Fast intraoperative histology-based diagnosis of gliomas with third harmonic generation microscopy and deep learning.

Journal: Scientific reports
Published Date:

Abstract

Management of gliomas requires an invasive treatment strategy, including extensive surgical resection. The objective of the neurosurgeon is to maximize tumor removal while preserving healthy brain tissue. However, the lack of a clear tumor boundary hampers the neurosurgeon's ability to accurately detect and resect infiltrating tumor tissue. Nonlinear multiphoton microscopy, in particular higher harmonic generation, enables label-free imaging of excised brain tissue, revealing histological hallmarks within seconds. Here, we demonstrate a real-time deep learning-based pipeline for automated glioma image analysis, matching video-rate image acquisition. We used a custom noise detection scheme, and a fully-convolutional classification network, to achieve on average 79% binary accuracy, 0.77 AUC and 0.83 mean average precision compared to the consensus of three pathologists, on a preliminary dataset. We conclude that the combination of real-time imaging and image analysis shows great potential for intraoperative assessment of brain tissue during tumor surgery.

Authors

  • Max Blokker
    Department of Physics and Astronomy, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. m.blokker@vu.nl.
  • Philip C de Witt Hamer
    Department of Neurosurgery, Amsterdam UMC location VU University Medical Center, Amsterdam, The Netherlands.
  • Pieter Wesseling
    Department of Pathology, VU University Medical Center, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, VU University Medical Center, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands; Department of Pathology, Princess Máxima Center for Pediatric Oncology and University Medical Center Utrecht, Lundlaan 6, 3584 EA Utrecht, the Netherlands.
  • Marie Louise Groot
    Department of Physics and Astronomy, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Mitko Veta
    Medical Image Analysis Group, Eindhoven University of Technology, Eindhoven, the Netherlands.