Qualitative and quantitative comparison of colonic microendoscopy image features to histopathology.
Qualitative and quantitative comparison of colonic microendoscopy image features to histopathology.
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结肠微观镜检查图像特征与组织病理学的定性和定量比较。
DOI：
10.1117/12.2079816
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发表时间：
2015-04-09
期刊：
影响因子：
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通讯作者：
Muldoon TJ
中科院分区：
文献类型：
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作者：
Prieto SP;Powless AJ;Lai K;Laryea JA;Mizell JS;Muldoon TJ
结直肠癌是美国癌症死亡的第二大原因，每年影响超过13万美国人。在手术切除前确定肿瘤边缘对于提供最佳治疗和减少复发率至关重要。高达20%的病例可能会出现结直肠癌复发，通常在治愈后三年内。通常，当切除结直肠癌时，需要肿瘤两侧正常组织的边缘。结肠癌的最小切缘为5厘米，直肠下端为2厘米。然而，通常在肿瘤的两侧提取更多的正常组织，因为整个节段的血液供应在手术中被移除，因此整个节段必须被移除。吻合口复发可能是由于切缘不足所致。病理学家检查边缘以确保没有肿瘤残留，这通常被记录在病理报告中。我们已经开发了一种便携式、护理点纤维束显微内窥镜成像系统，用于检测结肠上皮微结构的异常。该系统包括一台笔记本电脑、一个具有1 mm有效区域直径的改进型纤维束图像导向器和定制的Lab view界面，该系统已被阿肯色州医学大学批准用于对手术切除的结肠组织进行成像。显微内窥镜探头实时提供浅层上皮组织学的高分辨率图像，以辅助手术指导和定位可能看不到的异型增生的隐匿区。使用显微内窥镜设备采集新鲜切除的人结肠上皮的显微内窥镜图像，然后使用定制的后处理软件进行镶嵌。腺体的结构变化被映射到组织病理学切片上，这些切片取自显微内窥镜图像的准确位置。定性地，利用腺体变形和放置图像导向器从显微内窥镜图像到H&E幻灯片来标示结肠肿瘤的正常区域和发育不良区域以及周围区域。还探索了相关图像的量化指标，并通过分析腺体直径、空间分布和图像纹理获得了这些量化指标。
Colorectal cancer is the second leading cause of cancer deaths in the United States, affecting more than 130,000 Americans every year. Determining tumor margins prior to surgical resection is essential to providing optimal treatment and reducing recurrence rates. Colorectal cancer recurrence can occur in up to 20% of cases, commonly within three years after curative treatment. Typically, when colorectal cancers are resected, a margin of normal tissue on both sides of the tumor is required. The minimum margin required for colon cancer is 5 cm and for the lower rectum 2 cm. However, usually more normal tissue is taken on both sides of the tumor because the blood supply to the entire segment is removed with the surgery and therefore the entire segment must be removed. Anastomotic recurrences may result from inadequate margins. Pathologists look at the margins to ensure that there is no residual tumor and this is usually documented in the pathology report. We have developed a portable, point-of-care fiber bundle microendoscopy imaging system for detection of abnormalities in colonic epithelial microstructure. The system comprises a laptop, a modified fiber bundle image guide with a 1mm active area diameter and custom Lab VIEW interface, and is approved for imaging surgically resected colon tissue at the University of Arkansas for Medical Sciences. The microendoscopy probe provides high-resolution images of superficial epithelial histology in real-time to assist surgical guidance and to localize occult regions of dysplasia which may not be visible. Microendoscopy images of freshly resected human colonic epithelium were acquired using the microendoscopy device and subsequently mosaicked using custom post-processing software. Architectural changes in the glands were mapped to histopathology H&E slides taken from the precise location of the microendoscopy images. Qualitatively, glandular distortion and placement of image guide was used to map normal and dysplastic areas of the colonic tumor and surrounding region from microendoscopy images to H&E slides. Quantitative metrics for correlating images were also explored and were obtained by analyzing glandular diameter and spatial distribution as well as image texture.