Graduate School of Medicine, Nagoya University, Nagoya, Aichi, 461-8673, Japan.
Department of Radiological Technology, Hokkaido University of Science, Sapporo, Hokkaido, 006-8585, Japan.
Breast Cancer Res Treat. 2020 Apr;180(2):397-405. doi: 10.1007/s10549-020-05574-w. Epub 2020 Feb 13.
The three-dimensional (3D) structure of the human nipple has not been fully clarified. However, its importance has increased in recent years because it has become common practice to preoperatively explore the spread of breast cancer to the nipple with needle biopsy, ductoscopy, and/or ductal lavage for nipple-sparing mastectomy. Here, we demonstrated that X-ray dark-field computed tomography (XDFI-CT) is a powerful tool for reconstructing the 3D distribution pattern of human lactiferous ducts non-destructively, without contrast agent, and with high tissue contrast.
Nipples amputated from mastectomy specimens of 51 patients with breast cancer were visualized three-dimensionally by XDFI-CT. First, CT images and conventionally stained tissue sections were compared to demonstrate that XDFI-CT provides 3D anatomical information. Next, the number of ducts in the nipple and the number of ducts sharing an ostium near the tip of the nipple were measured from the volume set of XDFI-CT. Finally, the 3D distribution pattern of the ducts was determined.
XDFI-CT can provide images almost equivalent to those of low-magnification light microscopy of conventional hematoxylin-eosin-stained histological sections. The mean number of ducts in all cases was 28.0. The total number of ducts sharing an ostium near the tip of the nipple was 525 of 1428. The 3D distribution patterns of the ducts were classified into three types that we defined as convergent (22%), straight (39%), or divergent (39%).
XDFI-CT is useful for exploring the microanatomy of the human nipple and might be used for non-invasive nipple diagnosis in the future.
人类乳头的三维（3D）结构尚未完全阐明。然而，近年来，由于术前通过针活检、乳管镜检查和/或乳管灌洗对保乳乳头切除术进行乳腺癌向乳头扩散的探索已成为常规做法，其重要性有所增加。在这里，我们证明 X 射线暗场计算机断层扫描（XDFI-CT）是一种强大的工具，可用于非破坏性地重建人类输乳管的 3D 分布模式，无需造影剂，且具有高组织对比度。
通过 XDFI-CT 对 51 例乳腺癌乳房切除术标本切除的乳头进行三维可视化。首先，将 CT 图像与常规染色的组织切片进行比较，以证明 XDFI-CT 提供了 3D 解剖学信息。接下来，从 XDFI-CT 的体积集测量乳头中的导管数量和靠近乳头尖端的开口处共享导管的数量。最后，确定导管的 3D 分布模式。
XDFI-CT 可以提供几乎与传统苏木精-伊红染色组织学切片低倍光镜图像等效的图像。所有病例的平均导管数量为 28.0。靠近乳头尖端开口处共享的导管总数为 1428 个中的 525 个。导管的 3D 分布模式分为我们定义的三种类型：汇聚型（22%）、直线型（39%）或发散型（39%）。
XDFI-CT 可用于探索人类乳头的微观解剖结构，并且将来可能用于非侵入性乳头诊断。
