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Amygdalos I, Hachgenei E, Burkl L, Vargas D, Goßmann P, Wolff LI, Druzenko M, Frye M, König N, Schmitt RH, Chrysos A, Jöchle K, Ulmer TF, Lambertz A, Knüchel-Clarke R, Neumann UP, Lang SA. Optical coherence tomography and convolutional neural networks can differentiate colorectal liver metastases from liver parenchyma ex vivo. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04263-z. [PMID: 35960377 DOI: 10.1007/s00432-022-04263-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/02/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Optical coherence tomography (OCT) is an imaging technology based on low-coherence interferometry, which provides non-invasive, high-resolution cross-sectional images of biological tissues. A potential clinical application is the intraoperative examination of resection margins, as a real-time adjunct to histological examination. In this ex vivo study, we investigated the ability of OCT to differentiate colorectal liver metastases (CRLM) from healthy liver parenchyma, when combined with convolutional neural networks (CNN). METHODS Between June and August 2020, consecutive adult patients undergoing elective liver resections for CRLM were included in this study. Fresh resection specimens were scanned ex vivo, before fixation in formalin, using a table-top OCT device at 1310 nm wavelength. Scanned areas were marked and histologically examined. A pre-trained CNN (Xception) was used to match OCT scans to their corresponding histological diagnoses. To validate the results, a stratified k-fold cross-validation (CV) was carried out. RESULTS A total of 26 scans (containing approx. 26,500 images in total) were obtained from 15 patients. Of these, 13 were of normal liver parenchyma and 13 of CRLM. The CNN distinguished CRLM from healthy liver parenchyma with an F1-score of 0.93 (0.03), and a sensitivity and specificity of 0.94 (0.04) and 0.93 (0.04), respectively. CONCLUSION Optical coherence tomography combined with CNN can distinguish between healthy liver and CRLM with great accuracy ex vivo. Further studies are needed to improve upon these results and develop in vivo diagnostic technologies, such as intraoperative scanning of resection margins.
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Affiliation(s)
- Iakovos Amygdalos
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Enno Hachgenei
- Department of Production Metrology, Fraunhofer Institute for Production Technology IPT, Aachen, Germany
| | - Luisa Burkl
- Department of Production Metrology, Fraunhofer Institute for Production Technology IPT, Aachen, Germany
| | - David Vargas
- Institute for Histopathology, University Hospital RWTH Aachen, Aachen, Germany
| | - Paul Goßmann
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Laura I Wolff
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Mariia Druzenko
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Maik Frye
- Department of Production Metrology, Fraunhofer Institute for Production Technology IPT, Aachen, Germany
| | - Niels König
- Department of Production Metrology, Fraunhofer Institute for Production Technology IPT, Aachen, Germany
| | - Robert H Schmitt
- Department of Production Metrology, Fraunhofer Institute for Production Technology IPT, Aachen, Germany.,Laboratory for Machine Tools and Production Engineering (WZL), RWTH Aachen University, Aachen, Germany
| | - Alexandros Chrysos
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Katharina Jöchle
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Tom F Ulmer
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Andreas Lambertz
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Ruth Knüchel-Clarke
- Institute for Histopathology, University Hospital RWTH Aachen, Aachen, Germany
| | - Ulf P Neumann
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Sven A Lang
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Schleicher C, Kreipe HH, Schemmer P, Strassburg CP, Fischer-Fröhlich CL, Rahmel A, Flechtenmacher C. [Donor liver histology : Joint recommendations of the DGP, DTG and DSO]. Chirurg 2019; 90:899-904. [PMID: 31214724 DOI: 10.1007/s00104-019-0990-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The indications, implementation and reporting of liver biopsies for deceased organ donation are not mandatory or regulated. Reliable data on outcome quality and prognostic relevance are therefore not available. Defined standards are thus required to enable meaningful studies and to ensure high data quality of a national transplantation registry. OBJECTIVE Presentation of a synopsis of available studies and literature-based recommendations. RESULTS AND CONCLUSION Against the background of an organ shortage and a growing number of older donors, pretransplantation liver histology is of significant relevance to guide clinical decision making. With the joint recommendations of the German Transplantation Society (DTG), the German Society of Pathology (DGP) and the German Organ Transplantation Foundation (DSO) standardized procedures are defined for the first time.
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Affiliation(s)
- C Schleicher
- Region Baden-Württemberg, Deutsche Stiftung Organtransplantation, Kriegerstraße 6, 70191, Stuttgart, Deutschland.
| | - H-H Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - P Schemmer
- Allgemein-, Viszeral- und Transplantationschirurgie, Medizinische Universität Graz, Graz, Österreich
| | - C P Strassburg
- Medizinische Klinik1, Universitätsklinikum Bonn, Bonn, Deutschland
| | - C-L Fischer-Fröhlich
- Region Baden-Württemberg, Deutsche Stiftung Organtransplantation, Kriegerstraße 6, 70191, Stuttgart, Deutschland
| | - A Rahmel
- Hauptverwaltung, Deutsche Stiftung Organtransplantation, Frankfurt, Deutschland
| | - C Flechtenmacher
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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