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In Vivo Microscopy Topic Center

Pathologists are key players in the development, validation, and clinical implementation of new microscopic imaging technologies. At the forefront is In Vivo Microscopy, where microscopic images are obtained in vivo, in real- time, during clinical procedures.

In Vivo Microscopy in Detail

In Vivo Microscopy (IVM) is an exciting field where microscopic images are obtained in vivo, in real-time, during clinical procedures. IVM imaging technologies use light and rapidly produce 2D or 3D (tomographic) microscopic images. These images may be obtained using instrumentation compatible with existing standard of care clinical instruments (e.g., that can be inserted into endoscope accessory ports) or as standalone imaging tools. IVM is in clinical use in Gastroenterology, Ophthalmology, Cardiology, Dermatology, and in other clinical disciplines, including Pulmonary Medicine, Urology, Breast, and Neurosurgery.

Section Text Title
Confocal fluorescence micorscopic images of metastatic Adenocarcinoma in liver from colon primary, grey scale and false colored images. (Image courtesy of Savitri Krishnamurthy, MD, FCAP: The University of Texas MD Anderson Cancer Center)
Confocal fluorescence micorscopic images of normal liver, grey scale and false colored images. (Image courtesy of Savitri Krishnamurthy, MD, FCAP: The University of Texas MD Anderson Cancer Center

Why Pathologists are Central to IVM

Pathologists are the experts in diagnosing disease through the interpretation of diagnostic microscopic images. With the evolution of IVM technology, their expertise to properly interpret new types of microscopic images establishes a role for pathologists as interventional microscopists.

Benefits of In Vivo Microscopy

  • Guide biopsy site acquisition in real time to obtain targeted and diagnostically significant biopsies, as in pulmonary nodules or breast cancer
  • Perform comprehensive screening for occult microscopic disease, as in capsule screening for Barrett Esophagus
  • Obtain microscopic diagnoses when tissues cannot be easily or safely excised, as in coronary arteries, retinal screening or pulmonary fibrosis
  • Guide and assess the efficacy of therapy, such as in chemotherapy, laser ablation, guided surgical ablation, focused ultrasound, cryotherapy, radiofrequency, and brachytherapy

Ex Vivo Microscopy of IVM in Detail

Ex Vivo Microscopy (EVM) is the use of IVM technologies by pathologists in the ex vivo setting, without damage or destruction to the tissue. EVM imaging systems are small and portable, and can be used in virtually every pathology setting: the surgical suite, the procedure room, the grossing room, the laboratory, and the biobank. EVM creates digital images that can be viewed and interpreted remotely so the pathologist does not need to be physically present for EVM to be useful. Digital EVM images can be sent electronically to remote pathologists for consultation, and also used as digital documentation of biobank and other research tissues.

Benefits of Ex Vivo Microscopy

  • Evaluate small tissue biopsies for adequacy, as in breast, lymph nodes, and lung cancer biopsies.
  • Triage biopsy and other tissues for molecular and genomic studies, as in lung cancer
  • Guide the selection of tissue for frozen and permanent sections for diagnostic material
  • Guide tissue collection for Biobanking and other research purposes

IVM and EVM Resources

IVM and EVM Webinars

The IVM webinar series provides education about various applications of IVM/EVM. View the webinars section to find more details about these events and to access previous webinars.

Feb 26, 2019In Vivo Microscopy for Guiding Biopsy Acquisition in Patients
Speaker: Guillermo Tearney, MD, PhD
Apr 11, 2019Ex-Vivo Microscopy-A Promising Next Generation Digital Microscopy Tool for Surgical Pathology Practice
Speaker: Savitri Krinshnamurthy, MD
Jul 30, 2019Ex Vivo Microscopy (EVM) Systems- Functional Requirements and CAP Checklist Compliance
Speaker: Sharad Mathur, MD
Oct 29, 2019Stimulating Raman Histology- A novel technology to image fresh tissues in real-time.
Speaker: Sandra Ines Camelo-Piragua MD
Apr 25, 2017Confocal Microscopy for Pigmented Lesions
Speaker: Babar Rao, MD
May 30, 2017Creating a Successful Pathology-engineering Collaboration
Speaker: Nicholas P. Reder, MD, MPH
Sep 20, 2017Confocal Microscopy of Non Melanocytic Lesions
Speaker: Babar K. Rao, MD, FCAP
Oct 3, 2017Light-sheet Microscopy for 3D Pathology
Speakers: Nicholas P. Reder, MD, MPH; Lawrence True, MD
Nov 7, 2017Rapid Examination of Fresh Tissue Using Light-sheet Microscopy
Speaker: Nicholas P. Reder, MD, MPH
Dec 5, 2017Role of Reflectance Confocal Microscopy in Skin Inflammations
Speaker: Babar K. Rao, MD, FCAP

Get Involved With IVM Projects

Send us an email to get involved with IVM projects or request to be on our mailing list. If you are interested in being a part of the IVM Committee, apply now.

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IVM Committee