3D Virtual Histopathology by Phase-Contrast X-Ray Micro-CT for Follicular Thyroid Neoplasms

• Published in: IEEE transactions on medical imaging 2024-07, Vol.43 (7), p.2670-2678
• Main Authors: Tajbakhsh, Kiarash, Stanowska, Olga, Neels, Antonia, Perren, Aurel, Zboray, Robert
• Format: Article
• Language: English
• Subjects: 3D virtual histology; Computed tomography; Diagnosis; Electron tubes; Histology; Histopathology; Imaging; Invasions; Malignancy; Medical imaging; Morphology; Neoplasms; Nondestructive testing; phase-contrast X-ray imaging; precision medicine; propagation-based imaging; Three-dimensional displays; Thyroid; Thyroid cancer; Thyroid carcinoma; Thyroid neoplasm; X ray imagery; X-ray imaging
• ISSN: 0278-0062; 1558-254X; 1558-254X
• DOI: 10.1109/TMI.2024.3372602

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.