Volumetric Imaging of Lung Tissue at Micrometer Resolution: Clinical Applications of Micro-CT for the Diagnosis of Pulmonary Diseases
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Eligibility Criteria
2.3. Selection of Studies
2.4. Data Extraction and Tabulation
2.5. Quality Assessment
3. Results
3.1. Selection of Eligible Studies
3.2. Study Quality
3.3. Characteristics of Included Studies
4. Discussion
4.1. Visualization and Quantitative Analysis of the Lung Microanatomy in Chronic Obstructive and Restrictive Pulmonary Disease
4.2. Non-Destructive Imaging of Surgical Specimens for Lung Cancer Diagnosis
4.3. Evaluation of Lung Allograft Specimens upon Transplant Rejection or Prior to Transplantation
4.4. Assessing COVID-19-Related Alterations of Lung Tissue
4.5. Example of a Potential Future Micro-CT Application in Lung Cancer Management
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Studies | Selection (****) | Comparability (**) | Outcomes (***) | Total Score | |||||
---|---|---|---|---|---|---|---|---|---|
Representativeness of the Sample (*) | Sample Size (*) | Non-Respondents (*) | Ascertainment of the Exposure-Risk Factor (*) | Based on the Design (*) | Based on the Analysis (*) | Assessment of the Outcome (**) | Statistical-Test (*) | ||
Kayı Cangır, A. [17], 2021 | * | * | * | * | * | 5 | |||
Kirby, M. [18], 2020 | * | * | * | * | * | 5 | |||
Tanabe, N. [19], 2020 | * | * | * | * | ** | 6 | |||
Verleden, S. [20], 2020 | * | * | * | * | * | * | * | 7 | |
Nakamura, S. [21], 2020 | * | * | * | * | * | * | 6 | ||
Verleden, S. [22], 2020 | * | * | * | ** | 5 | ||||
Norvik, C. [23], 2020 | * | * | * | * | 5 | ||||
Umetani, K. [24], 2020 | * | * | ** | 4 | |||||
Vasilescu, D. [25], 2020 | * | * | ** | 4 | |||||
Everaerts, S. [26], 2019 | * | * | * | * | ** | * | 7 | ||
Katsamenis, O. [27], 2019 | * | * | ** | 4 | |||||
Troschel, F. [28], 2019 | * | * | * | ** | 5 | ||||
Shelmerdine, S.C. [29], 2019 | * | * | * | * | 4 | ||||
Vasilescu, D. [30], 2019 | * | * | * | ** | 5 | ||||
Robinson, S.K. [31], 2019 | * | * | ** | * | 5 | ||||
McDonough, J. [32], 2019 | * | * | * | *** | 6 | ||||
Verleden, S. [33], 2019 | * | * | * | * | * | *** | 8 | ||
Tanabe, N. [34], 2018 | * | * | * | ** | 5 | ||||
Everaerts, S. [35], 2018 | * | * | * | * | ** | * | 7 | ||
Verleden, S. [36], 2017 | * | * | * | * | ** | 6 | |||
Suzuki, M. [37], 2017 | * | * | * | * | * | 5 | |||
Tanabe, N. [38], 2017 | * | * | * | * | ** | 6 | |||
Mai, C. [39], 2017 | * | * | * | ** | * | 7 | |||
Vasilescu, D. [40], 2017 | * | * | * | ** | 5 | ||||
Guan, C.S. [41], 2016 | * | * | * | * | 4 | ||||
Jones, M. [42], 2016 | * | * | * | * | 4 | ||||
Boon, M. [43], 2016 | * | * | * | * | ** | 6 | |||
Scott, A. [44], 2015 | * | * | * | * | * | 5 | |||
Verleden, S. [45], 2015 | * | * | * | * | ** | * | 7 | ||
Zuo, Y.Z. [46], 2013 | * | * | * | ** | 5 | ||||
Kampschulte, M. [47], 2013 | * | * | * | * | * | 5 | |||
Okubo, Y. [48], 2013 | * | * | * | * | * | 5 | |||
Campell, J. [49], 2012 | * | * | * | * | * | 5 | |||
Litzlbauer, H. [50], 2010 | * | * | * | ** | 5 | ||||
Hogg, J. [51], 2009 | * | * | * | ** | 5 | ||||
Hogg, J. [52], 2009 | * | * | * | * | * | ** | * | 8 | |
Watz, H. [53], 2005 | * | * | * | * | * | 5 |
Main Author, Year, Country | Study Design | Main Outcome Assessed via Micro-CT | Number of Participants/Specimens (n: 74/105) | Cryo-MicroCT | Micro-CT Scanner |
---|---|---|---|---|---|
Verleden, S. [22], 2020, Belgium | Cs | Micro-CT was used to assess the number, length, and diameter of terminal bronchioles | 32/32 | No/not reported | Skyscan 1172 (Bruker, Kontich, Belgium) |
Umetani, K. [24], 2020, USA | Cs | Micro-CT was used for whole secondary pulmonary lobule visualization | 1/1 | No/not reported | BL20B2, SPring-8 (Englewood, CO, USA) |
Vasilescu, D. [25], 2020, Canada | Cs | Micro-CT was used as a part of a multi-resolution CT imaging in order to extract specific volumetric findings | 13/13 | Yes | XT H 225 (Nikon Metrology Inc, Brighton, MI, USA) |
Katsamenis, O. [27], 2019, UK | Cs | Micro-CT was used to enable nondestructive 3D-X-ray histology, and to examine its use and benefits in the exemplar of human lung biopsy specimens | 2/2 | No/not reported | Med-X (Nikon X-Tek Systems Ltd.& Southampton, UK) |
Vasilescu, D. [40], 2017, Canada | Cs | Micro-CT was used to image unfixed frozen human lung samples under conditions allowing the tissue to be afterwards used for immunohistochemistry | 1/1 | No/not reported | Nikon HMX-225 micro-CT scanner (Nikon Metrology, Tring, UK) |
Guan, C.S. [41], 2016, China | Cs | Micro-CT was used to retrospectively evaluate short linear shadows connecting pulmonary segmental arteries to oblique fissures in thin-section CT images and determine their anatomical basis | 11/11 | No/not reported | Siemens micro-CT scanner (Siemens Medical Solutions, Knoxville, TN, USA) |
Scott, A. [44], 2015, UK | Cs | Micro-CT was used to visualize, assess and analyze the 3D lung morphology | 4/4 | No/not reported | Nikon HMX-225 micro-CT scanner (Nikon Metrology, Tring, UK) |
Zuo, Y.Z. [46], 2013, China | Cs | Micro-CT was used to describe the normal imaging appearance of pulmonary intersegmental planes compared to thoracic CT scans | 10/30 | No/not reported | SkyScan 1176 (Bruker, Aartselaar, Belgium) |
Litzibauer, H. [50], 2010, Germany | Cs | High-resolution synchrotron-based micro-CT was used to generate a complete dataset of the intact three-dimensional architecture of the human acinus | 1/12 | No/not reported | X2B beamline, National Synchrotron Light Source (Brookhaven National Laboratories, Germany) |
Main Author, Year, Country | Study Design | Main Outcome Assessed via Micro-CT | Number of Participants/Specimens (n: 120/903) | Cryo-MicroCT | Micro-CT Scanner |
---|---|---|---|---|---|
Kirby, M. [18], 2019, Canada | Cs | Micro-CT was used to estimate the number of terminal bronchioles and their association with total airway count (assessed by multidetector CT) | 22/133 | Yes | XT H 225 (Nikon Metrology Inc, Brighton, MI, USA) |
Everaerts, S. [26], 2019, Belgium | Cs | Micro-CT was used to investigate and compare the airway generations between COPD lungs with and without bronchiectasis and unused donor lungs | 21/66 | Yes (in 60 specimens) | Skyscan 1172 (Bruker, Kontich, Belgium) |
Vasilescu, D. [30], 2019, Canada | Cs | Micro-CT was used to assess terminal bronchioles in emphysema | 55/55 | Yes | XT H 225 (Nikon Metrology Inc, Brighton, MI, USA) |
Tanabe, N. [34], 2018, Canada | Cs | Micro-CT was used to measure the mean linear intercept and the numbers of terminal bronchioles/mL lung in each tissue core | 15/15 | Yes | XT H 225 (Nikon Metrology Inc, Brighton, MI, USA) |
Everaerts, S. [35], 2018, Belgium | Cs | Micro-CT was used to measure surface density and determine the extent of normal tissue within each sample of normal lungs and end-stage COPD lungs. | 24/280 | Yes | Skyscan 1172 (Bruker, Kontich, Belgium) |
Suzuki, M. [37], 2017, USA | Cs | Micro-CT was used to measure the mean linear intercept and the numbers of terminal bronchioles/mL lung in each tissue core | 8/61 | Yes | eXplore Locus SP MicroCT scanner (GE Healthcare) |
Tanabe, N. [38], 2017, Canada | Cs | Micro-CT was used to study small airways pathology in centrilobular and panlobular emphysema and show that these airway alterations are more visible with micro-CT scanners, rather than with thoracic multidetector computed tomography | 20/95 | No/not reported | Locus SP MicroCT (GE Healthcare, Chicago, IL, USA), Scanco MicroCT35 (Scanco Medical, Brüttisellen, Switzerland), MicroXCT-400 (Zeiss, Oberkochen, Germany), HMX 225ST (Nikon Metrology, Leuven, Belgium) |
Kampschulte, M. [47], 2013, Germany | Cs | Micro-CT was used to obtain quantitative volumetric and morphologic information of changes in soft tissue, respiratory tracts and vascularization in fibrotic, emphysematous and non-diseased human lung specimens. | 32/32 | No/not reported | Not reported |
Hogg, J. [52], 2009, Canada | Cs | Micro-CT was used to measure the number and lumen area of terminal bronchioles in COPD lungs | 52/530 | No/not reported | Micro-CT scanner (Biomedical Imaging Resource, Mayo Clinic, Rochester, MN, USA) |
Hogg, J. [51], 2009, Canada | Cs | Micro-CT was used to examine bronchiolar remodelling and alveolar destruction in COPD | 8/8 | No/not reported | Not reported |
Watz, H. [53], 2005, Germany | Cs | Micro-CT was used to investigate the appearance of human lung parenchyma at the structural level of alveoli in a patient with centrilobular emphysema | 1/12 | No/not reported | CT 20; Scanco Medical, Bassersdorf, Switzerland |
Main Author, Year, Country | Study Design | Main Outcome Assessed via Micro-CT | Number of Participants/Specimens (n: 60/529) | Cryo-MicroCT | Micro-CT Scanner |
---|---|---|---|---|---|
Tanabe, N. [19], 2020, USA | Cs | Micro-CT was used to examine associations between histopathologic features of usual interstitial pneumonia and IPF in explanted lungs and to measure alveolar surface density, total lung volume taken up by tissue (%), and terminal bronchiolar number | 16/96 | No/not reported | Skyscan 1172 (Bruker, Kontich, Belgium) |
Verleden, S. [20], 2020, Belgium | Cohort | Micro-CT was used to anatomically identify terminal bronchioles and count them per mL of lung tissue | 21/240 | Yes | Skyscan 1172 (Bruker, Kontich, Belgium) |
McDonough, J. [32], 2019, USA | Cs | Micro-CT was used for the assessment of the extent of fibrosis in each sample via measuring alveolar surface density | 10/95 | Yes | Skyscan 1172 (Bruker, Kontich, Belgium) |
Mai, C. [39], 2017, Belgium | Cs | Micro-CT was used to study underlying lung changes responsible for the CT features of IPF and to gain insight into the way IPF proceeds through the lungs and progresses over time | 9/94 | No/not reported | Skyscan 1172 (Bruker, Kontich, Belgium) |
Jones, M. [42] 2016, UK | Cs | Micro-CT was used to characterize fibroblast foci morphology in lung specimens | 4/4 | No/Not reported | Nikon HMX-225 micro-CT scanner (Nikon Metrology, Tring, UK) |
Kampschulte, M. [47], 2013, Germany | Cs | Micro-CT was used to obtain quantitative volumetric and morphologic information of changes in soft tissue, respiratory tracts and vascularization in fibrotic, emphysematous and non-diseased human lung specimens. | 22/22 | No/not reported | Not reported |
Main Author, Year, Country | Study Design | Main Outcome Assessed via Micro-CT | Number of Participants/Specimens (n: 155/763) | Cryo-Micro-CT | Micro-CT Scanner |
---|---|---|---|---|---|
Kayı Cangır, A. [17], 2021, Turkey | Cs | Micro-CT was used to evaluate pulmonary adenocarcinoma specimens by comparing tumoral and non-tumoral areas and correlating micro-CT findings with hematoxylin and eosin sections. | 3/3 | No/not reported | Skyscan 1275 (Bruker, Kontich, Belgium) |
Nakamura, S. [21], 2020, Japan | Cs | Micro-CT was used to distinguish areas of normal lung tissue and lung adenocarcinoma | 10/10 | No/not reported | InspeXio SMX-100CT (Shimadzu, Kyoto, Japan) |
Norvik, C. [23], 2020, Sweden | Cs | Micro-CT was used to evaluate the micro-anatomy of normal lung tissue and microvascular anomalies of ACD/MPV (alveolar capillary dysplasia with misalignment of pulmonary veins) | 2/2 | No/not reported | X02DA TOMCAT beamline, Swiss Light Source (Villigen, Switzerland) |
Shelmerdine, S.C. [29], 2019, UK | Cs | Micro-CT was used for post-mortem investigation of an excised stenotic infant trachea | 1/1 | No/not reported | Med-X Alpha (Nikon Metrology, Tring, UK) |
Troschel, F. [28], 2019, USA | Cs | Micro-CT was used to peri-operatively evaluate fresh surgical lung resection specimens from patients with a presumptive diagnosis of lung cancer | 21/22 | No/not reported | Skyscan 1275 (Bruker, Kontich, Belgium)/XT H 225 (Nikon Metrology Inc, Brighton, MI, USA) |
Robinson, S.K. [31], 2019, UK | Cs | Micro-CT was used to identify via mathematic modelling and Immunohistochemistry lymphatic heterogeneity within and between lung tissue | 2/4 | No/not reported | Nikon Metrology micro-CT scanner (Nikon Metrology, Tring Herts, UK) |
Verleden, S. [33], 2019, Belgium | Cohort | Micro-CT findings were compared to 18F-FDG PET/CT scan findings in a patient with restrictive allograft syndrome undergoing redo transplantation | 1/1 | Yes | Skyscan 1172 (Bruker, Kontich, Belgium) |
Everaerts, S. [35], 2018, Belgium | Cs | Micro-CT was used to measure surface density and determine the extent of normal tissue within each sample of normal lungs and lungs with end-stage cystic fibrosis, chronic hypersensitivity pneumonitis, bronchiolitis obliterans and restrictive allograft syndromes. | 46/280 | Yes | Skyscan 1172 (Bruker, Kontich, Belgium) |
Verleden, S. [36], 2017, Belgium | Cs | Micro-CT was used to assess mass and density of donor lungs, aiding in decision-making to accept or decline lung allografts | 28/28 | Yes | Skyscan 1172 (Bruker, Kontich, Belgium) |
Boon, M. [43], 2016, Netherlands | Cs | Micro-CT was used to quantify the involvement of small and large airways in end-stage cystic fibrosis | 18/167 | No/not reported | Not reported |
Verleden, S. [45], 2015, Belgium | Cs | Micro-CT was used to evaluate lungs from patients with chronic lung allograft dysfunction | 24/246 | Yes | Skyscan 1172 (Bruker, Kontich, Belgium) |
Okubo, Y. [48], 2013, Japan | Cs | Micro-CT was used to evaluate the pathophysiological implications of the reversed CT halo sign in a patient with invasive pulmonary mucormycosis and a patient with invasive pulmonary aspergillosis | 2/2 | No/not reported | InspeXio SMX-100CT (Shimadzu, Kyoto, Japan) |
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Bompoti, A.; Papazoglou, A.S.; Moysidis, D.V.; Otountzidis, N.; Karagiannidis, E.; Stalikas, N.; Panteris, E.; Ganesh, V.; Sanctuary, T.; Arvanitidis, C.; et al. Volumetric Imaging of Lung Tissue at Micrometer Resolution: Clinical Applications of Micro-CT for the Diagnosis of Pulmonary Diseases. Diagnostics 2021, 11, 2075. https://doi.org/10.3390/diagnostics11112075
Bompoti A, Papazoglou AS, Moysidis DV, Otountzidis N, Karagiannidis E, Stalikas N, Panteris E, Ganesh V, Sanctuary T, Arvanitidis C, et al. Volumetric Imaging of Lung Tissue at Micrometer Resolution: Clinical Applications of Micro-CT for the Diagnosis of Pulmonary Diseases. Diagnostics. 2021; 11(11):2075. https://doi.org/10.3390/diagnostics11112075
Chicago/Turabian StyleBompoti, Andreana, Andreas S. Papazoglou, Dimitrios V. Moysidis, Nikolaos Otountzidis, Efstratios Karagiannidis, Nikolaos Stalikas, Eleftherios Panteris, Vijayakumar Ganesh, Thomas Sanctuary, Christos Arvanitidis, and et al. 2021. "Volumetric Imaging of Lung Tissue at Micrometer Resolution: Clinical Applications of Micro-CT for the Diagnosis of Pulmonary Diseases" Diagnostics 11, no. 11: 2075. https://doi.org/10.3390/diagnostics11112075