Objective: For tumor resections, margin status typically correlates with patient survival but positive margin rates are generally high (up to 45% for head and neck cancer). Frozen section analysis (FSA) is often used to intraoperatively assess the margins of excised tissue, but suffers from severe under-sampling of the actual margin surface, inferior image quality, slow turnaround, and tissue destructiveness.

Methods: Here, we have developed an imaging workflow to generate en face histologic images of freshly excised surgical margin surfaces based on open-top light-sheet (OTLS) microscopy. Key innovations include (1) the ability to generate false-colored H&E-mimicking images of tissue surfaces stained for < 1 min with a single fluorophore, (2) rapid OTLS surface imaging at a rate of 15 min/cm followed by real-time post-processing of datasets within RAM at a rate of 5 min/cm, and (3) rapid digital surface extraction to account for topological irregularities at the tissue surface.

Results: In addition to the performance metrics listed above, we show that the image quality generated by our rapid surface-histology method approaches that of gold-standard archival histology.

Conclusion: OTLS microscopy has the feasibility to provide intraoperative guidance of surgical oncology procedures.

Significance: The reported methods can potentially improve tumor-resection procedures, thereby improving patient outcomes and quality of life.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10324671PMC
http://dx.doi.org/10.1109/TBME.2023.3237267DOI Listing

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