3-D reconstruction and virtual ductoscopy of high-grade ductal carcinoma in situ of the breast with casting type calcifications using refraction-based X-ray CT

Virchows Arch. 2008 Jan;452(1):41-7. doi: 10.1007/s00428-007-0528-y. Epub 2007 Nov 14.

Abstract

Stereomicroscopic observations of thick sections, or three-dimensional (3-D) reconstructions from serial sections, have provided insights into histopathology. However, they generally require time-consuming and laborious procedures. Recently, we have developed a new algorithm for refraction-based X-ray computed tomography (CT). The aim of this study is to apply this emerging technology to visualize the 3-D structure of a high-grade ductal carcinomas in situ (DCIS) of the breast. The high-resolution two-dimensional images of the refraction-based CT were validated by comparing them with the sequential histological sections. Without adding any contrast medium, the new CT showed strong contrast and was able to depict the non-calcified fine structures such as duct walls and intraductal carcinoma itself, both of which were barely visible in a conventional absorption-based CT. 3-D reconstruction and virtual endoscopy revealed that the high-grade DCIS was located within the dichotomatous branches of the ducts. Multiple calcifications occurred in the necrotic core of the continuous DCIS, resulting in linear and branching (casting type) calcifications, a hallmark of high-grade DCIS on mammograms. In conclusion, refraction-based X-ray CT approaches the low-power light microscopic view of the histological sections. It provides high quality slice data for 3-D reconstruction and virtual ductosocpy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Neoplasms / complications
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology*
  • Calcinosis / complications
  • Calcinosis / diagnostic imaging
  • Calcinosis / pathology*
  • Carcinoma, Intraductal, Noninfiltrating / complications
  • Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging
  • Carcinoma, Intraductal, Noninfiltrating / pathology*
  • Computer Graphics
  • Female
  • Humans
  • Image Processing, Computer-Assisted*
  • Imaging, Three-Dimensional*
  • Tomography, X-Ray Computed / instrumentation
  • Tomography, X-Ray Computed / methods*