org > Search for “IVM Topic Center”
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© College of American Pathologists
THANK YOU!
Thank you for attending our webinar “Stimulating Raman Histology: A
novel technology to image fresh tissues in real-time.” by Sandra
Camelo-Piragua, MD
For comments about this webinar or suggestions for upcoming webinars, contact [email protected]
NOTE: There is no CME/CE credit available for today’s complimentary webinar. The pdf of the presentation will
be sent out in about 1 week.
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