| Title: |
Feasibility of an MR-based digital specimen for tongue cancer resection specimens:a novel approach for margin evaluation |
| Authors: |
de Koning, Klijs Jacob; Dankbaar, Jan Willem; de Keizer, Bart; Willemsen, Koen; van der Toorn, Annette; Breimer, Gerben Eise; van Es, Robert Jelle Johan; de Bree, Remco; Noorlag, Rob; Philippens, Marielle Emile Petronella; MS Hoofd-Hals Chirurgische Oncologie; MS Radiologie; Brain; Cancer; Circulatory Health; DHS 3D Lab; ORT Research; In Vivo NMR ISI; Pathologie Pathologen staf; CMM Groep Burgering; Klinische Fysica RT |
| Publication Year: |
2024 |
| Subject Terms: |
high-field; image guided surgery; magnetic resonance imaging; oral cancer; resection margin; tongue cancer; Oncology; Cancer Research |
| Description: |
Objective: 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. Methods: 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. Results: 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. Conclusion: This proof of concept for volumetric assessment of resection margins using MR-DSs, demonstrates ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text/plain |
| Language: |
English |
| ISSN: |
2234-943X |
| Relation: |
https://dspace.library.uu.nl/handle/1874/451793 |
| Availability: |
https://dspace.library.uu.nl/handle/1874/451793 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.4917801 |
| Database: |
BASE |