Introduction: Intraoperative neuropathology is essential for guiding surgical decision-making and optimizing patient outcomes in neurosurgery. Frozen section histopathology remains the gold standard for intraoperative diagnosis, but it is labor-intensive, time-consuming, and reliant on specialized personnel. This study explores the use of Stimulated Raman Histology (SRH) as an innovative alternative to frozen section analysis in spinal tumor surgery, aiming to evaluate its qualitative diagnostic accuracy and its potential integration into the intraoperative workflow.
Methods: This retrospective study included 14 patients who underwent spinal tumor surgery at our institution between January 2022 and December 2023. Intraoperative tissue specimens were collected, with SRH images obtained using the NIO Imaging System and compared to both frozen section and permanent section histopathology. A neuropathologist and neurosurgeon performed a qualitative assessment of SRH images, evaluating histological features such as cellularity, tissue architecture, and molecular composition.
Results: The study found high concordance between SRH and permanent sections across various tumor types, including Schwannoma, T-cell lymphoma, and ependymoma. In real-time, SRH provided critical insights that influenced surgical decision-making, particularly in complex cases where frozen sections were either impractical or delayed. SRH acquisition times ranged from 2 to 5 minutes, substantially reducing intraoperative delays compared to the 20-minute frozen section process. The real-time nature of SRH allowed for dynamic adjustments to resection strategies, contributing to precise tumor removal and optimized surgical outcomes.
Conclusion : SRH represents a transformative tool in spinal neuro-oncology by offering real-time, label-free imaging with diagnostic accuracy comparable to traditional frozen section analysis. Its seamless integration into the intraoperative workflow holds the potential to reduce operative time, enhance decision-making, and improve patient outcomes. Further studies are needed to validate these findings across larger cohorts and to explore the cost-effectiveness of SRH in routine neurosurgical practice.
.jpg)
