Qualitative and quantitative assessment of <i>ex vivo</i> human brain tumors using quantitative oblique back-illumination microscopy (qOBM)

Accurate intraoperative diagnosis of brain tumors is critical for improving patient outcomes, yet current histopathology is time-consuming and performed outside the operating room. We investigate the use of quantitative oblique back-illumination microscopy (qOBM) for the identification and classification of tumors in brain tumor core samples ex vivo . We studied samples from 28 patients across four tumor types and identified diagnostic features in qOBM images corroborated by H&amp;E. Using samples from 19 glioma patients, a leave-one-out classifier distinguishes high- from low-grade glioma cases with 86.6% accuracy (95% CI: 85.9-87.4%), demonstrating qOBM’s potential for real-time intraoperative diagnosis in future studies.