IEEE Trans Med Imaging. 2024 Jul;43(7):2670-2678. doi: 10.1109/TMI.2024.3372602. Epub 2024 Jul 1.
Histological analysis is the core of follicular thyroid carcinoma (FTC) classification. The histopathological criteria of capsular and vascular invasion define malignancy and aggressiveness of FTC. Analysis of multiple sections is cumbersome and as only a minute tissue fraction is analyzed during histopathology, under-sampling remains a problem. Application of an efficient tool for complete tissue imaging in 3D would speed-up diagnosis and increase accuracy. We show that X-ray propagation-based imaging (XPBI) of paraffin-embedded tissue blocks is a valuable complementary method for follicular thyroid carcinoma diagnosis and assessment. It enables a fast, non-destructive and accurate 3D virtual histology of the FTC resection specimen. We demonstrate that XPBI virtual slices can reliably evaluate capsular invasions. Then we discuss the accessible morphological information from XPBI and their significance for vascular invasion diagnosis. We show 3D morphological information that allow to discern vascular invasions. The results are validated by comparing XPBI images with clinically accepted histology slides revised by and under supervision of two experienced endocrine pathologists.
组织学分析是滤泡状甲状腺癌 (FTC) 分类的核心。包膜和血管侵犯的组织病理学标准定义了 FTC 的恶性程度和侵袭性。分析多个切片很繁琐，而且由于组织病理学仅分析微小的组织部分，因此仍然存在取样不足的问题。应用有效的 3D 全组织成像工具将加速诊断并提高准确性。我们表明，基于 X 射线传播的成像 (XPBI) 是一种用于滤泡状甲状腺癌诊断和评估的有价值的补充方法。它可以快速、无损且准确地对 FTC 切除标本进行 3D 虚拟组织学检查。我们证明 XPBI 虚拟切片可以可靠地评估包膜侵犯。然后，我们讨论了 XPBI 提供的可访问形态学信息及其对血管侵犯诊断的意义。我们展示了允许区分血管侵犯的 3D 形态学信息。通过将 XPBI 图像与两位经验丰富的内分泌病理学家修订和监督的临床公认的组织学幻灯片进行比较，验证了这些结果。
