Towards in vivo characterization of thyroid nodules suspicious for malignancy using multispectral optoacoustic tomography

Milou E Noltes; Maximilian Bader; Madelon J H Metman; Jasper Vonk; Pieter J Steinkamp; Jan Kukačka; Henriette E Westerlaan; Rudi A J O Dierckx; Bettien M van Hemel; Adrienne H Brouwers; Gooitzen M van Dam; Dominik Jüstel; Vasilis Ntziachristos; Schelto Kruijff

doi:10.1007/s00259-023-06189-1

Towards in vivo characterization of thyroid nodules suspicious for malignancy using multispectral optoacoustic tomography

Eur J Nucl Med Mol Imaging. 2023 Jul;50(9):2736-2750. doi: 10.1007/s00259-023-06189-1. Epub 2023 Apr 11.

Authors

Milou E Noltes^#^{1

2}, Maximilian Bader^#^{3

4}, Madelon J H Metman^#¹, Jasper Vonk⁵, Pieter J Steinkamp¹, Jan Kukačka^{3

4}, Henriette E Westerlaan⁶, Rudi A J O Dierckx², Bettien M van Hemel⁷, Adrienne H Brouwers², Gooitzen M van Dam^{2

8}, Dominik Jüstel^{3

4

9}, Vasilis Ntziachristos^{3

4

10}, Schelto Kruijff^{11

12}

Affiliations

¹ Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
² Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
³ Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, Munich, Germany.
⁴ Institute of Biological and Medical Imaging, Helmholtz Zentrum München, Neuherberg, Germany.
⁵ Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
⁶ Department of Radiology, University Medical Center Groningen, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
⁷ Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
⁸ AxelaRx/TRACER Europe BV, Groningen, the Netherlands.
⁹ Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany.
¹⁰ Munich Institute of Robotics and Machine Intelligence (MIRMI), Technical University of Munich, Munich, Germany.
¹¹ Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. s.kruijff@umcg.nl.
¹² Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. s.kruijff@umcg.nl.

^# Contributed equally.

Abstract

Purpose: Patient-tailored management of thyroid nodules requires improved risk of malignancy stratification by accurate preoperative nodule assessment, aiming to personalize decisions concerning diagnostics and treatment. Here, we perform an exploratory pilot study to identify possible patterns on multispectral optoacoustic tomography (MSOT) for thyroid malignancy stratification. For the first time, we directly correlate MSOT images with histopathology data on a detailed level.

Methods: We use recently enhanced data processing and image reconstruction methods for MSOT to provide next-level image quality by means of improved spatial resolution and spectral contrast. We examine optoacoustic features in thyroid nodules associated with vascular patterns and correlate these directly with reference histopathology.

Results: Our methods show the ability to resolve blood vessels with diameters of 250 μm at depths of up to 2 cm. The vessel diameters derived on MSOT showed an excellent correlation (R²-score of 0.9426) with the vessel diameters on histopathology. Subsequently, we identify features of malignancy observable in MSOT, such as intranodular microvascularity and extrathyroidal extension verified by histopathology. Despite these promising features in selected patients, we could not determine statistically relevant differences between benign and malignant thyroid nodules based on mean oxygen saturation in thyroid nodules. Thus, we illustrate general imaging artifacts of the whole field of optoacoustic imaging that reduce image fidelity and distort spectral contrast, which impedes quantification of chromophore presence based on mean concentrations.

Conclusion: We recommend examining optoacoustic features in addition to chromophore quantification to rank malignancy risk. We present optoacoustic images of thyroid nodules with the highest spatial resolution and spectral contrast to date, directly correlated to histopathology, pushing the clinical translation of MSOT.

Keywords: Multispectral optoacoustic tomography; Optoacoustic; Photoacoustic; Thyroid cancer; Thyroid nodule.

MeSH terms

Humans
Photoacoustic Techniques* / methods
Pilot Projects
Thyroid Nodule* / diagnostic imaging
Tomography / methods
Tomography, X-Ray Computed

Abstract

MeSH terms

Grants and funding