Optical Biopsy in Oncology: The Promise of Macroscopic Fluorescence Lifetime Imaging
Marina V. Shirmanova1, Daria A. Sachkova1, Anton A. Plekhanov1, Varvara V. Dudenkova1, Ilya D. Shchechkin1, Anastasia D. Komarova1, Snezhana D. Sinyushkina1, Arseniy L. Potapov1, Elena B. Kiseleva1, Konstantin S. Yashin1, Artem S. Grishin1, Evgeny A. Shirshin2, Alexey Yu. Vorontsov3, Sergey V. Gamayunov3, Vladislav I. Shcheslavskiy1
1Privolzhsky Research Medical University; Nizhny Novgorod, Russia
2Lomonosov Moscow State University; Moscow, Russia
3Nizhny Novgorod Regional Oncologic Hospital; Nizhny Novgorod, Russia
Abstract
Accurate intraoperative tissue characterization remains a critical challenge in oncology.
Macroscopic fluorescence lifetime imaging (macro-FLIM) enables rapid, label-free imaging of whole surgical specimens, including lymph nodes, without tissue processing or contrast agent administration.
In this presentation we review the physical principles of macro-FLIM system, demonstrate its application in discriminating tumor from normal tissues, and discuss the critical advantages and challenges of translating this technology into clinical practice.
We demonstrate that in gliomas FLIM in the NAD(P)H spectral channel effectively discriminates between tumor tissue and normal white and gray matter, enabling precise delineation of infiltration margins. Our study reports high diagnostic performance, with sensitivity and specificity reaching 92% and 85%, respectively, for detecting glioblastoma, the most aggressive brain tumor.
For breast cancer metastases, our preliminary experiments on a mouse model using two-photon fluorescence microscopy of NAD(P)H, revealed distinct metabolic signatures between metastatic lesions and lymphoid tissue at the cellular level. In patients samples, macro-FLIM evaluates breast cancer metastases in sentinel lymph nodes by sequential measuring autofluorescence of NAD(P)H and flavins. We found that diagnostic accuracy >88% can be achieved with macro-FLIM.
Collectively, these applications highlight macroscopic FLIM as a promising optical biopsy tool for real-time surgical guidance.
The study was supported by the RSF grant № 25-14-00313.
Speaker
Marina Shirmanova
Privolzhsky Research Medical University
Russia
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