目的:PET成像的最新技术进步提高了灵敏度和空间分辨率。因此,临床核医学将以以前不熟悉的分辨率面对PET图像。为了更好地了解亚毫米尺度的[18F]FDG分布,需要放射性核素显像和组织病理学的直接相关性.
方法:共有5例诊断为头颈部恶性肿瘤的患者在接受手术切除前注射了临床活性的[18F]FDG。切除的标本使用临床前高分辨率PET/CT成像,然后切片样品。使用微型PET/CT设备对多个切片进行了重新扫描,其中一片被快速冷冻用于冷冻切片。冷冻切片放在放射自显影胶片上,然后进行苏木精和伊红染色,以准备进行组织病理学评估。放射自显影和组织病理学的结果使用迭代配准算法进行配准,并确定了感兴趣的区域来研究放射性示踪剂的摄取。
结果:在所有标本中,放射自显影及其相应的组织病理学之间的共配准都是成功的。使用这种新颖的方法可以直接比较放射自显影和组织病理学,并可以可视化良性和恶性组织中[18F]FDG摄取的未知异质性。
结论:我们在此描述了一种新的方法,该方法能够将[18F]FDG放射自显影与人类恶性组织的组织病理学金标准直接联合登记。当前方法的未来使用可以进一步增加我们对手术切除的恶性肿瘤中放射性核素分布的理解,因此,从多尺度的角度提高病理学和分子影像学的整合。
背景:ClinicalTrials.gov标识符:NCT05068687。
Recent technical advancements in PET imaging have improved sensitivity and spatial resolution. Consequently, clinical nuclear medicine will be confronted with PET images on a previously unfamiliar resolution. To better understand [18F]FDG distribution at submillimetric scale, a direct correlation of radionuclide-imaging and histopathology is required.
A total of five patients diagnosed with a malignancy of the head and neck were injected with a clinical activity of [18F]FDG before undergoing surgical resection. The resected specimen was imaged using a preclinical high-resolution PET/CT, followed by slicing of the specimen. Multiple slices were rescanned using a micro-PET/CT device, and one of the slices was snap-frozen for frozen sections. Frozen sections were placed on an autoradiographic film, followed by haematoxylin and eosin staining to prepare them for histopathological assessment. The results from both
autoradiography and histopathology were co-registered using an iterative co-registration algorithm, and regions of interest were identified to
study radiotracer uptake.
The co-registration between the autoradiographs and their corresponding histopathology was successful in all specimens. The use of this novel methodology allowed direct comparison of
autoradiography and histopathology and enabled the visualisation of uncharted heterogeneity in [18F]FDG uptake in both benign and malignant tissue.
We here describe a novel methodology enabling the direct co-registration of [18F]FDG
autoradiography with the gold standard of histopathology in human malignant tissue. The future use of the current methodology could further increase our understanding of the distribution of radionuclides in surgically excised malignancies and hence, improve the integration of pathology and molecular imaging in a multiscale perspective.
ClinicalTrials.gov Identifier: NCT05068687.