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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Integration of Stimulated Raman Histology (SRH) into intraoperative neuropathology in neurosurgery

Einbindung der stimulierten Raman-Histologie in die intraoperative neuropathologische Gewebeuntersuchung in der Neurochirurgie

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  • presenting/speaker Nicolas Neidert - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Jakob Straehle - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Daniel Erny - Universitätsklinikum Freiburg, Institut für Neuropathologie, Freiburg i. Br., Deutschland
  • Vlad Sacalean - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Amir El Rahal - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • David Steybe - Universitätsklinikum Freiburg, Klinik für Mund-, Kiefer- und Plastische Gesichtschirurgie, Freiburg i. Br., Deutschland
  • Rainer Schmelzeisen - Universitätsklinikum Freiburg, Klinik für Mund-, Kiefer- und Plastische Gesichtschirurgie, Freiburg i. Br., Deutschland
  • Andreas Vlachos - Medizinische Fakultät Albert-Ludwigs-Universität, Institut für Anatomie und Zellbiologie, Freiburg i. Br., Deutschland
  • Peter Christoph Reinacher - Universitätsklinikum Freiburg, Abteilung für Stereotaktische und Funktionelle Neurochirurgie, Freiburg i. Br., Deutschland; Fraunhofer Institut für Lasertechnik (ILT), Aachen, Deutschland
  • Volker Arnd Coenen - Universitätsklinikum Freiburg, Abteilung für Stereotaktische und Funktionelle Neurochirurgie, Freiburg i. Br., Deutschland
  • Boris Mizaikoff - Universität Ulm, Institut für Analytische und Bioanalytische Chemie, Ulm, Deutschland
  • Dieter Henrik Heiland - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Marco Prinz - Universitätsklinikum Freiburg, Institut für Neuropathologie, Freiburg i. Br., Deutschland
  • Jürgen Beck - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Oliver Schnell - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV086

doi: 10.3205/22dgnc089, urn:nbn:de:0183-22dgnc0893

Published: May 25, 2022

© 2022 Neidert et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Histopathological assessment is the gold standard in diagnostics and classification of neurooncological entities. Raman-based intraoperative tissue analysis has been reported to be fast and valuable. Here, we report our experience in implementing Stimulated Raman Histology (SRH) in a major neurosurgical center. Furthermore, we compared the neuropathological interpretability of SRH imaging to standard-of-care intraoperative hematoxylin–eosin (H&E)-staining.

Methods: We evaluated the possibility of establishing a dedicated workflow for SRH serving as an intraoperative diagnostic, research and quality control tool in neurosurgery. In total, 429 SRH-images from 108 patients were analysed. A SRH-naive board-certified neuropathologist evaluated image quality by rating the subjective tumor infiltration and providing a diagnosis based on the SRH images in 73 neurooncological cases. The accuracy of these diagnoses was compared to intraoperative H&E-stainings and related to the gold standard of the final integrated neuropathological diagnoses.

Results: The Raman imaging system was rapidly integrated into the surgical workflow of a large neurosurgical center with a steep learning curve. High-quality images could be acquired in a “plug-and-play” manner from the first days onwards. In order to establish a workflow for high-throughput SRH image acquisition and analysis, certain prerequisites were described. The accuracy of SRH-based diagnosis was 87.3%, which was en par (p = 0.783) to the assessment of standard of care H&E-stainings (88.9%) in our study.

Conclusion: Stimulated Raman Histology (SRH) is an innovative label-free and near real-time intraoperative tool for tissue analysis in neurosurgery. It can be easily implemented in the surgical workflow. Neuropathological assessment of SRH imaging is non-inferior to standard-of-care intraoperative fast-frozen H&E-staining. However, further research is required to modify SRH image analysis in order to obtain information about alterations of the genome, methylome, transcriptome and proteome. This may lead to an intraoperative SRH-based prediction of prognosis and therapy response.