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Papazoglou AS, Karagiannidis E, Liatsos A, Bompoti A, Moysidis DV, Arvanitidis C, Tsolaki F, Tsagkaropoulos S, Theocharis S, Tagarakis G, Michaelson JS, Herrmann MD. Volumetric Tissue Imaging of Surgical Tissue Specimens Using Micro-Computed Tomography: An Emerging Digital Pathology Modality for Nondestructive, Slide-Free Microscopy-Clinical Applications of Digital Pathology in 3 Dimensions. Am J Clin Pathol 2023; 159:242-254. [PMID: 36478204 DOI: 10.1093/ajcp/aqac143] [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: 08/16/2022] [Accepted: 10/14/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Micro-computed tomography (micro-CT) is a novel, nondestructive, slide-free digital imaging modality that enables the acquisition of high-resolution, volumetric images of intact surgical tissue specimens. The aim of this systematic mapping review is to provide a comprehensive overview of the available literature on clinical applications of micro-CT tissue imaging and to assess its relevance and readiness for pathology practice. METHODS A computerized literature search was performed in the PubMed, Scopus, Web of Science, and CENTRAL databases. To gain insight into regulatory and financial considerations for performing and examining micro-CT imaging procedures in a clinical setting, additional searches were performed in medical device databases. RESULTS Our search identified 141 scientific articles published between 2000 and 2021 that described clinical applications of micro-CT tissue imaging. The number of relevant publications is progressively increasing, with the specialties of pulmonology, cardiology, otolaryngology, and oncology being most commonly concerned. The included studies were mostly performed in pathology departments. Current micro-CT devices have already been cleared for clinical use, and a Current Procedural Terminology (CPT) code exists for reimbursement of micro-CT imaging procedures. CONCLUSIONS Micro-CT tissue imaging enables accurate volumetric measurements and evaluations of entire surgical specimens at microscopic resolution across a wide range of clinical applications.
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Affiliation(s)
| | - Efstratios Karagiannidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Liatsos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreana Bompoti
- Diagnostic Imaging, Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough, UK
| | - Dimitrios V Moysidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Arvanitidis
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research, Heraklion, Crete, Greece.,LifeWatch ERIC, Sector II-II, Seville, Spain
| | - Fani Tsolaki
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
| | | | - Stamatios Theocharis
- First Department of Pathology, National and Kapoditrian University of Athens, Athens, Greece
| | - Georgios Tagarakis
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
| | - James S Michaelson
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Markus D Herrmann
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Bahar P, Nguyen D, Wang M, Mazilu D, Bennett EE, Wen H. Online Calibration of a Linear Micro Tomosynthesis Scanner. J Imaging 2022; 8:jimaging8100292. [PMID: 36286386 PMCID: PMC9604648 DOI: 10.3390/jimaging8100292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
In a linear tomosynthesis scanner designed for imaging histologic samples of several centimeters size at 10 µm resolution, the mechanical instability of the scanning stage (±10 µm) exceeded the resolution of the image system, making it necessary to determine the trajectory of the stage for each scan to avoid blurring and artifacts in the images that would arise from the errors in the geometric information used in 3D reconstruction. We present a method for online calibration by attaching a layer of randomly dispersed micro glass beads or calcium particles to the bottom of the sample stage. The method was based on a parametric representation of the rigid body motion of the sample stage-marker layer assembly. The marker layer was easy to produce and proven effective in the calibration procedure.
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Nguyen DT, Larsen TC, Wang M, Knutsen RH, Yang Z, Bennett EE, Mazilu D, Yu ZX, Tao X, Donahue DR, Gharib AM, Bleck CKE, Moss J, Remaley AT, Kozel BA, Wen H. X-ray microtomosynthesis of unstained pathology tissue samples. J Microsc 2021; 283:9-20. [PMID: 33482682 PMCID: PMC8248055 DOI: 10.1111/jmi.13003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/14/2020] [Accepted: 01/17/2021] [Indexed: 12/15/2022]
Abstract
In pathology protocols, a tissue block, such as one containing a mouse brain or a biopsy sample from a patient, can produce several hundred thin sections. Substantial time may be required to analyse all sections. In cases of uncertainty regarding which sections to focus on, noninvasive scout imaging of intact blocks can help in guiding the pathology procedure. The scouting step is ideally done in a time window of minutes without special sample preparation that may interfere with the pathology procedures. The challenge is to obtain some visibility of unstained tissue structures at sub‐10 µm resolution. We explored a novel x‐ray tomosynthesis method as a way to maximise contrast‐to‐noise ratio, a determinant of tissue visibility. It provided a z‐stack of thousands of images at 7.3 μm resolution (10% contrast, half‐period of 68.5 line pairs/mm), in scans of 5‐15 minutes. When compared with micro‐CT scans, the straight‐line tomosynthesis scan did not need to rotate the sample, which allowed flat samples, such as paraffin blocks, to be kept as close as possible to the x‐ray source. Thus, given the same hardware, scan time and resolution, this mode maximised the photon flux density through the sample, which helped in maximising the contrast‐to‐noise ratio. The tradeoff of tomosynthesis is incomplete 3D information. The microtomosynthesis scanner has scanned 110 unstained human and animal tissue samples as part of their respective pathology protocols. In all cases, the z‐stack of images showed tissue structures that guided sectioning or provided correlative structural information. We describe six examples that presented different levels of visibility of soft tissue structures. Additionally, in a set of coronary artery samples from an HIV patient donor, microtomosynthesis made a new discovery of isolated focal calcification in the internal elastic lamina of coronary wall, which was the onset of medial calcific sclerosis in the arteries.
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Affiliation(s)
- David T Nguyen
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | | | - Muyang Wang
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Russel H Knutsen
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Zhihong Yang
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Eric E Bennett
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Dumitru Mazilu
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Zu-Xi Yu
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Xi Tao
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China
| | - Danielle R Donahue
- Mouse Imaging Facility, National Institutes of Health, Bethesda, Maryland
| | - Ahmed M Gharib
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Christopher K E Bleck
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Joel Moss
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Alan T Remaley
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Beth A Kozel
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Han Wen
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
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4
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Knutsen RH, Gober LM, Sukinik JR, Donahue DR, Kronquist EK, Levin MD, McLean SE, Kozel BA. Vascular Casting of Adult and Early Postnatal Mouse Lungs for Micro-CT Imaging. J Vis Exp 2020. [PMID: 32628170 DOI: 10.3791/61242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Blood vessels form intricate networks in 3-dimensional space. Consequently, it is difficult to visually appreciate how vascular networks interact and behave by observing the surface of a tissue. This method provides a means to visualize the complex 3-dimensional vascular architecture of the lung. To accomplish this, a catheter is inserted into the pulmonary artery and the vasculature is simultaneously flushed of blood and chemically dilated to limit resistance. Lungs are then inflated through the trachea at a standard pressure and the polymer compound is infused into the vascular bed at a standard flow rate. Once the entire arterial network is filled and allowed to cure, the lung vasculature may be visualized directly or imaged on a micro-CT (µCT) scanner. When performed successfully, one can appreciate the pulmonary arterial network in mice ranging from early postnatal ages to adults. Additionally, while demonstrated in the pulmonary arterial bed, this method can be applied to any vascular bed with optimized catheter placement and endpoints.
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Affiliation(s)
- Russell H Knutsen
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health
| | - Leah M Gober
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health
| | - Joseph R Sukinik
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health
| | - Danielle R Donahue
- Mouse Imaging Facility, National Institute of Neurological Disorders and Stroke, National Institutes of Health
| | - Elise K Kronquist
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health
| | - Mark D Levin
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health
| | - Sean E McLean
- Division of Pediatric Surgery, Department of Surgery, University of North Carolina at Chapel Hill
| | - Beth A Kozel
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health;
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