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Proceedings Paper

Feasibility of structured illumination fluorescence microscopy of liver biopsies for transplant evaluation (Conference Presentation)
Author(s): David B. Tulman; Mei Wang; Kate Elfer; Samuel Luethy; Carly Askinas; Daniel Mena; Andrew Sholl; Ari Cohen; Jonathon Q. Brown; Gretchen Galliano M.D.

Paper Abstract

Increased utilization of transplantation as treatment for patients with end-stage hepatic disease has resulted in a shortfall of available livers. Efforts to expand the available donor pool have resulted in the inclusion of donors who might not have been considered in the past. This has resulted in more requests for frozen section biopsy evaluation of the liver from "marginal" donors with significant co-morbidities. The information gained from the biopsy analysis determines whether the organ is suitable for transplantation. Critical to determining the adequacy of donor livers is analyzing the lipid content for macrosteatosis; high lipid livers are not suitable for transplant. Frozen section analysis (FSA) creates artifacts that limit tissue evaluation, exhausts tissue for downstream histological analysis, and requires a specialized team to evaluate these procedures in the hospital 24/7. We have developed a fluorescence microscopy system that utilizes structured illumination (SIM) to produce images of liver biopsies within seconds of removal from a deceased organ donor. Liver biopsies that require evaluation for donation suitability are stained with fast-acting fluorescent histology dyes and lipid specific stains in order to differentiate the lipids on SIM. The SIM images are compared to the standard-of-care FSA and the final pathology report. Here, we present the results of this blinded review performed by a liver pathology specialist. Imaging liver biopsies with SIM provides a more direct and accurate tool for determining macrosteatosis compared to standard FSA. SIM offers minimal tissue processing complexity and remote viewing capabilities, creating the potential to revolutionize tissue donation evaluation.

Paper Details

Date Published: 5 April 2018
Proc. SPIE 10484, Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XVI, 1048406 (5 April 2018); doi: 10.1117/12.2290824
Show Author Affiliations
David B. Tulman, Tulane Univ. (United States)
Mei Wang, Tulane Univ. (United States)
Kate Elfer, Tulane Univ. (United States)
Samuel Luethy, Tulane Univ. (United States)
Carly Askinas, Tulane Univ. (United States)
Daniel Mena, Tulane Univ. (United States)
Andrew Sholl, Tulane Univ. (United States)
Ari Cohen, Ochsner Health System (United States)
Jonathon Q. Brown, Tulane Univ. (United States)
Gretchen Galliano M.D., Cedars-Sinai Medical Ctr. (United States)

Published in SPIE Proceedings Vol. 10484:
Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XVI
Tuan Vo-Dinh; Anita Mahadevan-Jansen; Warren S. Grundfest M.D., Editor(s)

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