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Nolte P, Brettmacher M, Gröger CJ, Gellhaus T, Svetlove A, Schilling AF, Alves F, Rußmann C, Dullin C. Spatial correlation of 2D hard-tissue histology with 3D microCT scans through 3D printed phantoms. Sci Rep 2023; 13:18479. [PMID: 37898676 PMCID: PMC10613209 DOI: 10.1038/s41598-023-45518-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/20/2023] [Indexed: 10/30/2023] Open
Abstract
Hard-tissue histology-the analysis of thin two-dimensional (2D) sections-is hampered by the opaque nature of most biological specimens, especially bone. Therefore, the cutting process cannot be assigned to regions of interest. In addition, the applied cutting-grinding method is characterized by significant material loss. As a result, relevant structures might be missed or destroyed, and 3D features can hardly be evaluated. Here, we present a novel workflow, based on conventual microCT scans of the specimen prior to the cutting process, to be used for the analysis of 3D structural features and for directing the sectioning process to the regions of interest. 3D printed fiducial markers, embedded together with the specimen in resin, are utilized to retrospectively register the obtained 2D histological images into the 3D anatomical context. This not only allows to identify the cutting position, but also enables the co-registration of the cell and extracellular matrix morphological analysis to local 3D information obtained from the microCT data. We have successfully applied our new approach to assess hard-tissue specimens of different species. After matching the predicted microCT cut plane with the histology image, we validated a high accuracy of the registration process by computing quality measures namely Jaccard and Dice similarity coefficients achieving an average score of 0.90 ± 0.04 and 0.95 ± 0.02, respectively. Thus, we believe that the novel, easy to implement correlative imaging approach holds great potential for improving the reliability and diagnostic power of classical hard-tissue histology.
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Affiliation(s)
- Philipp Nolte
- Faculty of Engineering and Health, University of Applied Sciences and Arts, Göttingen, Germany
- Institute for Diagnostic and Interventional Radiology, University Medical Center, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Marcel Brettmacher
- Faculty of Engineering and Health, University of Applied Sciences and Arts, Göttingen, Germany
| | - Chris Johann Gröger
- Faculty of Engineering and Health, University of Applied Sciences and Arts, Göttingen, Germany
| | - Tim Gellhaus
- Department of Oral and Maxillofacial Surgery, University Medical Center, Göttingen, Germany
| | - Angelika Svetlove
- Max Plank Institute for Multidisciplinary Sciences, Göttingen, Germany
| | - Arndt F Schilling
- Department of Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center, Göttingen, Germany
| | - Frauke Alves
- Institute for Diagnostic and Interventional Radiology, University Medical Center, Robert-Koch-Straße 40, 37075, Göttingen, Germany
- Max Plank Institute for Multidisciplinary Sciences, Göttingen, Germany
- Department of Haematology and Medical Oncology, University Medical Center, Göttingen, Germany
| | - Christoph Rußmann
- Faculty of Engineering and Health, University of Applied Sciences and Arts, Göttingen, Germany
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Christian Dullin
- Institute for Diagnostic and Interventional Radiology, University Medical Center, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
- Max Plank Institute for Multidisciplinary Sciences, Göttingen, Germany.
- Department for Diagnostic and Interventional Radiology, University Hospital, Heidelberg, Germany.
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.
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Lee DH, Park JE, Kim N, Park SY, Kim YH, Cho YH, Kim JH, Kim HS. Tumor Habitat Analysis Using Longitudinal Physiological MRI to Predict Tumor Recurrence After Stereotactic Radiosurgery for Brain Metastasis. Korean J Radiol 2023; 24:235-246. [PMID: 36788768 PMCID: PMC9971843 DOI: 10.3348/kjr.2022.0492] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/08/2022] [Accepted: 12/11/2022] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE It is difficult to predict the treatment response of tissue after stereotactic radiosurgery (SRS) because radiation necrosis (RN) and tumor recurrence can coexist. Our study aimed to predict tumor recurrence, including the recurrence site, after SRS of brain metastasis by performing a longitudinal tumor habitat analysis. MATERIALS AND METHODS Two consecutive multiparametric MRI examinations were performed for 83 adults (mean age, 59.0 years; range, 27-82 years; 44 male and 39 female) with 103 SRS-treated brain metastases. Tumor habitats based on contrast-enhanced T1- and T2-weighted images (structural habitats) and those based on the apparent diffusion coefficient (ADC) and cerebral blood volume (CBV) images (physiological habitats) were defined using k-means voxel-wise clustering. The reference standard was based on the pathology or Response Assessment in Neuro-Oncologycriteria for brain metastases (RANO-BM). The association between parameters of single-time or longitudinal tumor habitat and the time to recurrence and the site of recurrence were evaluated using the Cox proportional hazards regression analysis and Dice similarity coefficient, respectively. RESULTS The mean interval between the two MRI examinations was 99 days. The longitudinal analysis showed that an increase in the hypovascular cellular habitat (low ADC and low CBV) was associated with the risk of recurrence (hazard ratio [HR], 2.68; 95% confidence interval [CI], 1.46-4.91; P = 0.001). During the single-time analysis, a solid low-enhancing habitat (low T2 and low contrast-enhanced T1 signal) was associated with the risk of recurrence (HR, 1.54; 95% CI, 1.01-2.35; P = 0.045). A hypovascular cellular habitat was indicative of the future recurrence site (Dice similarity coefficient = 0.423). CONCLUSION After SRS of brain metastases, an increased hypovascular cellular habitat observed using a longitudinal MRI analysis was associated with the risk of recurrence (i.e., treatment resistance) and was indicative of recurrence site. A tumor habitat analysis may help guide future treatments for patients with brain metastases.
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Affiliation(s)
- Da Hyun Lee
- Department of Radiology, Ajou University School of Medicine, Suwon, Korea
| | - Ji Eun Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
| | | | - Seo Young Park
- Department of Statistics and Data Science, Korea National Open University, Seoul, Korea
| | - Young-Hoon Kim
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Young Hyun Cho
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jeong Hoon Kim
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Ho Sung Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Delgado-Ortet M, Reinius MAV, McCague C, Bura V, Woitek R, Rundo L, Gill AB, Gehrung M, Ursprung S, Bolton H, Haldar K, Pathiraja P, Brenton JD, Crispin-Ortuzar M, Jimenez-Linan M, Escudero Sanchez L, Sala E. Lesion-specific 3D-printed moulds for image-guided tissue multi-sampling of ovarian tumours: A prospective pilot study. Front Oncol 2023; 13:1085874. [PMID: 36860310 PMCID: PMC9969130 DOI: 10.3389/fonc.2023.1085874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/24/2023] [Indexed: 02/16/2023] Open
Abstract
Background High-Grade Serous Ovarian Carcinoma (HGSOC) is the most prevalent and lethal subtype of ovarian cancer, but has a paucity of clinically-actionable biomarkers due to high degrees of multi-level heterogeneity. Radiogenomics markers have the potential to improve prediction of patient outcome and treatment response, but require accurate multimodal spatial registration between radiological imaging and histopathological tissue samples. Previously published co-registration work has not taken into account the anatomical, biological and clinical diversity of ovarian tumours. Methods In this work, we developed a research pathway and an automated computational pipeline to produce lesion-specific three-dimensional (3D) printed moulds based on preoperative cross-sectional CT or MRI of pelvic lesions. Moulds were designed to allow tumour slicing in the anatomical axial plane to facilitate detailed spatial correlation of imaging and tissue-derived data. Code and design adaptations were made following each pilot case through an iterative refinement process. Results Five patients with confirmed or suspected HGSOC who underwent debulking surgery between April and December 2021 were included in this prospective study. Tumour moulds were designed and 3D-printed for seven pelvic lesions, covering a range of tumour volumes (7 to 133 cm3) and compositions (cystic and solid proportions). The pilot cases informed innovations to improve specimen and subsequent slice orientation, through the use of 3D-printed tumour replicas and incorporation of a slice orientation slit in the mould design, respectively. The overall research pathway was compatible with implementation within the clinically determined timeframe and treatment pathway for each case, involving multidisciplinary clinical professionals from Radiology, Surgery, Oncology and Histopathology Departments. Conclusions We developed and refined a computational pipeline that can model lesion-specific 3D-printed moulds from preoperative imaging for a variety of pelvic tumours. This framework can be used to guide comprehensive multi-sampling of tumour resection specimens.
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Affiliation(s)
- Maria Delgado-Ortet
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
| | - Marika A. V. Reinius
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Cathal McCague
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Vlad Bura
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Department of Radiology, Clinical Emergency Children’s Hospital, Cluj-Napoca, Romania
| | - Ramona Woitek
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Research Center for Medical Image Analysis & Artificial Intelligence (MIAAI), Danube Private University, Krems, Austria
| | - Leonardo Rundo
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
- Department of Information and Electrical Engineering and Applied Mathematics, University of Salerno, Fisciano, SA, Italy
| | - Andrew B. Gill
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Marcel Gehrung
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Stephan Ursprung
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Helen Bolton
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Krishnayan Haldar
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Pubudu Pathiraja
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - James D. Brenton
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Mireia Crispin-Ortuzar
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Mercedes Jimenez-Linan
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Lorena Escudero Sanchez
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
| | - Evis Sala
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
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van der Beek JN, Fitski M, de Krijger RR, Wijnen MHWA, van den Heuvel-Eibrink MM, Vermeulen MA, van der Steeg AFW, Littooij AS. Direct correlation of MRI with histopathology in pediatric renal tumors through the use of a patient-specific 3-D-printed cutting guide: a feasibility study. Pediatr Radiol 2023; 53:235-243. [PMID: 36040524 PMCID: PMC9892092 DOI: 10.1007/s00247-022-05476-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/16/2022] [Accepted: 07/31/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Pediatric renal tumors are often heterogeneous lesions with variable regions of distinct histopathology. Direct comparison between in vivo imaging and ex vivo histopathology might be useful for identification of discriminating imaging features. OBJECTIVE This feasibility study explored the use of a patient-specific three-dimensional (3D)-printed cutting guide to ensure correct alignment (orientation and slice thickness) between magnetic resonance imaging (MRI) and histopathology. MATERIALS AND METHODS Before total nephrectomy, a patient-specific cutting guide based on each patient's preoperative renal MRI was generated and 3-D printed, to enable consistent transverse orientation of the histological specimen slices with MRI slices. This was expected to result in macroscopic slices of 5 mm each. The feasibility of the technique was determined qualitatively, through questionnaires administered to involved experts, and quantitatively, based on structured measurements including overlap calculation using the dice similarity coefficient. RESULTS The cutting guide was used in eight Wilms tumor patients receiving a total nephrectomy, after preoperative chemotherapy. The median age at diagnosis was 50 months (range: 4-100 months). The positioning and slicing of the specimens were rated overall as easy and the median macroscopic slice thickness of each specimen ranged from 5 to 6 mm. Tumor consistency strongly influenced the practical application of the cutting guide. Digital correlation of a total of 32 slices resulted in a median dice similarity coefficient of 0.912 (range: 0.530-0.960). CONCLUSION We report the feasibility of a patient-specific 3-D-printed MRI-based cutting guide for pediatric renal tumors, allowing improvement of the correlation of MRI and histopathology in future studies.
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Affiliation(s)
- Justine N. van der Beek
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands ,Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Matthijs Fitski
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands ,Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | | | | | - Annemieke S. Littooij
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands ,Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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5
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Ursprung S, Woitek R, McLean MA, Priest AN, Crispin-Ortuzar M, Brodie CR, Gill AB, Gehrung M, Beer L, Riddick ACP, Field-Rayner J, Grist JT, Deen SS, Riemer F, Kaggie JD, Zaccagna F, Duarte JAG, Locke MJ, Frary A, Aho TF, Armitage JN, Casey R, Mendichovszky IA, Welsh SJ, Barrett T, Graves MJ, Eisen T, Mitchell TJ, Warren AY, Brindle KM, Sala E, Stewart GD, Gallagher FA. Hyperpolarized 13C-Pyruvate Metabolism as a Surrogate for Tumor Grade and Poor Outcome in Renal Cell Carcinoma-A Proof of Principle Study. Cancers (Basel) 2022; 14:335. [PMID: 35053497 PMCID: PMC8773685 DOI: 10.3390/cancers14020335] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 02/01/2023] Open
Abstract
Differentiating aggressive clear cell renal cell carcinoma (ccRCC) from indolent lesions is challenging using conventional imaging. This work prospectively compared the metabolic imaging phenotype of renal tumors using carbon-13 MRI following injection of hyperpolarized [1-13C]pyruvate (HP-13C-MRI) and validated these findings with histopathology. Nine patients with treatment-naïve renal tumors (6 ccRCCs, 1 liposarcoma, 1 pheochromocytoma, 1 oncocytoma) underwent pre-operative HP-13C-MRI and conventional proton (1H) MRI. Multi-regional tissue samples were collected using patient-specific 3D-printed tumor molds for spatial registration between imaging and molecular analysis. The apparent exchange rate constant (kPL) between 13C-pyruvate and 13C-lactate was calculated. Immunohistochemistry for the pyruvate transporter (MCT1) from 44 multi-regional samples, as well as associations between MCT1 expression and outcome in the TCGA-KIRC dataset, were investigated. Increasing kPL in ccRCC was correlated with increasing overall tumor grade (ρ = 0.92, p = 0.009) and MCT1 expression (r = 0.89, p = 0.016), with similar results acquired from the multi-regional analysis. Conventional 1H-MRI parameters did not discriminate tumor grades. The correlation between MCT1 and ccRCC grade was confirmed within a TCGA dataset (p < 0.001), where MCT1 expression was a predictor of overall and disease-free survival. In conclusion, metabolic imaging using HP-13C-MRI differentiates tumor aggressiveness in ccRCC and correlates with the expression of MCT1, a predictor of survival. HP-13C-MRI may non-invasively characterize metabolic phenotypes within renal cancer.
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Affiliation(s)
- Stephan Ursprung
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Ramona Woitek
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Mary A. McLean
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Andrew N. Priest
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Mireia Crispin-Ortuzar
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
| | - Cara R. Brodie
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
| | - Andrew B. Gill
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Marcel Gehrung
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
| | - Lucian Beer
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Antony C. P. Riddick
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
| | - Johanna Field-Rayner
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - James T. Grist
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Surrin S. Deen
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Frank Riemer
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Joshua D. Kaggie
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Fulvio Zaccagna
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Joao A. G. Duarte
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Matthew J. Locke
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Amy Frary
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Tevita F. Aho
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
| | - James N. Armitage
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
| | - Ruth Casey
- Department of Endocrinology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Iosif A. Mendichovszky
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Sarah J. Welsh
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Oncology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Department of Surgery, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Tristan Barrett
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Martin J. Graves
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Tim Eisen
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Oncology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Thomas J. Mitchell
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
- Department of Surgery, University of Cambridge, Cambridge CB2 0QQ, UK
- Wellcome Sanger Institute, Hinxton CB10 1RQ, UK
| | - Anne Y. Warren
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Pathology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Kevin M. Brindle
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
| | - Evis Sala
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Grant D. Stewart
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
- Department of Surgery, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Ferdia A. Gallagher
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
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6
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Beer L, Martin-Gonzalez P, Delgado-Ortet M, Reinius M, Rundo L, Woitek R, Ursprung S, Escudero L, Sahin H, Funingana IG, Ang JE, Jimenez-Linan M, Lawton T, Phadke G, Davey S, Nguyen NQ, Markowetz F, Brenton JD, Crispin-Ortuzar M, Addley H, Sala E. Ultrasound-guided targeted biopsies of CT-based radiomic tumour habitats: technical development and initial experience in metastatic ovarian cancer. Eur Radiol 2021; 31:3765-3772. [PMID: 33315123 PMCID: PMC8128813 DOI: 10.1007/s00330-020-07560-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/29/2020] [Accepted: 11/23/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To develop a precision tissue sampling technique that uses computed tomography (CT)-based radiomic tumour habitats for ultrasound (US)-guided targeted biopsies that can be integrated in the clinical workflow of patients with high-grade serous ovarian cancer (HGSOC). METHODS Six patients with suspected HGSOC scheduled for US-guided biopsy before starting neoadjuvant chemotherapy were included in this prospective study from September 2019 to February 2020. The tumour segmentation was performed manually on the pre-biopsy contrast-enhanced CT scan. Spatial radiomic maps were used to identify tumour areas with similar or distinct radiomic patterns, and tumour habitats were identified using the Gaussian mixture modelling. CT images with superimposed habitat maps were co-registered with US images by means of a landmark-based rigid registration method for US-guided targeted biopsies. The dice similarity coefficient (DSC) was used to assess the tumour-specific CT/US fusion accuracy. RESULTS We successfully co-registered CT-based radiomic tumour habitats with US images in all patients. The median time between CT scan and biopsy was 21 days (range 7-30 days). The median DSC for tumour-specific CT/US fusion accuracy was 0.53 (range 0.79 to 0.37). The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76-0.79) while it was lower for the smaller omental metastases (DSC: 0.37-0.53). CONCLUSION We developed a precision tissue sampling technique that uses radiomic habitats to guide in vivo biopsies using CT/US fusion and that can be seamlessly integrated in the clinical routine for patients with HGSOC. KEY POINTS • We developed a prevision tissue sampling technique that co-registers CT-based radiomics-based tumour habitats with US images. • The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76-0.79) while it was lower for the smaller omental metastases (DSC: 0.37-0.53).
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Affiliation(s)
- Lucian Beer
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, 1090, Vienna, Austria
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Paula Martin-Gonzalez
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Maria Delgado-Ortet
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Marika Reinius
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Leonardo Rundo
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Ramona Woitek
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, 1090, Vienna, Austria
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Stephan Ursprung
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Lorena Escudero
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Hilal Sahin
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Ionut-Gabriel Funingana
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Joo-Ern Ang
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | | | | | | | | | - Nghia Q Nguyen
- Information Engineering Division, Department of Engineering, University of Cambridge, Cambridge, CB2 1PZ, UK
| | - Florian Markowetz
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
| | - James D Brenton
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Mireia Crispin-Ortuzar
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Helen Addley
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Evis Sala
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK.
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK.
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7
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Precision radiogenomics: fusion biopsies to target tumour habitats in vivo. Br J Cancer 2021; 125:778-779. [PMID: 33864016 PMCID: PMC8437988 DOI: 10.1038/s41416-021-01381-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022] Open
Abstract
High-grade serous ovarian cancer lesions display a high degree of heterogeneity on CT scans. We have recently shown that regions with distinct imaging profiles can be accurately biopsied in vivo using a technique based on the fusion of CT and ultrasound scans.
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