Ex vivo confocal microscopy performs real-time assessment of renal biopsy in non-neoplastic diseases
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ORIGINAL ARTICLE
Ex vivo confocal microscopy performs real‑time assessment of renal biopsy in non‑neoplastic diseases Jesús Z. Villarreal1,2 · J. Pérez‑Anker3 · S. Puig3,4 · G. Pellacani5 · M. Solé6,7 · J. Malvehy3,4 · Luis F. Quintana1,2,7 · A. García‑Herrera6,7 Received: 2 April 2020 / Accepted: 13 August 2020 © Italian Society of Nephrology 2020
Abstract Background Ex vivo confocal microscopy is a technique for tissue examination, which generates images of fresh samples with an optical resolution comparable to those obtained by conventional pathology. The objective of this study was to evaluate the feasibility of using ex vivo confocal microscopy in fusion mode (reflectance and fluorescence) and the H&E-like digital staining that is obtained for the analysis of non-neoplastic kidney biopsies. Methods Twenty-four renal samples acquired from autopsies were scanned in a 4th generation ex vivo confocal microscopy device. The imaging process was completed in an average of three minutes. Results Confocal images correlated very well to the corresponding conventional histological sections, both in normal tissue and in chronic lesions (glomerulosclerosis, fibrosis and tubular atrophy). The ex vivo confocal microscopy protocol did not add artifacts to the sample for the ulterior study with light microscopy, nor to the histochemical or immunohistochemical studies. Conclusion The ease and speed of grayscale and fluorescence image acquisition, together with the quality of the H&E-like digitally stained images obtained with this approach, suggest that this technique shows promise for use in clinical nephrology and renal transplantation.
Jesús Z. Villarreal and J. Pérez-Anker contributed equally to this manuscript. Luis F. Quintana and A. García-Herrera share senior authorship. * Luis F. Quintana [email protected] 1
Pi I Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain 4
Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
5
Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
Nephrology and Renal Transplantation Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
2
Institut d’Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
6
Pathology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
3
Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, Institut d’Investigacions Biomediques August
7
Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), Barcelona, Spain
13
Vol.:(0123456789)
Journal of Nephrology
Graphic abstract
Keywords Reflectance confocal microscopy · Fluorescence confocal microscopy · Fusion confocal microscopy · Ex vivo confocal microscopy · Renal biopsy
Introduction The study of renal biopsy continues to be the key in implementing a specific treatment in nephrology [1–4]. However, routine histopathological evaluation is a time-consuming and ir
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