Disclosure Dr. Richard Levenson is co-founder and CEO of MUSE - - PowerPoint PPT Presentation

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Disclosure Dr. Richard Levenson is co-founder and CEO of MUSE - - PowerPoint PPT Presentation

Feb 05, 2024 249 likes •885 views

MUSE (Microscopy with UV Surface Excitation) Amir Ghorbani-Aghbolaghi MD, Samuel Balin MD PhD, Tareq Mohammad MD, Yasmine Lahoubi MD Zachary T Harmany PhD, Austin Todd, Farzad Fereidouni PhD Richard M Levenson MD, Maxwell A Fung MD ASDP 54 th

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MUSE

(Microscopy with UV Surface Excitation)

Amir Ghorbani-Aghbolaghi MD, Samuel Balin MD PhD, Tareq Mohammad MD, Yasmine Lahoubi MD Zachary T Harmany PhD, Austin Todd, Farzad Fereidouni PhD Richard M Levenson MD, Maxwell A Fung MD ASDP 54th Annual Meeting, Baltimore, MD

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  • Disclosure

 Dr. Richard Levenson is co-founder and CEO of MUSE Microscopy Inc.  Remaining authors declare no conflicts of interest

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  • Pathology
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  • Pathology

 Conventional microscopy  Require traditional fixation, thin-sectioning and staining

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  • Pathology

 Conventional microscopy  Require traditional fixation, thin-sectioning and staining  Ex-vivo microscopy (Slide-free)  Rapid imaging of biopsy material

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SLIDE 6
  • Pathology

 Conventional microscopy  Require traditional fixation, thin-sectioning and staining  Ex-vivo microscopy (Slide-free)  Rapid imaging of biopsy material  In-Vivo microscopy (Biopsy-free)  Evaluation of human tissue microstructure in real time

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  • What is MUSE?

 A novel Ex-Vivo microscopy  Slide-free method developed at UC Davis  First in evaluating on human tissue  Microscopy with UV Surface Excitation (MUSE)  Using UV-emitting LED with wavelength of 275 to 285 nm  Digital camera captures the excitation light

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  • How MUSE works?

 Ultraviolet (UV) is an electromagnetic radiation  Wavelength: 10 nm to 400 nm (Shorter than visible light)

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SLIDE 9
  • How MUSE works?

 Ultraviolet (UV) is an electromagnetic radiation  Wavelength: 10 nm to 400 nm (Shorter than visible light)  The light penetration depth is depends on the wavelength

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SLIDE 10
  • How MUSE works?

 Ultraviolet (UV) is an electromagnetic radiation  Wavelength: 10 nm to 400 nm (Shorter than visible light)  The light penetration depth is depends on the wavelength  275 to 285 nm UV light has penetrate depth of 3 microns  Approximately the thickness of a conventional tissue section

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SLIDE 11
  • How MUSE works?

 UV light can excite dyes or endogenous auto-florescent materials  The emission light varies from blue to red

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SLIDE 12
  • How MUSE works?

 UV light can excite dyes or endogenous auto-florescent materials  The emission light varies from blue to red  A digital camera can capture the emitted lights  3 microns thickness from the surface of the specimen  The images must be similar to H&E but in full color

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  • MUSE setup:
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  • MUSE setup:

 Prepare flat tissue surface  Staining (50 sec total)  Rhodamine B,  Hoechst 33342  Eosin  Propidium iodide  Capture images

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SLIDE 15

Normal Histology

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Normal Histology

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Normal Histology

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  • MUSE: Diagnostic value

30 selected cases

Epidermal Lesions Melanocytic Lesions Pilar & Sebaceous Cysts Elastin

1 Verruca Vulgaris 2 AK, Acantholytic and hypertrophic 3 Bowen’s 4 SCC KA type 5 SCC in dermis 6 BCC superficial 7 BCC nodular 8 Pig nodular BCC 9 BCC infiltrative 10 Pig Seborrheic keratosis

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  • MUSE: Diagnostic value

11 IDN 12 Compound Nevus 13 Lentiginous Nevus 14 Blue Nevus 15 Spitz Nevus 16 MIS 17 MM

30 selected cases

Epidermal Lesions Melanocytic Lesions Pilar & Sebaceous Cysts Elastin

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  • MUSE: Diagnostic value

18 Sebaceous hyperplasia 19 Nevus Sebaceous 20 Pilomatricoma 21 Cylindroma 22 Poroma 23 Mixed tumor 24 Syringoma

30 selected cases

Epidermal Lesions Melanocytic Lesions Pilar & Sebaceous Cysts Elastin

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SLIDE 21
  • MUSE: Diagnostic value

25 Hidrocystoma 26 Steatocystoma 27 Pilar Cyst 28 EIC 29 PXE 30 Solar elastosis

30 selected cases

Epidermal Lesions Melanocytic Lesions Pilar & Sebaceous Cysts Elastin

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  • MUSE: Scoring

Diagnostic score:

 Percentage of correct diagnosis of each MUSE image

Comparison score:

 Assessed by the concordance between MUSE images and correlated H&E images generated by whole slide scanner

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  • MUSE: Diagnostic score

 What is this?  Total Dx score: 70.83%

 Cystic lesions: 88%  Epidermal lesions: 80%  Adnexal lesions: 79%  Melanocytic: 46%  Elastin lesions: 62%

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  • MUSE: Comparison score

 Is it better than H&E?

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SLIDE 25

BCC

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IDN

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Compound Nevus

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Blue Nevus

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Spitz Nevus

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Melanoma

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Nevus Sebaceous

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Pilomatricoma

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Cylindroma

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Poroma

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Syringoma

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Hidrocystoma

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Steatocystoma

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PXE

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  • MUSE: Comparison score

 Is it better than H&E?  Total C. score: 0.8

 Cystic lesions: 1.2  Adnexal lesions: 1.0  Elastin lesions: 1.0  Epidermal lesions: 0.7  Melanocytic: 0.6

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SLIDE 48
  • MUSE vs H&E:
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  • MUSE vs H&E:

 Cons:  Pre-image:

  • Unable to changing magnifications
  • Hard to work with very small specimens

 Image:

  • Nuclear features (melanocytic, inflammatory)
  • Unfamiliar colors

 Post-image:

  • Large data
  • Tissue storage
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SLIDE 50
  • MUSE vs H&E:

 Pros:  Robust method

  • Simple physical & chemical principles
  • Fast (2 minutes)
  • Fresh, formalin or alcohol

 MUSE images:

  • Multi-color (more informative)
  • 3 Dimensional
  • Similar to H&E (orientation/thickness)
  • High diagnostic value (even for fresh eyes)
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  • MUSE vs H&E:

 Pros:  Ex-vivo microscopy:

  • Inexpensive (No histology)
  • Preserving tissue (downstream molecular testing)
  • Potential use in intraoperative consultation
  • Can potentially be used as POC

 Digital pathology:

  • Provide service to low resource areas
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SLIDE 52
  • MUSE vs H&E:

 Pros:  Its BEAUTIFUL

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  • MUSE vs H&E:

 Pros:  Its BEAUTIFUL

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  • MUSE now:
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  • MUSE future?
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  • MUSE future?
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SLIDE 57
  • MUSE future?

@BSTPath @FungMaxwell

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  • Our team:

Maxwell A Fung MD Richard Levenson MD Samuel Balin MD PhD Tareq Mohammad MD

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SLIDE 59
  • Our team:

Farzad Fereidouni PhD Yasmine Lahoubi MD Zachary Harmany PhD Austin Todd

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SLIDE 60
  • Thank you …
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SLIDE 61
  • Thank you …