Biopsy (biopsy) a thing of the past

The MediSCAPE, a high-speed 3D microscope designed by Columbia University engineers, can observe cellular details in living tissue in real time to guide surgery, speed up tissue analysis, and improve treatment

A Columbia University engineering team has developed a technique that can replace traditional biopsies and histology with live imaging in vivo

For many medical procedures, especially cancer surgery and screening, doctors often take biopsies, which are small pieces of tissue removed so that they can be viewed more closely with a microscope

Hillman's team envisioned a bold alternative, wondering if it was possible to capture images of tissue while it was still in the body

Another major benefit of this approach is that removing tissue, just to figure out what it is, can be a difficult decision for doctors, especially for precious tissue such as the brain, spinal cord, nerves, eyes, and facial areas

While there are already some microscopes for surgical guidance, they can only provide doctors with a small, single 2D plane image, making it difficult to quickly examine larger areas of tissue and interpret results

For the past decade, Hillman, who is also the Herbert and Florence Owen Professor at Columbia University's Zuckerman Institute for Brain Behavior, has been developing new microscopes for neuroscience research that can capture Very fast 3D images of living samples, such as small bugs, fish, and fly by to see how the neurons of their brains and bodies are activated as they move

"One of the first tissues we looked at was fresh mouse kidneys, and we were shocked to see gorgeous structures that were very similar to standard histology," said Kripa Patel, who recently learned from The Hill A graduate of the Hillman lab, he is the lead author of the study

As she "walks around," Patel can even stitch the acquired volumes together and turn the data into a large 3D representation of the tissue that a pathologist can examine like a box of tissue slides

"It's something I didn't expect -- I could actually see 3D structures from different perspectives," said collaborator Shanna Corley, PhD, a renal pathologist at Columbia University Medical Center who worked closely on the study.

The team demonstrated MediSCAPE's capabilities for a wide range of applications, from the analysis of pancreatic cancer in mice to Coley's interest in non-destructive, rapid evaluation of transplanted organs in humans, such as kidneys

The team also realized that by imaging living tissue, they could gain more information than they could from lifeless excised biopsies

"It's really important to understand whether the tissue stays healthy and gets a good blood supply during surgery," Hillman said

A critical final step for the team was to shrink the large size of the standard SCAPE microscope in Hillman's lab to a size that could fit in an operating room and be used by surgeons in the human body
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Postdoctoral researcher Wenxuan Liang worked with the team to develop a smaller version of the system with a better form factor, and a sterile imaging cap
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Doctoral student Malte Casper helped obtain the team's first demonstration of MediSCAPE in humans, collecting images of a series of tissues and mouths
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These results included rapid imaging as the volunteer licked the end of the imaging probe, producing a detailed 3D view of the tongue papilla
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The team is eager to take the technology to the next level with larger clinical trials, and is currently working on commercialization and FDA approval
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Hillman added: "Every time we used MediSCAPE on a new tissue, it was amazing to see what it revealed, especially since we didn't even need to add dyes or staining to see the disease.
Structures that physicists can recognize
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Hillman and her team hope that MediSCAPE will make standard histology a thing of the past, putting the power of real-time histology and decision-making in the hands of surgeons
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article title

High-speed light-sheet microscopy for the in-situ acquisition of volumetric histological images of living tissue