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  • Grating-based phase-contrast CT (PCCT): histopathological correlation of human liver cirrhosis and hepatocellular carcinoma specimen

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Original research
Grating-based phase-contrast CT (PCCT): histopathological correlation of human liver cirrhosis and hepatocellular carcinoma specimen
  1. Melanie A Kimm1,
  2. Marian Willner2,
  3. Enken Drecoll3,
  4. Julia Herzen2,
  5. Peter B Noël1,4,
  6. Ernst J Rummeny1,
  7. Franz Pfeiffer2,
  8. Alexander A Fingerle1
  1. 1 Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
  2. 2 Chair of Biomedical Physics, Department of Physics and Munich School of Bioengineering, Technical University of Munich, Garching, Germany
  3. 3 Department of Pathology, School of Medicine & Technical University of Munich, Munich, Germany
  4. 4 Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Melanie A Kimm, Department of diagnostic and interventional Radiology, Klinikum rechts der Isar der Technischen Universitat Muenchen, Munich, Germany; melanie.kimm{at}tum.de

Abstract

Aims To correlate signal intensities in grating-based phase-contrast CT (PCCT) images obtained at a synchrotron light source and a conventional X-ray source with tissue components in human liver cirrhosis and hepatocellular carcinoma (HCC) specimen.

Methods Study approval was obtained by the institutional review board. Human specimen of liver cirrhosis and HCC were imaged at experimental grating-based PCCT setups using either a synchrotron radiation source or a conventional X-ray tube. Tissue samples were sectioned and processed for H&E and Elastica van Gieson staining. PCCT and histological images were manually correlated. Depending on morphology and staining characteristics tissue components like fibrosis, HCC, inflammation, connective tissue and necrosis were differentiated and visually correlated with signal intensity in PCCT images using a 5-point Likert scale with normal liver parenchyma as a reference.

Results Grating-based PCCT images of human cirrhotic liver and HCC specimen showed high soft-tissue contrast allowing correlation with histopathological sections. Signal intensities were similar in both setups independent of the nature of the radiation source. Connective tissue and areas of haemorrhage displayed the highest signal intensities, fibrotic liver tissue the lowest.

Conclusions Grating-based PCCT provides comparable results for the characterisation of human specimen of liver cirrhosis and HCC using either a synchrotron light source or a conventional X-ray tube. Due to its high soft-tissue contrast and its applicability to conventional X-ray tubes grating-based PCCT holds potential for preclinical research and virtual histology applications.

  • cancer
  • digital pathology
  • diagnosis

https://doi.org/10.1136/jclinpath-2019-206380

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    Footnotes

    • Handling editor Runjan Chetty.

    • Contributors MAK, MW, ED, JH, PBN, FP and AAF designed the study. MAK, MW, ED, JH, PBN and AAF were responsible for data acquisition. Analysis and interpretation of data was performed by MAK, MW, ED, JH, PBN, EJR, FP and AAF. MAK and ED had full access to the histological data. MW, JH, PBN, FP and AAF had full access to the CT data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors were involved in drafting the article or revising it critically for important intellectual content and all authors approved the final version to be published.

    • Funding Supported in part by the DFG Cluster of Excellence Munich-Centre for Advanced Photonics (MAP, DFG EXC-158) and the Center for Advanced Laser Applications (CALA).

    • Competing interests PBN reports grants from Philips Healthcare, outside the submitted work.

    • Patient consent for publication Not required.

    • Ethics approval The study was fully approved by the local ethics committee at the Faculty of Medicine of the Technical University of Munich (project number 4029/11).

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Data availability statement Data are available on reasonable request. The data are not publicly available due to them containing information that could compromise patient privacy.