Abstract
Micro-computed tomography (micro-CT) is a promising novel medical imaging modality that allows for non-destructive volumetric imaging of surgical tissue specimens at high spatial resolution. The aim of this study is to provide a comprehensive assessment of the clinical applications of micro-CT for the tissue-based diagnosis of lung diseases. This scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews, aiming to include every clinical study reporting on micro-CT imaging of human lung tissues. A literature search yielded 570 candidate articles, out of which 37 were finally included in the review. Of the selected studies, 9 studies explored via micro-CT imaging the morphology and anatomy of normal human lung tissue; 21 studies investigated microanatomic pulmonary alterations due to obstructive or restrictive lung diseases, such as chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, and cystic fibrosis; and 7 studies examined the utility of micro-CT imaging in assessing lung cancer lesions (n = 4) or in transplantation-related pulmonary alterations (n = 3). The selected studies reported that micro-CT could successfully detect several lung diseases providing three-dimensional images of greater detail and resolution than routine optical slide microscopy, and could additionally provide valuable volumetric insight in both restrictive and obstructive lung diseases. In conclusion, micro-CT-based volumetric measurements and qualitative evaluations of pulmonary tissue structures can be utilized for the clinical management of a variety of lung diseases. With micro-CT devices becoming more accessible, the technology has the potential to establish itself as a core diagnostic imaging modality in pathology and to enable integrated histopathologic and radiologic assessment of lung cancer and other lung diseases.
Highlights
Micro-computed tomography constitutes a novel non-destructive ex vivo medical imaging modality that enables volumetric imaging of intact surgical lung tissue specimens at high spatial resolution and is thereby capable of providing microscopic insight into alveolar anatomy and pathology [1]
In contrast to the CT devices used in radiology for in vivo imaging, micro-CT devices used for ex vivo imaging operate at a much smaller scale and with a higher radiation dose, which allows for the acquisition of digital images of lung tissue specimens at micrometre resolution, thereby enabling the diagnosis of pulmonary diseases that manifest itself at the microanatomic scale [5,6]
After reading the full-text reports of the potentially eligible studies, a total of 37 studies reporting clinical applications of micro-CT imaging of human lung specimens were included for systematic analysis
Summary
Micro-computed tomography (micro-CT) constitutes a novel non-destructive ex vivo medical imaging modality that enables volumetric imaging of intact surgical lung tissue specimens at high spatial resolution and is thereby capable of providing microscopic insight into alveolar anatomy and pathology [1]. Due to these favourable properties, micro-CT has been used in research settings and helped to advance our understanding of lung histopathology [2]. Given its favourable imaging characteristics and rapid image acquisition speed, micro-CT has great potential for clinical applications across a wide spectrum of pulmonary pathologies, including chronic restrictive and obstructive lung disease as well as lung cancer [6,11,12]
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