Intra-operative assessment of cancer with x-ray phase contrast computed tomography
Intra-operative assessment of cancer with x-ray phase contrast computed tomography
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X 射线相差计算机断层扫描术中癌症评估
DOI：
10.1117/12.2632294
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Partridge T
中科院分区：
文献类型：
--
作者：
Partridge T
X 射线相衬计算机断层扫描 (PC-CT) 可提高软组织等弱衰减样本的对比度。在边缘照明 (EI) PC-CT 中，使用放置在样本和探测器之前的交替传输和衰减掩模，通过 X 射线束的幅度调制来获取相位效应。使用该技术的大视场 PC-CT 扫描仪应用于癌症评估的两个领域，即切除的乳房和食管组织。对于乳腺组织，使用 PC-CT 在术中研究广泛局部切除 (WLE)，以评估保乳手术中的肿瘤切除情况。图像在 10 分钟内获得，且图像质量不受影响，这表明该技术可用于临床环境。还拍摄了更长、更高分辨率的 PC-CT 图像，分析显示以前未检测到的肿瘤链变细。这将允许该系统在手术之外再次用于“虚拟组织病理学”。对于食管样本，组织取自食管切除手术，其中食管下部被切除，胃被重新定位。为了评估正在进行的治疗，根据组织病理学提供的当前金标准，对切除的食管中的肿瘤进行准确的分期至关重要。 PCCT 图像是在多个样本上获取的，并与组织病理学进行了很好的比较，两种模式都显示出相似的特征。示例显示仅使用 PC-CT 图像就可以对肿瘤渗透进行分期，希望这将成为术中进行成像和分期的重要一步。
X-ray Phase-Contrast Computed Tomography (PC-CT) increases contrast in weakly attenuating samples, such as soft tissues. In Edge-Illumination (EI) PC-CT, phase effects are accessed from amplitude modulation of the x-ray beam using alternating transmitting and attenuating masks placed prior to the sample and detector. A large field of view PC-CT scanner using this technique was applied to two areas of cancer assessment, namely excised breast and esophageal tissue. For the breast tissue, Wide Local Excisions (WLEs) were studied intra-operatively using PC-CT for the evaluation of tumor removal in breast conservation surgery. Images were acquired in 10 minutes without compromising on image quality, showing this can be used in a clinical setting. Longer, higher resolution PC-CT images were also taken, with analysis showing previously undetected thinning of tumor strands. This would allow a second use of the system for “virtual histopathology”, outside of surgery. For the esophagus samples, tissues were taken from esophagectomy surgery, where the lower part of the esophagus is removed, and the stomach relocated. For the assessment of ongoing therapy, accurate staging of tumors in the removed esophagus is essential, with the current gold standard provided by histopathology. PCCT images were acquired on several samples and compare well with histopathology, with both modalities showing similar features. Examples are shown where staging of tumor penetration is possible with PC-CT images alone, which is hoped will be an important step in performing the imaging and staging intra-operatively.