With histopathology results typically taking several days, the ability to stage tumors during interventions could provide a step change in various cancer interventions. X-ray technology has advanced significantly in recent years with the introduction of phase-based imaging methods. These have been adapted for use in standard labs rather than specialized facilities such as synchrotrons, and approaches that enable fast 3D scans with conventional x-ray sources have been developed. This opens the possibility to produce 3D images with enhanced soft tissue contrast at a level of detail comparable to histopathology, in times sufficiently short to be compatible with use during surgical interventions. In this paper we discuss the application of one such approach to human esophagi obtained from esophagectomy interventions. We demonstrate that the image quality is sufficiently high to enable tumor \rm T$\rm T$ staging based on the x-ray datasets alone. Alongside detection of involved margins with potentially life-saving implications, staging tumors intra-operatively has the potential to change patient pathways, facilitating optimization of therapeutic interventions during the procedure itself. Besides a prospective intra-operative use, the availability of high-quality 3D images of entire esophageal tumors can support histopathological characterization, from enabling “right slice first time” approaches to understanding the histopathology in the full 3D context of the surrounding tumor environment.

中文翻译：

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X 线食管肿瘤 T 分期


由于组织病理学结果通常需要几天的时间，因此在干预期间对肿瘤进行分期的能力可以为各种癌症干预措施提供阶跃变化。近年来，随着基于相位的成像方法的引入，X 射线技术取得了显着进步。这些设备已经过改造，适合在标准实验室中使用，而不是在同步加速器等专用设施中使用，并且已经开发出能够使用传统 X 射线源进行快速 3D 扫描的方法。这使得生成具有增强的软组织对比度的 3D 图像成为可能，其细节水平可与组织病理学相媲美，而且时间足够短，足以与外科手术期间的使用兼容。在本文中，我们讨论了一种通过食管切除术干预获得的人类食管方法的应用。我们证明图像质量足够高，足以使肿瘤\rm T 仅基于 X 射线数据集进行分期。除了检测涉及的边缘可能具有挽救生命的意义外，术中肿瘤分期还有可能改变患者的治疗路径，促进手术过程中治疗干预措施的优化。除了前瞻性的术中使用之外，整个食管肿瘤的高质量 3D 图像的可用性可以支持组织病理学表征，从启用“第一次正确切片”方法到了解周围肿瘤环境的完整 3D 环境中的组织病理学。