William Twengström1, Carlos F Moro2,3, Jenny Romell1, Jakob C Larsson1, Ernesto Sparrelid4, Mikael Björnstedt2,3, Hans M Hertz1. 1. KTH/Albanova, Department of Applied Physics, Stockholm, Sweden. 2. Karolinska University Hospital, Department of Clinical Pathology and Cancer Diagnostics, Stockholm, Sweden. 3. Karolinska University Hospital Huddinge, Karolinska Institutet, Division of Pathology F46, Department of Laboratory Medicine, Stockholm, Sweden. 4. Karolinska Institutet, Division of Surgery, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden.
Abstract
Purpose: Surgery is an essential part of the curative plan for most patients affected with solid tumors. The outcome of such surgery, e.g., recurrence rates and ultimately patient survival, depends on several factors where the resection margin is of key importance. Presently, the resection margin is assessed by classical histology, which is time-consuming (several days), destructive, and basically only gives two-dimensional information. Clearly, it would be advantageous if immediate feedback on tumor extension in all three dimensions were available to the surgeon intraoperatively. Approach: We investigate a laboratory propagation-based phase-contrast x-ray computed tomography system that provides the resolution, the contrast, and, potentially, the speed for this purpose. The system relies on a liquid-metal jet microfocus source and a scintillator-coated CMOS detector. Our study is performed on paraffin-embedded non-stained samples of human pancreatic neuroendocrine tumors, liver intrahepatic cholangiocarcinoma, and pancreatic serous cystic neoplasm (benign). Results: We observe tumors with distinct and sharp edges having cellular resolution ( ∼ 10 μ m ) as well as many assisting histological landmarks, allowing for resection margin assessment. All x-ray data are compared with classical histology. The agreement is excellent. Conclusion: We conclude that the method has potential for intraoperative three-dimensional virtual histology.
Purpose: Surgery is an essential part of the curative plan for most patients affected with solid tumors. The outcome of such surgery, e.g., recurrence rates and ultimately patient survival, depends on several factors where the resection margin is of key importance. Presently, the resection margin is assessed by classical histology, which is time-consuming (several days), destructive, and basically only gives two-dimensional information. Clearly, it would be advantageous if immediate feedback on tumor extension in all three dimensions were available to the surgeon intraoperatively. Approach: We investigate a laboratory propagation-based phase-contrast x-ray computed tomography system that provides the resolution, the contrast, and, potentially, the speed for this purpose. The system relies on a liquid-metal jet microfocus source and a scintillator-coated CMOS detector. Our study is performed on paraffin-embedded non-stained samples of human pancreatic neuroendocrine tumors, liver intrahepatic cholangiocarcinoma, and pancreatic serous cystic neoplasm (benign). Results: We observe tumors with distinct and sharp edges having cellular resolution ( ∼ 10 μ m ) as well as many assisting histological landmarks, allowing for resection margin assessment. All x-ray data are compared with classical histology. The agreement is excellent. Conclusion: We conclude that the method has potential for intraoperative three-dimensional virtual histology.
Authors: T Zhou; U Lundström; T Thüring; S Rutishauser; D H Larsson; M Stampanoni; C David; H M Hertz; A Burvall Journal: Opt Express Date: 2013-12-16 Impact factor: 3.894
Authors: Arne Westgaard; Svetlana Tafjord; Inger N Farstad; Milada Cvancarova; Tor J Eide; Oystein Mathisen; Ole Petter F Clausen; Ivar P Gladhaug Journal: BMC Cancer Date: 2008-01-14 Impact factor: 4.430