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European Radiology Experimental
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Chondrosarcoma evaluation using hematein-based x-ray staining and high-resolution 3D micro-CT: a feasibility study

Authors: Alexandra S. Gersing; Melanie A. Kimm; Christine Bollwein; Patrick Ilg; Carolin Mogler; Felix G. Gassert; Georg C. Feuerriegel; +5 Authors

Chondrosarcoma evaluation using hematein-based x-ray staining and high-resolution 3D micro-CT: a feasibility study

Abstract

Abstract Background Chondrosarcomas are rare malignant bone tumors diagnosed by analyzing radiological images and histology of tissue biopsies and evaluating features such as matrix calcification, cortical destruction, trabecular penetration, and tumor cell entrapment. Methods We retrospectively analyzed 16 cartilaginous tumor tissue samples from three patients (51-, 54-, and 70-year-old) diagnosed with a dedifferentiated chondrosarcoma at the femur, a moderately differentiated chondrosarcoma in the pelvis, and a predominantly moderately differentiated chondrosarcoma at the scapula, respectively. We combined a hematein-based x-ray staining with high-resolution three-dimensional (3D) microscopic x-ray computed tomography (micro-CT) for nondestructive 3D tumor assessment and tumor margin evaluation. Results We detected trabecular entrapment on 3D micro-CT images and followed bone destruction throughout the volume. In addition to staining cell nuclei, hematein-based staining also improved the visualization of the tumor matrix, allowing for the distinction between the tumor and the bone marrow cavity. The hematein-based staining did not interfere with further conventional histology. There was a 5.97 ± 7.17% difference between the relative tumor area measured using micro-CT and histopathology (p = 0.806) (Pearson correlation coefficient r = 0.92, p = 0.009). Signal intensity in the tumor matrix (4.85 ± 2.94) was significantly higher in the stained samples compared to the unstained counterparts (1.92 ± 0.11, p = 0.002). Conclusions Using nondestructive 3D micro-CT, the simultaneous visualization of radiological and histopathological features is feasible. Relevance statement 3D micro-CT data supports modern radiological and histopathological investigations of human bone tumor specimens. It has the potential for being an integrative part of clinical preoperative diagnostics. Key points • Matrix calcifications are a relevant diagnostic feature of bone tumors. • Micro-CT detects all clinically diagnostic relevant features of x-ray-stained chondrosarcoma. • Micro-CT has the potential to be an integrative part of clinical diagnostics. Graphical Abstract

Keywords

Male, Staining and Labeling, Bone neoplasms, R895-920, Chondrosarcoma, Staining and labeling, Bone Neoplasms, X-Ray Microtomography, Middle Aged, Original Article ; Bone neoplasms ; Chondrosarcoma ; Hematein ; Staining and labeling ; X-ray microtomography, Female [MeSH] ; Hematein ; Aged [MeSH] ; Humans [MeSH] ; Staining and Labeling/methods [MeSH] ; Retrospective Studies [MeSH] ; Middle Aged [MeSH] ; Feasibility Studies [MeSH] ; X-ray microtomography ; Original Article ; Chondrosarcoma/pathology [MeSH] ; Male [MeSH] ; Chondrosarcoma ; X-Ray Microtomography/methods [MeSH] ; Chondrosarcoma/diagnostic imaging [MeSH] ; Imaging, Three-Dimensional/methods [MeSH] ; Staining and labeling ; Bone Neoplasms/diagnostic imaging [MeSH] ; Bone Neoplasms/pathology [MeSH] ; Bone neoplasms, Medical physics. Medical radiology. Nuclear medicine, Imaging, Three-Dimensional, X-ray microtomography, Hematein, Humans, Feasibility Studies, Original Article, Female, Aged, Retrospective Studies, ddc: ddc:

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    influence
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Top 10%
Average
Average
Green
gold