Peritoneal carcinomatosis is metastatic stage aggravating digestive, gynecological or bladder cancer dissemination and
the preoperative evaluation of lesions remains difficult. There is therefore a need for minimal invasive innovative
techniques to establish a precise preoperative assessment of cancer peritoneal cavity. Probe-based confocal laser
endomicroscopy (pCLE) provides dynamic images of the microarchitecture of tissues during an endoscopy. The
PERSEE project proposes new developments in robotics and pCLE for the exploration of the peritoneal cavity during
Two fluorescent dyes, Patent blue V and Indocyanine green have been evaluated on human ex vivo samples to improve
the contrast of pCLE images. For a future implementation in clinical study, two topically staining protocols operable in
vivo have been validated on 70 specimens from 25 patients with a peritoneal carcinomatosis. The specimens were then
imaged by pCLE with an optical probe designed for the application. A histo-morphological correlative study was
performed on 350 pCLE images and 70 standard histological preparations. All images were interpreted in a random way
by two pathologists.
Differential histological diagnostics such as normal peritoneum or pseudomyxoma could be recognized on fluorescence
images. The statistical analysis of the correlative study is underway. These dyes already approved for human use are
interesting for pCLE imaging because some micromorphological criteria look like to conventional histology and are
readable by pathologist. Thus pCLE images using both dyes do not require a specific semiology unlike to what is
described in the literature, for pCLE associated with fluorescein for the in vivo imaging of pancreatic cysts.
Full-Field OCT (FFOCT) produces optical slices of tissue using white light interferometry providing in-depth 2D images, with an isotropic resolution around 1 micrometer. These optical biopsy images are similar to those obtained with established histological procedures, but without tissue preparation and within few minutes. This technology could be useful when diagnosing a lesion or at the time of its surgical management. <p> </p> Here we evaluate the clinical value of FFOCT imaging in the management of patients with Head and Neck cancers by assessing the accuracy of the diagnosis done on FFOCT images from resected specimen. <p> </p> FFOCT images from Head and Neck samples were first compared to the gold standard (HES-conventional histology). An image atlas dedicated to the training of pathologists was built and diagnosis criteria were identified. <p> </p>Then, we performed a morphological correlative study: both healthy and cancerous samples from patients who undergo Head and Neck surgery of oral cavity, pharynx, and larynx were imaged. Images were interpreted in a random way by two pathologists and the FFOCT based diagnostics were compared with HES (gold standard) of the same samples. <p> </p> Here we present preliminary results showing that FFOCT provides a quick assessment of tissue architecture at microscopic level that could guide surgeons for tumor margin delineation during intraoperative procedure.
Here we evaluate the clinical value of Full-Field OCT imaging in the management of patients with Head and Neck
cancers by making a reliable histological diagnosis on FFOCT images produced during preoperative procedure. FFOCT
performs a true "virtual extemporaneous exam" that we want to compare to the gold standard (extemporaneous and
conventional histology with H and E staining). This new optical technology could be useful when diagnosing a lesion,
cancerous or precancerous, or at the time of its surgical management.
Full-Field Optical Coherence Tomography virtually slices the tissue using white light interferometry to produce in-depth
2D images with an isotropic resolution around 1 micrometer. With such a high resolution FFOCT systems produce
”optical biopsy” images that are similar to that obtained with classical histology procedures, but without any staining and
in only a few minutes.
We imaged freshly excised samples from patients, of mouth, tongue, epiglottis and larynx tissues, both healthy and
cancerous. FFOCT images were acquired and later compared with histology of the same samples. Common features
were identified and characteristics of each tissue type were matched in order to form an image atlas for pathologist
training. We were able to identify indicators of tumors such as heterogeneities in cell distribution, surrounding stroma,
In conclusion, FFOCT is a fast, non-invasive, non-destructive imaging tool that can be inserted into the pathology lab
workflow and can provide a quick assessment of microscopic tissue architecture and content. Furthermore we are
developing a similar system with a rigid endoscopic probe in order to do in vivo and in situ high-resolution imaging. Our
probe could thus guide the surgeon in real time before and during excision and ensure a more precise gesture.