Intelligent Histology for Tumor Neurosurgery

TL;DR

Intelligent Histology combines AI with stimulated Raman histology to enable rapid, real-time, digital tumor tissue analysis during neurosurgery, potentially transforming intraoperative decision-making.

Contribution

The paper introduces a novel intraoperative histologic method integrating AI with stimulated Raman histology for real-time tumor analysis.

Findings

SRH provides high-resolution digital images within seconds.

AI enables tumor classification and infiltration detection.

Potential to improve surgical outcomes through rapid analysis.

Abstract

The importance of rapid and accurate histologic analysis of surgical tissue in the operating room has been recognized for over a century. Our standard-of-care intraoperative pathology workflow is based on light microscopy and H\&E histology, which is slow, resource-intensive, and lacks real-time digital imaging capabilities. Here, we present an emerging and innovative method for intraoperative histologic analysis, called Intelligent Histology, that integrates artificial intelligence (AI) with stimulated Raman histology (SRH). SRH is a rapid, label-free, digital imaging method for real-time microscopic tumor tissue analysis. SRH generates high-resolution digital images of surgical specimens within seconds, enabling AI-driven tumor histologic analysis, molecular classification, and tumor infiltration detection. We review the scientific background, clinical translation, and future applications of intelligent histology in tumor neurosurgery. We focus on the major scientific and clinical studies that have demonstrated the transformative potential of intelligent histology across multiple neurosurgical specialties, including neurosurgical oncology, skull base, spine oncology, pediatric tumors, and periperal nerve tumors. Future directions include the development of AI foundation models through multi-institutional datasets, incorporating clinical and radiologic data for multimodal learning, and predicting patient outcomes. Intelligent histology represents a transformative intraoperative workflow that can reinvent real-time tumor analysis for 21st century neurosurgery.