Imaging of metastatic lymph nodes by X-ray phase-contrast micro-tomography

Torben Haugaard Jensen; Martin Bech; Tina Binderup; Arvid P.L. Böttiger; Christian David; Timm Weitkamp; Irene Zanette; Elena Reznikova; Jürgen Mohr; Fritz Rank; Robert Feidenhans'l; Andreas Kjær; Liselotte Højgaard; Franz Pfeiffer

doi:10.1371/journal.pone.0054047

Imaging of metastatic lymph nodes by X-ray phase-contrast micro-tomography

Torben Haugaard Jensen, Martin Bech, Tina Binderup, Arvid P.L. Böttiger, Christian David, Timm Weitkamp, Irene Zanette, Elena Reznikova, Jürgen Mohr, Fritz Rank, Robert Feidenhans'l, Andreas Kjær, Liselotte Højgaard, Franz Pfeiffer

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Abstract

Invasive cancer causes a change in density in the affected tissue, which can be visualized by x-ray phase-contrast tomography. However, the diagnostic value of this method has so far not been investigated in detail. Therefore, the purpose of this study was, in a blinded manner, to investigate whether malignancy could be revealed by non-invasive x-ray phase-contrast tomography in lymph nodes from breast cancer patients. Seventeen formalin-fixed paraffin-embedded lymph nodes from 10 female patients (age range 37-83 years) diagnosed with invasive ductal carcinomas were analyzed by X-ray phase-contrast tomography. Ten lymph nodes had metastatic deposits and 7 were benign. The phase-contrast images were analyzed according to standards for conventional CT images looking for characteristics usually only visible by pathological examinations. Histopathology was used as reference. The result of this study was that the diagnostic sensitivity of the image analysis for detecting malignancy was 100% and the specificity was 87%. The positive predictive value was 91% for detecting malignancy and the negative predictive value was 100%. We conclude that x-ray phase-contrast imaging can accurately detect density variations to obtain information regarding lymph node involvement previously inaccessible with standard absorption x-ray imaging.

Original language	English
Article number	e54047
Journal	P L o S One
Volume	8
Issue number	1
Pages (from-to)	1-5
Number of pages	5
ISSN	1932-6203
DOIs	https://doi.org/10.1371/journal.pone.0054047
Publication status	Published - 18 Jan 2013

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Imaging of Metastatic Lymph Nodes by X-ray Phase-contrast ...Final published version, 178 KB

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title = "Imaging of metastatic lymph nodes by X-ray phase-contrast micro-tomography",

abstract = "Invasive cancer causes a change in density in the affected tissue, which can be visualized by x-ray phase-contrast tomography. However, the diagnostic value of this method has so far not been investigated in detail. Therefore, the purpose of this study was, in a blinded manner, to investigate whether malignancy could be revealed by non-invasive x-ray phase-contrast tomography in lymph nodes from breast cancer patients. Seventeen formalin-fixed paraffin-embedded lymph nodes from 10 female patients (age range 37-83 years) diagnosed with invasive ductal carcinomas were analyzed by X-ray phase-contrast tomography. Ten lymph nodes had metastatic deposits and 7 were benign. The phase-contrast images were analyzed according to standards for conventional CT images looking for characteristics usually only visible by pathological examinations. Histopathology was used as reference. The result of this study was that the diagnostic sensitivity of the image analysis for detecting malignancy was 100% and the specificity was 87%. The positive predictive value was 91% for detecting malignancy and the negative predictive value was 100%. We conclude that x-ray phase-contrast imaging can accurately detect density variations to obtain information regarding lymph node involvement previously inaccessible with standard absorption x-ray imaging.",

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T1 - Imaging of metastatic lymph nodes by X-ray phase-contrast micro-tomography

AU - Jensen, Torben Haugaard

AU - Bech, Martin

AU - Binderup, Tina

AU - Böttiger, Arvid P.L.

AU - David, Christian

AU - Weitkamp, Timm

AU - Zanette, Irene

AU - Reznikova, Elena

AU - Mohr, Jürgen

AU - Rank, Fritz

AU - Feidenhans'l, Robert

AU - Kjær, Andreas

AU - Højgaard, Liselotte

AU - Pfeiffer, Franz

PY - 2013/1/18

Y1 - 2013/1/18

N2 - Invasive cancer causes a change in density in the affected tissue, which can be visualized by x-ray phase-contrast tomography. However, the diagnostic value of this method has so far not been investigated in detail. Therefore, the purpose of this study was, in a blinded manner, to investigate whether malignancy could be revealed by non-invasive x-ray phase-contrast tomography in lymph nodes from breast cancer patients. Seventeen formalin-fixed paraffin-embedded lymph nodes from 10 female patients (age range 37-83 years) diagnosed with invasive ductal carcinomas were analyzed by X-ray phase-contrast tomography. Ten lymph nodes had metastatic deposits and 7 were benign. The phase-contrast images were analyzed according to standards for conventional CT images looking for characteristics usually only visible by pathological examinations. Histopathology was used as reference. The result of this study was that the diagnostic sensitivity of the image analysis for detecting malignancy was 100% and the specificity was 87%. The positive predictive value was 91% for detecting malignancy and the negative predictive value was 100%. We conclude that x-ray phase-contrast imaging can accurately detect density variations to obtain information regarding lymph node involvement previously inaccessible with standard absorption x-ray imaging.

AB - Invasive cancer causes a change in density in the affected tissue, which can be visualized by x-ray phase-contrast tomography. However, the diagnostic value of this method has so far not been investigated in detail. Therefore, the purpose of this study was, in a blinded manner, to investigate whether malignancy could be revealed by non-invasive x-ray phase-contrast tomography in lymph nodes from breast cancer patients. Seventeen formalin-fixed paraffin-embedded lymph nodes from 10 female patients (age range 37-83 years) diagnosed with invasive ductal carcinomas were analyzed by X-ray phase-contrast tomography. Ten lymph nodes had metastatic deposits and 7 were benign. The phase-contrast images were analyzed according to standards for conventional CT images looking for characteristics usually only visible by pathological examinations. Histopathology was used as reference. The result of this study was that the diagnostic sensitivity of the image analysis for detecting malignancy was 100% and the specificity was 87%. The positive predictive value was 91% for detecting malignancy and the negative predictive value was 100%. We conclude that x-ray phase-contrast imaging can accurately detect density variations to obtain information regarding lymph node involvement previously inaccessible with standard absorption x-ray imaging.

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Imaging of metastatic lymph nodes by X-ray phase-contrast micro-tomography

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