wetenschapsdag 2023 | 75 Sessie 2c: Laat Me, opereren! x5 Auteurs S.D. Kok, P.M. Rodriguez Schaap, L. van Dommelen, L.M.G. van Huizen, C. Dickhoff, E.J.M. Nieveen-van Dijkum, A.F. Engelsman, P. van der Valk, M. L. Groot Abstract titel Validation of third and second harmonic generation microscopy for the assessment of fresh thyroid tissue Background During thyroid surgery fast and reliable intra-operative pathological feedback has the potential to avoid a two-stage procedure and significantly reduce morbidity and health care costs in patients undergoing a diagnostic hemithyroidectomy (HT). However, current techniques often fail to provide reliable results within the operation time. The use of Higher Harmonic Generation Microscopy (HHGM) provides a potential solution to this problem. HHGM combines third harmonic generation (THG), second harmonic generation (SHG) and multiphoton excited autofluorescence (MPEF). Methods In this study, a compact, portable microscope was used to record images of freshly excised healthy thyroid-tissue: benign nodules (follicular adenoma) and malignant tissue (papillary carcinoma, follicular carcinoma and spindle cell carcinoma). The THG/SHG/MPEF images were generated within a few minutes and were compared with the images from frozen section analysis and standard histology. Results The THG/SHG/MPEF images show relevant morphological thyroid structures in good accordance with the histology images. The thyroid follicle architecture, cells, cell nuclei (THG), collagen organization (SHG) and the distribution of thyroglobulin and/or thyroid hormones T3 or T4 (MPEF) could be visualized. Conclusion We conclude that THG/SHG/MPEF imaging is a promising tool for clinical intraoperative assessment of thyroid tissue. More patients need to be included, to assess the feasibility of HHGM to determine essential features for intra-operative thyroid cancer diagnosis such as capsular or vascular invasion.
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