PDF(Pubmed)
Abstract：
UNASSIGNED: This study explores the feasibility of ex-vivo high-field magnetic resonance (MR) imaging to create digital a three-dimensional (3D) representations of tongue cancer specimens, referred to as the \"MR-based digital specimen\" (MR-DS). The aim was to create a method to assist surgeons in identifying and localizing inadequate resection margins during surgery, a critical factor in achieving locoregional control.
UNASSIGNED: Fresh resection specimens of nine tongue cancer patients were imaged in a 7 Tesla small-bore MR, using a high-resolution multislice and 3D T2-weighted Turbo Spin Echo. Two independent radiologists (R1 and R2) outlined the tumor and mucosa on the MR-images whereafter the outlines were configured to an MR-DS. A color map was projected on the MR-DS, mapping the inadequate margins according to R1 and R2. We compared the hematoxylin-eosin-based digital specimen (HE-DS), which is a histopathological 3D representation derived from HE stained sections, with its corresponding MR-images. In line with conventional histopathological assessment, all digital specimens were divided into five anatomical regions (anterior, posterior, craniomedial, caudolateral and deep central). Over- and underestimation 95th-percentile Hausdorff-distances were calculated between the radiologist- and histopathologist-determined tumor outlines. The MR-DS\' diagnostic accuracy for inadequate margin detection (i.e. sensitivity and specificity) was determined in two ways: with conventional histopathology and HE-DS as reference.
UNASSIGNED: Using conventional histopathology as a reference, R1 achieved 77% sensitivity and 50% specificity, while R2 achieved 65% sensitivity and 57% specificity. When referencing to the HE-DS, R1 achieved 94% sensitivity and 61% specificity, while R2 achieved 88% sensitivity and 71% specificity. Range of over- and underestimation 95HD was 0.9 mm - 11.8 mm and 0.0 mm - 5.3 mm, respectively.
UNASSIGNED: This proof of concept for volumetric assessment of resection margins using MR-DSs, demonstrates promising potential for further development. Overall, sensitivity is higher than specificity for inadequate margin detection, because of the radiologist\'s tendency to overestimate tumor size.
UNASSIGNED: Fresh resection specimens of nine tongue cancer patients were imaged in a 7 Tesla small-bore MR, using a high-resolution multislice and 3D T2-weighted Turbo Spin Echo. Two independent radiologists (R1 and R2) outlined the tumor and mucosa on the MR-images whereafter the outlines were configured to an MR-DS. A color map was projected on the MR-DS, mapping the inadequate margins according to R1 and R2. We compared the hematoxylin-eosin-based digital specimen (HE-DS), which is a histopathological 3D representation derived from HE stained sections, with its corresponding MR-images. In line with conventional histopathological assessment, all digital specimens were divided into five anatomical regions (anterior, posterior, craniomedial, caudolateral and deep central). Over- and underestimation 95th-percentile Hausdorff-distances were calculated between the radiologist- and histopathologist-determined tumor outlines. The MR-DS\' diagnostic accuracy for inadequate margin detection (i.e. sensitivity and specificity) was determined in two ways: with conventional histopathology and HE-DS as reference.
UNASSIGNED: Using conventional histopathology as a reference, R1 achieved 77% sensitivity and 50% specificity, while R2 achieved 65% sensitivity and 57% specificity. When referencing to the HE-DS, R1 achieved 94% sensitivity and 61% specificity, while R2 achieved 88% sensitivity and 71% specificity. Range of over- and underestimation 95HD was 0.9 mm - 11.8 mm and 0.0 mm - 5.3 mm, respectively.
UNASSIGNED: This proof of concept for volumetric assessment of resection margins using MR-DSs, demonstrates promising potential for further development. Overall, sensitivity is higher than specificity for inadequate margin detection, because of the radiologist\'s tendency to overestimate tumor size.
摘要：
■这项研究探讨了离体高场磁共振（MR）成像以创建舌癌标本的数字三维（3D）表示的可行性，称为“基于MR的数字样本”(MR-DS)。目的是创建一种方法来帮助外科医生在手术期间识别和定位不充分的切除边缘。实现局部控制的关键因素。
■9名舌癌患者的新鲜切除标本在7特斯拉小口径MR中成像，使用高分辨率多层和3DT2加权Turbo自旋回波。两个独立的放射科医师(R1和R2)在MR图像上勾勒出肿瘤和粘膜的轮廓,然后将轮廓配置为MR-DS。在MR-DS上投影了一张彩色地图,根据R1和R2映射不足的余量。我们比较了基于苏木精-伊红的数字样本（HE-DS），这是一个来自HE染色切片的组织病理学3D表示，与相应的MR图像。根据常规的组织病理学评估，所有数字标本都分为五个解剖区域(前，后部,颅骨,尾外侧和深中央）。在放射科医师和组织病理学家确定的肿瘤轮廓之间计算了高估和低估95百分位数Hausdorff距离。MR-DS对边缘检测不足的诊断准确性（即敏感性和特异性）通过两种方式确定：以常规组织病理学和HE-DS作为参考。
■使用常规组织病理学作为参考，R1达到77%的灵敏度和50%的特异性，而R2达到65%的灵敏度和57%的特异性。当引用HE-DS时，R1达到94%的灵敏度和61%的特异性，而R2达到88%的灵敏度和71%的特异性。95HD的高估和低估范围为0.9毫米-11.8毫米和0.0毫米-5.3毫米，分别。
■使用MR-DSs对切除边缘进行体积评估的概念证明，显示出进一步发展的潜力。总的来说,对于边缘检测不足的敏感性高于特异性，因为放射科医生倾向于高估肿瘤的大小。
■9名舌癌患者的新鲜切除标本在7特斯拉小口径MR中成像，使用高分辨率多层和3DT2加权Turbo自旋回波。两个独立的放射科医师(R1和R2)在MR图像上勾勒出肿瘤和粘膜的轮廓,然后将轮廓配置为MR-DS。在MR-DS上投影了一张彩色地图,根据R1和R2映射不足的余量。我们比较了基于苏木精-伊红的数字样本（HE-DS），这是一个来自HE染色切片的组织病理学3D表示，与相应的MR图像。根据常规的组织病理学评估，所有数字标本都分为五个解剖区域(前，后部,颅骨,尾外侧和深中央）。在放射科医师和组织病理学家确定的肿瘤轮廓之间计算了高估和低估95百分位数Hausdorff距离。MR-DS对边缘检测不足的诊断准确性（即敏感性和特异性）通过两种方式确定：以常规组织病理学和HE-DS作为参考。
■使用常规组织病理学作为参考，R1达到77%的灵敏度和50%的特异性，而R2达到65%的灵敏度和57%的特异性。当引用HE-DS时，R1达到94%的灵敏度和61%的特异性，而R2达到88%的灵敏度和71%的特异性。95HD的高估和低估范围为0.9毫米-11.8毫米和0.0毫米-5.3毫米，分别。
■使用MR-DSs对切除边缘进行体积评估的概念证明，显示出进一步发展的潜力。总的来说,对于边缘检测不足的敏感性高于特异性，因为放射科医生倾向于高估肿瘤的大小。
