Abstract
The aim of this study was to evaluate the clinical implication of synchrotron radiation imaging techniques for human lung adenocarcinoma in comparison with pathologic examination. A refraction-based tomographic imaging technique called the X-ray dark-field imaging (XDFI) method was used to obtain computed tomographic images of human lung adenocarcinoma at the beam line at Photon Factory BL 14B at the High Energy Accelerator Research Organization (KEK) in Tsukuba, Japan. Images of normal lung tissue were also obtained using the same methods and reconstructed as 3D images. Both reconstructed images were compared with pathologic examinations from histologic slides which were made with identical samples. Pulmonary alveolar structure including terminal bronchioles, alveolar sacs, and vasculatures could be identified in synchrotron radiation images of normal lung. Hyperplasia of interstitial tissue and dysplasia of alveolar structures were noticed in images of lung adenocarcinoma. Both synchrotron radiation images were considerably correlated with images from histologic slides. Lepidic patterns of cancer tissue were distinguished from the invasive area in synchrotron radiation images of lung adenocarcinoma. Refraction-contrast tomographic techniques using synchrotron radiation could provide high-resolution images of lung adenocarcinoma which are compatible with those from pathologic examinations.
Highlights
A specimen for imaging was obtained from a 67-year-old male patient who had been diagnosed with lung adenocarcinoma and underwent surgical treatment (VATS left upper lobectomy with mediastinal LN dissection) in Korea University Anam Hospital with written informed consent
The resected lung cancer specimen was fixed in 10% neutral buffered formalin solution, and after all pathologic procedures including airway instillation, fixation, gross examination, mapping of cancer, slicing in 3-mm section, paraffin block making, hematoxylin and eosin (H&E) staining, and immunohistochemistry were performed [11], a lung cancer tissue block as well as normal tissue for experiments were harvested under the supervision of a pathologic specialist
Those lesions could be identified as benign ones because they did not accompany interstitial thickening and preserved their inherent alveolar structures
Summary
Lung cancer has been the leading cause of cancer-related death worldwide [1,2]. Patients with early stage disease have showed promising prognosis with 70% to 95% 5-year survival [3]. About 75% of lung cancer patients were in advanced stages at the time of diagnosis. Despite the splendid achievement in oncologic management, the survival of those patients still remains in poor; less than 20% of those patients could survive after. 1 year from diagnosis [4,5]. Early detection of lung cancer is essential for survival improvement [1]
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