Transparency-enhancing technology allows the three-dimensional assessment of esophageal carcinoma obtained by endoscopic submucosal dissection

Yuichi Asahina; Munetoshi Hinata; Asami Tanaka; Kaori Oshio; Haruki Ogawa; Makoto Aihara; Hiroshi Onodera; Tetsuo Ushiku

doi:10.1007/s10388-024-01055-x

Transparency-enhancing technology allows the three-dimensional assessment of esophageal carcinoma obtained by endoscopic submucosal dissection

Esophagus. 2024 Mar 18. doi: 10.1007/s10388-024-01055-x. Online ahead of print.

Authors

Yuichi Asahina^{1

2}, Munetoshi Hinata², Asami Tanaka³, Kaori Oshio^{2

4}, Haruki Ogawa^{2

5}, Makoto Aihara¹, Hiroshi Onodera⁶, Tetsuo Ushiku⁷

Affiliations

¹ Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
² Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
³ Photon Science Center, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan.
⁴ Department of Gastroenterology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
⁵ Department of Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
⁶ Institute for Photon Science and Technology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan.
⁷ Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. usikut@g.ecc.u-tokyo.ac.jp.

PMID: 38498095
DOI: 10.1007/s10388-024-01055-x

Abstract

Background: Although much progress has been made in diagnosis of carcinomas, no established methods have been confirmed to elucidate their morphological features.

Methods: Three-dimensional structure of esophageal carcinomas was assessed using transparency-enhancing technology. Endoscopically resected esophageal squamous cell carcinoma was fluorescently stained, optically cleared using a transparency-enhancing reagent called LUCID, and visualized using laser scanning microscopy. The resulting microscope images were converted to virtual HE images for observation using ImageJ software.

Results: Microscopic observation and image editing enabled three-dimensional image reconstruction and conversion to virtual HE images. The structure of abnormal blood vessels in esophageal carcinoma recognized by endoscopy could be observed in the 3 dimensions. Squamous cell carcinoma and normal squamous epithelium could be distinguished in the virtual HE images.

Conclusions: The results suggested that transparency-enhancing technology and virtual HE images may be feasible for clinical application and represent a novel histopathological method for evaluating endoscopically resected specimens.

Keywords: 3D imaging; Esophageal carcinoma; Microvessel morphology; Transparency-enhancing technology; Virtual hematoxylin and eosin.