First-in-human pilot study of snapshot multispectral endoscopy for delineation of pituitary adenoma.

Significance: The definitive treatment for pituitary adenoma is transsphenoidal surgical resection. Conventional white light imaging shows limited contrast between the adenoma and the pituitary gland, and only the tissue surface is visualized, leaving a pressing unmet need for improved intraoperative adenoma delineation to preserve pituitary function during surgery. Aim: To evaluate the potential of multispectral imaging to enhance visualization of adenoma during transsphenoidal resection. Approach: A multispectral camera based on a spectrally resolved detector array was coupled to a standard 4-mm rigid endoscope for Results: The multispectral imaging (MSI) endoscope was deployed during transsphenoidal surgery, and usable data were obtained from 12 patients. MSI was able to distinguish between an adenoma and a healthy pituitary based on the spectral angle with the reference spectrum of blood. Conclusions: The MSI endoscope holds the potential to differentiate adenoma tissue and healthy pituitary. With further development, MSI endoscopy could enable real-time label-free delineation of tumors during surgery, based on quantitative thresholds, which should contribute to improving the completeness of resection, while helping to preserve the pituitary gland, preventing serious life-changing complications.