{"id":534962,"date":"2022-09-27T12:46:22","date_gmt":"2022-09-27T16:46:22","guid":{"rendered":"https:\/\/www.rochester.edu\/newscenter\/?p=534962"},"modified":"2026-03-04T09:20:53","modified_gmt":"2026-03-04T14:20:53","slug":"near-instant-biopsy-results-from-novel-imaging-system-534962","status":"publish","type":"post","link":"https:\/\/www.rochester.edu\/newscenter\/near-instant-biopsy-results-from-novel-imaging-system-534962\/","title":{"rendered":"Novel imaging system could mean near-instant biopsy results"},"content":{"rendered":"

Biopsies have been performed the same way since the 19th century, but new technology could enable point-of-care skin cancer diagnosis.<\/h2>\n

Medicine has advanced dramatically during the last century. But when it comes to getting biopsy results, very little has changed. Consider, for example, what happens when a patient comes in to have a skin lesion biopsied for nonmelanoma skin cancer.<\/p>\n

\u201cThe surgeon will take a little piece of the skin out,\u201d says Michael Giacomelli<\/a>, an assistant professor of biomedical engineering and of optics at the Ä¢¹½´«Ã½<\/a>. Next, \u201csomeone in pathology will look at it under a microscope. And then, depending on what they find, the patient is notified that everything\u2019s fine, don\u2019t worry about it, or we need you to come back for a second appointment so we can treat you.\u201d<\/p>\n

Giacomelli, who is also\u00a0on the research faculty at the University\u2019s Wilmot Cancer Institute<\/a>\u00a0is developing a novel imaging system, contained on a portable cart, to shorten this process to two minutes. This would enable a surgeon to immediately determine whether the lesion is cancerous and, if so, to \u201ctreat the patient during the same visit instead of stretching it out over the next month and multiple visits.\u201d<\/p>\n

The system\u2014using two-photon fluorescence microscopy (TPFM)\u2014demonstrated remarkable accuracy in a pilot study summarized recently in JAMA Dermatology<\/em><\/a>. When tested on 15 biopsies of known nonmelanoma skin cancer, the technology was able to detect basal cell carcinoma with perfect accuracy (100 percent sensitivity and specificity) and squamous cell carcinoma with high accuracy (89 percent sensitivity and 100 percent specificity).<\/p>\n

Nonmelanoma skin cancer is the most common type of human cancer, with more cases annually than all other types of cancer combined in the United States. Eighty percent of nonmelanoma skin cancers are basal cell carcinoma.<\/p>\n

Applications in \u2018all sorts of scenarios\u2019<\/strong><\/h3>\n

Typically biopsied tissue is excised, fixed, paraffinized<\/a> (preserved), stained, and mounted on slides before being evaluated by a dermatopathologist. \u201cThis is how it has been done since the late 19th century,\u201d Giacomelli says. \u201cBillions and billions of biopsies have been done this way. Everybody is on the same page; it works great. The problem is that it is very slow.\u201d<\/p>\n

Giacomelli is now working closely with associate professor of dermatology Sherrif Ibrahim on a 200-patient follow-up study of the imaging system.<\/div>\n

Even when tissue is quickly frozen for quicker analysis, surgeons can wait an hour or more for the biopsy results to be sure they have completely removed a malignant tumor from a patient still on the operating table. This ties up the surgeon\u2019s time and the operating room, while interrupting the workflow in busy pathology departments.<\/p>\n

Giacomelli sees potential applications for his system in quickly providing biopsy results for all kinds of diseases. \u201cThere are all sorts of scenarios,\u201d he says.<\/p>\n

For example, \u201cin prostate cases, surgeons often have a very poor idea what they\u2019re getting into based on just an X-ray or MRI image beforehand,\u201d Giacomelli says. \u201cYou see random cases where they take out the prostate, and sometimes there\u2019s an obvious tumor that has spread beyond the prostate, or other times it is very localized. This technology offers a possibility to adjust the patient\u2019s therapy on the fly.\u201d<\/p>\n

The advantage of using TPFM is that it not only generates high-resolution images but it also uses near-infrared light that penetrates deeper through tissue, making it \u201cadvantageous for rapid imaging of fresh, irregularly shaped biopsies with minimal preparation,\u201d the paper notes.<\/p>\n

Giacomelli is now working closely with Sherrif Ibrahim<\/a>, an associate professor of dermatology at the University\u2019s Medical Center, on a larger, 200-patient follow up study, using biopsy samples taken at random at Ibrahim\u2019s Rochester Dermatological Surgery in nearby Victor, New York.<\/p>\n

\u201cThe goal is to analyze how well the technique works in a real-world scenario, where you have a lot people coming in and all kinds of things can show up,\u201d Giacomelli says. \u201cWe really want to make sure that there isn\u2019t some bizarre thing that normally has nothing to do with cancer that we somehow confuse with cancer\u2014or something that does have something to do with cancer but we can\u2019t image. You never know what you\u2019re going to find once you start taking random biopsies of people.<\/p>\n

Using TPFM imaging to guide surgeries?<\/strong><\/h3>\n

Giacomelli has also embarked on a parallel study to see if a novel system he has developed incorporating TPFM and video can be used to guide surgeries.<\/p>\n

The system overlays TPFM images of the site where tissue is being removed on a webcam image, co-registering what it looks like to the eye with what it would look like processed on a slide. \u201cYou can show what the excised tissue looks like, and how much of the tumor is located on the excision,\u201d Giacomelli says. \u201cThey can then map that back into the wound that they are creating in order to decide which side to cut.\u201d<\/p>\n

In addition to Ibrahim, other coauthors of the JAMA Dermatology<\/em> study include Vincent Ching-Roa and Chi Huang, graduate students in Giacomelli\u2019s lab, and Bruce Smoller, professor of pathology and laboratory medicine.<\/p>\n

The National Institutes of Health funded the project.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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