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© College of American Pathologists

Sandra Camelo-Piragua, MD October 29, 2019

Stimulating Raman Histology

A novel technology to image

fresh tissues in real-time


Sandra Camelo-Piragua, MD

• Clinical Associate

Professor of Pathology

at the University of

Michigan

• Specializes in

neuropathology with a

clinical practice in

surgical and autopsy

neuropathology

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Disclaimer

• The CAP does not permit reproduction of any substantial

portion of the material in this Webinar without its written

authorization. The CAP hereby authorizes attendees of the

CAP Webinar to use the PDF presentation solely for

educational purposes within their own institutions. The CAP

prohibits use of the material in the Webinar – and any

unauthorized use of the CAP’s name or logo – in connection

with promotional efforts by marketers of laboratory

equipment, reagents, materials, or services.

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Disclaimer

• Opinions expressed by the speaker are the speaker’s own

and do not necessarily reflect an endorsement by the CAP of

any organizations, equipment, reagents, materials, or

services used by participating laboratories.

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• I have no conflicts of interests related to this

presentation.

Disclosures

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Objectives:

1. Understand the principles of stimulating Raman

scattering microcopy

2. Compare and contrast the images acquired in

stimulated Raman Histology versus standard HE

3. Discuss the current and potential future applications

of this technology in surgical pathology

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Stimulated Raman Scattering (SRS)

Microscopy

LIPID

PROT/DNA

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In-vivo SRS Mouse Brain Tumor Imaging

500mm 500mm

Ji et al Sci Trans Med 2013

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SRS Mouse Neuroanatomy and Tumors

Ji et al Sci Trans Med 2013

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Stimulated Raman Histology (SRH)

Orringer, et al. Nature Biomedical

Engineering 1,0027 (2017)

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SRS Evolution

Harvard Medical School

Professor Xie

V1 University of

Michigan V2 University of

Michigan

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SRH: Normal Cortex



100um

Conventional H&E (CHE): Normal Cortex

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100um

SRH: Gliosis



CHE: Gliosis

Frozen GFAP

Smear

Frozen

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SRH: Macrophages



100um

CHE: Macrophages

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Diffuse Infiltrating Astrocytoma, WHO grade II

Frozen FFPESRH

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Oligodendroglioma, WHO grade II

CHE: Frozen Section SRH CHE: FFPE

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SRH: Glioblastoma, WHO grade IV

Hypercellularity Nuclear atypia

Mitosis

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Microvascular Proliferation Necrosis

SRH: Glioblastoma, WHO grade IV

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Pilocytic Astrocytoma, WHO grade I

Frozen Section SRH Rosenthal Fibers

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Ependymoma, WHO grade II

Frozen Section SRH

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SRH: Meningioma, WHO grade I

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SRH

Medulloblastoma,

WHO grade IV

Lymphoma Metastatic carcinoma

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Frozen SRH

Chordoma

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Germinoma

Prominent nucleoliMixed population

Smear Frozen

CHESRH

F

F

P

E

SRH CHE

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Is SRH imaged tissue suitable for standard

histopathologic analysis?

GFAP

Ki67 ATRX

IDH1

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Concordance

Lesional vs.

Non-Lesional

Glial vs.

Non-GlialDiagnosis



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Workflow: Conventional Histology vs SRH

Time: 2 minutes in a 3 x 3 mm

piece of tissue27


SRH PACS integration

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SRH Cloud Based System

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SRH Cloud Based System

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AI using SRH images to predict diagnosis

AI: CNN

Image

Acquisition Image Processing

Image Prediction

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Multiclass Confusion Matrices

Diagnostic

accuracy: CH:95.8% vs. SRH+CNN: 93%

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t-SNE plot of internal CNN feature

representations SRH+CNN

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Applications in Surgical Pathology

• Fast imaging of fresh, unable, unfrozen,

unprocessed tissue for small specimens.

• SRH images resemble conventional histology

• Tissue used for SRH is suitable for standard

histopathologic examination

• Can be used to screen and select tissue for banking,

molecular testing and research

• Imaging can be integrated in PACS or in the future

Access in a cloud for consultation by experts

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Limitations and Future Applications

• Requires a specific instrument not yet widely available

• Larger specimens (>3 x 3x 3 mm) require longer image

acquisition time

• As any new testing modality, pathologists need to get familiar

with imaging characteristics

• Additional non-CNS tissue imaging is in progress and will

determine utility in other areas of pathology (e.g. cytology,

renal, transplants, head and neck, etc.)

• AI algorithms can be used in the future to guide pathologists

that lack on-site expertise in certain areas.

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Stimulating Raman Histology

Sandra

Camelo-Piragua, MD

Associate Professor of

Pathology

[email protected]

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mailto:[email protected]


IVM Resources at CAP

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The CAP In Vivo Microscopy Resource Guide – see handout

• The IVM resource guide highlights current IVM articles and

other resources that assist in understanding and potentially

adopting IVM and EVM

o Printed guides are available for members ($39) and non-members ($69)

o The digital copies of all four Resource Guides are a complimentary member

benefit

o Access them www.cap.org > Resources and Publications

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http://www.cap.org/


IVM Short Presentations on Emerging

Concepts (SPECs) – see handout

• IVM SPECs are:o Short PowerPoints, created for

pathologists

o Useful for educating colleagues about

IVM and GI specialist on the role and

value of pathologists in IVM

• IVM SPEC Topics: o In Vivo Microscopy (IVM): A New Role for

Pathologists

o IVM of the GI Tract

o Ex Vivo Microscopy (EVM): A New Tool

for Pathologists

o Access them www.cap.org > Resources

and Publications

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http://www.cap.org/


IVM Topic Center Page on CAP.ORG

• Check the IVM Topic Center for continued updates and for all your IVM resources

www.cap.org > Search for “IVM Topic Center”

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THANK YOU!

Thank you for attending our webinar “Stimulating Raman Histology: A

novel technology to image fresh tissues in real-time.” by Sandra

Camelo-Piragua, MD

For comments about this webinar or suggestions for upcoming webinars, contact [email protected]

NOTE: There is no CME/CE credit available for today’s complimentary webinar. The pdf of the presentation will

be sent out in about 1 week.

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mailto:[email protected]

stimulating raman histology · camelo-piragua, md for comments about this webinar or suggestions...

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