{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:33:07Z","timestamp":1793147587612,"version":"4.5.0"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Accurate intraoperative identification of adenomatous versus normal pituitary tissue remains challenging during surgery for pituitary neuroendocrine tumors (PitNETs), as both can appear similar macroscopically. Stimulated Raman histology (SRH) is a label-free optical imaging technique that provides high-resolution digital histological images of unprocessed tissue within minutes. This study evaluated the feasibility, diagnostic accuracy, and histopathological concordance of SRH compared with conventional hematoxylin and eosin (H&amp;E) staining in PitNETs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Adult patients (\u2265 18 years) who underwent surgery for suspected PitNET were included. Fresh tissue samples from the tumor core and, when feasible, from peritumoral regions were analyzed intraoperatively using SRH followed by standard histopathological processing. A board-certified neuropathologist, blinded to clinical data, independently compared SRH and H&amp;E images regarding diagnostic accuracy, tissue classification (adenomatous vs nonadenomatous), and histopathological features using a semiquantitative scoring system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 28 patients were included, yielding 66 tissue samples for final comparative analysis. SRH imaging was feasible in all cases. SRH demonstrated excellent comparability with conventional H&amp;E in 37 samples (56.1%), good comparability in 20 (30.3%), and low comparability in 9 (13.6%). No significant difference in comparability was observed between tumor core and peritumoral tissue samples (p = 0.409). SRH accurately depicted key histopathological features, including the loss of the lobular glandular structure in adenomatous tissue and connective tissue organization in surrounding structures. Characteristic subtype features\u2014such as Crooke cells in corticotroph PitNET or perivascular tumor cell arrangements in gonadotroph PitNET\u2014were also identifiable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>SRH showed high feasibility for intraoperative assessment of PitNETs, generating near H&amp;E-quality digital images within minutes. It reliably enabled distinguishing tumor from normal gland tissue and detected tumor infiltration into adjacent structures. These findings support SRH as a useful aid to intraoperative decision-making in pituitary surgery, with future AI integration likely to further improve diagnostic speed and accuracy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.5.jns2667","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:01:12Z","timestamp":1792540872000},"page":"1-8","source":"Crossref","is-referenced-by-count":0,"title":["Near real-time intraoperative assessment of pituitary neuroendocrine tumors using stimulated Raman histology during endoscopic transsphenoidal surgery: comparison with conventional histopathology"],"prefix":"10.3171","author":[{"given":"Matthias","family":"Millesi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Medical University of Vienna;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Roetzer-Pejrimovsky","sequence":"additional","affiliation":[{"name":"Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Matula","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Vienna;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Herta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Vienna;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Widhalm","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Vienna;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"R\u00f6ssler","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Vienna;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greisa","family":"Vila","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Austria; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Freudiger","sequence":"additional","affiliation":[{"name":"Invenio Imaging, Inc., Menlo Park, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens C.","family":"Vogel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Vienna;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Bachhofner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Vienna;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa I.","family":"K\u00f6rner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Vienna;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"J Neurosurg","first-page":"1674","article-title":"Association between pituitary adenoma consistency, resection techniques, and patient outcomes: a single-institution experience","volume":"142","author":"Guerra GA","year":"2025","unstructured":"Guerra GA, Kashif Z, Cote DJ,  Association between pituitary adenoma consistency, resection techniques, and patient outcomes: a single-institution experience. J Neurosurg. 2025;142(6):1674\u20131681. doi:10.3171\/2024.8.JNS232715"},{"issue":"Supplement_6","key":"b2","series-title":"Neuro Oncol","first-page":"vi1","article-title":"CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2017\u20132021","volume":"26","author":"Price M","year":"2024","unstructured":"Price M, Ballard C, Benedetti J,  CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2017\u20132021. Neuro Oncol. 2024;26(Supplement_6):vi1\u2013vi85. doi:10.1093\/neuonc\/noae145"},{"issue":"16","key":"b3","series-title":"JAMA","first-page":"1386","article-title":"Diagnosis and management of pituitary adenomas: a review","volume":"329","author":"Tritos NA","year":"2023","unstructured":"Tritos NA, Miller KK. Diagnosis and management of pituitary adenomas: a review. 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