Abstract
338 Background: Partial orchiectomy is becoming more accepted for indications such as a solitary testis, and small nonpalpable testicular masses found incidentally on scrotal ultrasonography. Unfortunately, intraoperative frozen-section pathological analysis is often unable to accurately predict the presence of malignancy. Multiphoton microscopy (MPM) enables in vivo imaging of tissue without the use of labeling techniques and could potentially diagnose testicular tumor pathology. We performed a non-randomized, non-controlled study to evaluate the feasibility of MPM to image testicular biopsies. Methods: Two men with testicular masses underwent radical orchiectomy for primary testicular tumor from June to August 2011. A total of six specimens from testicular tumor and uninvolved testes were imaged with MPM. In order to assess the diagnostic accuracy of MPM, we performed a blinded assessment by three uropathologists. The diagnosis rendered based on these images was then correlated with the findings seen on hematoxylin and eosin (H&E) staining. Results: Our diagnosis based on MPM correlated with H&E in five of six (83%) specimens. Images of seminoma acquired with the MPM are easily distinguished from those of teratoma and normal testicular parenchyma. Images of seminoma show abnormal architectural and cellular changes compared to cystic structures often seen with teratoma. Conclusions: Multiphoton microscopy can be used to reliably differentiate between teratoma, seminoma and normal testis tissue in our pilot group. MPM imaging could be potentially applied in intra-operative diagnosis of testicular tumors especially in testis-sparing surgery. Additional imaging of non-seminomatous germ cell tumors and non-germ cell tumors need to performed to verify the ultimate role of this technology.
