Gastrinomas are gastrin-producing neuroendocrine tumors (NETs) located in the gastroenteropancreatic system. Gastrinomas are often small, multifocal, and found at late stages. Their unpredictable behavior and metastatic potential make it extremely challenging to develop therapeutic strategies. Surgery is the only potentially curative treatment for gastrinoma, but current tumor localization techniques such as intraoperative ultrasound and manual palpitation have poor sensitivity for small tumors, resulting in higher rates of recurrence and metastasis. Therefore, there is a strong clinical need for developing advanced intraoperative imaging technologies for tumor localization in treating gastrinoma. Polarized light imaging (PLI) is a promising method for label-free tissue characterization due to its sensitivity to micro and nanoscale structures, which are often influenced with the onset of cancer, but no works have yet investigated the application of PLI for gastrinoma localization.

To assess the suitability of PLI for gastrinoma localization, we imaged 11 formalin-fixed paraffin embedded (FFPE) specimens of gastrinoma using a five-wavelength Mueller Matrix Polarization Microscope. The Lu-Chipman decomposition was applied to spatial maps of the sixteen Mueller matrix parameters. Values for depolarization, diattenuation, and retardance were compared for regions of interest corresponding to tumor and adjacent tissues. There was significant difference between the average depolarization of the Brunner’s gland and tumors when imaged with light at 442, 543, and 632 nm (p<0.05), and the average diattenuation values of the two at 405 nm (p<0.05), suggesting that these properties could be used for label-free localization. These results motivate further study of the use of PLI for NET localization. Future steps include broadening the sample pool to other NETs and validating results in fresh tissue studies.