Traditional tissue diagnostics rely on staining protocols followed by examination under an optical microscope. One common staining method used by pathologists is H&E staining: hematoxylin stains cell nuclei a purplish blue, and eosin stains the extracellular matrix and cytoplasm pink. This simple staining remains the gold standard in pathology for many tissue diagnoses tasks, particularly cancer diagnosis. However, H&E histopathology, particularly the frozen sectioning technique used in an intraoperative setting, still has limitations. The staining procedure is a laborious process involving tissue embedding, sectioning, fixation, and staining1. The typical turnaround time is 20 min or longer. Performing H&E during frozen sectioning can sometimes become more challenging when multiple sections are processed at once due to the need to evaluate cellular features or growth patterns in 3D for margin assessment. Moreover, intraoperative histological techniques require skilled technicians and clinicians. Limitation in the number of board-certified pathologists in many hospitals is a constraint for intraoperative consultation in many cases. Such limitations may be alleviated with the fast development interests in digital pathology and artificial intelligence-based diagnosis2. However, the H&E staining results are variable, depending on the experience of the technician, which presents additional challenges for computer-based diagnosis2.
These challenges can potentially be addressed with label-free optical imaging techniques. One such technique is SRS microscopy. SRS uses synchronized pulsed lasers—pump and Stokes—to excite molecular vibrations with high efficiency3. Recent reports have demonstrated that SRS imaging of proteins and lipids can generate H&E-equivalent images (also known as stimulated Raman histology or SRH) with intact fresh tissue, which bypasses the need for any tissue processing, significantly shortens the time needed for diagnosis, and has been adapted intraoperatively4. Moreover, SRS imaging can provide 3D images, which offers additional information for diagnosis when 2D images are insufficient5. SRH is unbiased and generates digital images that are readily available for computer-based diagnosis. It quickly emerges as a possible solution for intraoperative cancer diagnosis and tumor margin analysis, especially in brain cancer6,7,8. More recently, SRS imaging of chemical changes of tissue has also been suggested to provide useful diagnostic information that can further help clinicians stratify different cancer types or stages9.
Despite its tremendous potential in tissue diagnosis applications, SRS imaging is mostly limited to academic laboratories specialized in optics due to the complexity associated with the imaging platform, which includes ultrafast lasers, the laser scanning microscope, and sophisticated detection electronics. This protocol provides a detailed workflow to demonstrate the use of a common femtosecond laser source for real-time, two-color SRS imaging and the generation of pseudo-H&E images from mouse brain tissue. The protocol will cover the following procedures:
Alignment and chirp optimization
Most SRS imaging schemes use either picosecond or femtosecond lasers as the excitation source. With femtosecond lasers, the bandwidth of the laser is much larger than the Raman linewidth. To overcome this limitation, a spectral focusing approach is used to chirp the femtosecond lasers to a picosecond timescale to achieve narrow spectral resolution10. Optimal spectral resolution is only achieved when the temporal chirp (also known as the group delay dispersion or just dispersion) is properly matched for the pump and the Stokes lasers. The alignment procedure and the steps needed to optimize the dispersion of the laser beams using highly dispersive glass rods are demonstrated here.
Frequency calibration
An advantage of spectral focusing SRS is that the Raman excitation can be quickly tuned by changing the time delay between the pump and the Stokes lasers. Such tuning affords fast imaging and reliable spectral acquisition compared to tuning laser wavelengths. However, the linear relationship between excitation frequency and time delay requires external calibration. Organic solvents with known Raman peaks are used to calibrate the Raman frequency for spectral focusing SRS.
Real-time, two-color imaging
It is important to increase the imaging speed in tissue diagnosis applications to shorten the time needed for analyzing large tissue specimens. Simultaneous two-color SRS imaging of lipids and proteins obviates the need to tune the laser or time delay, which increases the imaging speed by more than two-fold. This is achieved by using a novel orthogonal modulation technique and dual-channel demodulation with a lock-in amplifier11. This paper describes the protocol for orthogonal modulation and dual-channel image acquisition.
Epi-mode SRS imaging
The majority of SRS imaging shown to date is performed in transmission mode. Epi-mode imaging detects backscattered photons from tissue12. For pathology applications, surgical specimens can be quite large. For transmission mode imaging, tissue sectioning is often necessary, which undesirably requires extra time. In contrast, epi-mode imaging can work with intact surgical specimens. Because the same objective is used to collect backscattered light, there is also no need for aligning a high numerical-aperture condenser required for transmission imaging. Epi-mode is also the only option when tissue sectioning is difficult, such as with bone. Previously we have demonstrated that for brain tissue, epi-mode imaging offers superior imaging quality for tissue thickness > 2 mm13. This protocol uses a polarizing beam splitter (PBS) to collect scattered photons depolarized by tissue. It is possible to collect more photons with an annular detector at the expense of the complexity of customized detector assembly12. The PBS approach is simpler to implement (similar to fluorescence), with the standard photodiode already being used for transmission mode detection.
Pseudo-H&E image generation
Once two-color SRS images are collected, they can be recolored to simulate H&E staining. This paper demonstrates the procedure for converting lipid and protein SRS images to pseudo-H&E SRS images for pathology applications. The experimental protocol details critical steps needed to generate high-quality SRS images. The procedure shown here is not only applicable to tissue diagnosis but also can be adapted for many other hyperspectral SRS imaging applications such as drug imaging and metabolic imaging14,15.
General system requirements
The laser system for this protocol must be able to output 2 synchronized femtosecond laser beams. Systems ideally feature an Optical Parametric Oscillator (OPO) for broad wavelength tuning of one of the laser beams. The setup in this protocol uses a commercial laser system Insight DS+ that outputs two lasers (one fixed beam at 1,040 nm and one OPO-based tunable beam, ranging from 680 to 1,300 nm) with a repetition rate of 80 MHz. Laser scanning microscopes, either from major microscope manufacturers or home-built, can be used for SRS imaging. The utilized microscope is an upright laser scanning microscope built on top of a commercial upright microscope frame. A pair of 5 mm galvo mirrors are used to scan the laser beam. For users choosing to adopt a homebuilt laser scanning microscope, refer to a previously published protocol for the construction of a laser scanning microscope16.