经导管基于光相干断层扫描的子宫内膜组织检查的初步研究和离体研究。

A pilot and ex-vivo study of examination of endometrium tissue by catheter based optical coherence tomography.

机构信息

Department of Gynaecology and Obstetrics, The Affiliated Zhongda Hospital, Southeast University, Nanjing, 21009, China.

School of Precision Instruments and Opto-Electronics Engineering, Tianjin University, Tianjin, 300072, China.

出版信息

BMC Med Imaging. 2022 Sep 10;22(1):162. doi: 10.1186/s12880-022-00890-7.

DOI:10.1186/s12880-022-00890-7

PMID:36088282

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9464373/

Abstract

OBJECTIVE

This study aimed to distinguish ex-vivo normal and abnormal endometrium tissue samples histologically by catheter based optical coherence tomography (OCT).

METHODS

A total of 72 ex-vivo endometrium specimens were obtained from June 2018 to March 2021 and were imaged fresh after hysterectomy. The scanned region of endometrium was excised for histological examination and endometrium OCT images were precisely compared to corresponding histological images. Meanwhile endometrium OCT images were analyzed quantitatively with intensity of backscattered light in region of interest (ROI) and maximum penetration depth of the OCT signal. Blinded qualitative analysis on endometrium OCT images was performed by 2 assessors to determine accuracy rate and inter-rating reliability on the histopathological diagnosis.

RESULTS

OCT images were performed successfully in 72 endometrium specimens. Five endometrium specimens developed OCT interpretation criteria and the rest 67 endometrium specimens validated qualitatively and analyzed quantitatively. We defined an OCT criteria to distinguish normal endometrium and five different abnormal endometrium phases including proliferative endometrium, secretory phase endometrium, atrophic endometrium, endometrial hyperplasia with atypia and endometrial carcinoma based on OCT imaging features. The overall diagnosis accuracy achieved by the two assessors was 72.4% based on the OCT criteria. The inter-rater reliability between assessors on overall OCT images was substantial (Kendall τb of 0.720, p < 0.05). The changes in ROI minimum intensity, ROI maximum intensity, ROI average intensity and OCT signal maximum penetration depth of five different abnormal endometrium phases were significantly different (all p < 0.001). These parameters of endometrium carcinomas were significantly different from the other four endometrium phases (all p < 0.001).

CONCLUSION

OCT has the advantage of noninvasive and rapid diagnosis, which can contribute to the diagnosis of endometrial cancer and will be an indispensable complement to traditional biopsy. Future studies in vivo with larger samples are needed to confirm this conclusion.

摘要

目的

本研究旨在通过基于导管的光学相干断层扫描（OCT）对离体正常和异常子宫内膜组织样本进行组织学区分。

方法

本研究共纳入 2018 年 6 月至 2021 年 3 月期间因子宫切除手术获得的 72 例离体子宫内膜标本。在手术后立即对扫描的子宫内膜区域进行新鲜组织学检查，并将 OCT 图像与相应的组织学图像进行精确比较。同时，对感兴趣区域（ROI）的背散射光强度和 OCT 信号的最大穿透深度进行定量分析。由 2 名评估者对子宫内膜 OCT 图像进行盲法定性分析，以确定对组织病理学诊断的准确性和评估者之间的可靠性。

结果

72 例子宫内膜标本均成功进行了 OCT 成像。有 5 例子宫内膜标本建立了 OCT 判读标准，其余 67 例子宫内膜标本进行了定性和定量分析。我们根据 OCT 成像特征定义了一种 OCT 标准，以区分正常子宫内膜和五种不同的异常子宫内膜阶段，包括增生期子宫内膜、分泌期子宫内膜、萎缩性子宫内膜、子宫内膜增生伴不典型和子宫内膜癌。根据 OCT 标准，两名评估者的总体诊断准确率为 72.4%。评估者之间的总体 OCT 图像的可靠性较强（Kendall τb 为 0.720，p<0.05）。五种不同异常子宫内膜阶段的 ROI 最小强度、ROI 最大强度、ROI 平均强度和 OCT 信号最大穿透深度的变化均有统计学意义（均 p<0.001）。这些参数在子宫内膜癌与其他四种子宫内膜阶段之间存在显著差异（均 p<0.001）。