Bridging the Gap Between Radiology and Microscopy Using microCT: Implications for Neoplastic and Non-neoplastic Lung
Stijn E Verleden1,2,3, Annemiek Snoeckx4,5, Dieter Peeters6
1Antwerp Surgical Training, Anatomy and Research Centre (ASTARC).
Journal of Thoracic Imaging
|August 23, 2025
Summary
MicroCT imaging of lung resection specimens identified previously undetected cancerous lesions in 9% of cases. This technique can guide pathologists, improving lung cancer TNM staging accuracy.
Area of Science:
- Pulmonary pathology
- Medical imaging
- Oncology
Background:
- Accurate lung cancer TNM staging relies on evaluating resection specimens.
- Small nodules (<1 cm) pose challenges for macroscopic and microscopic evaluation.
- Correlating in vivo imaging with pathology for small lesions is difficult.
Purpose of the Study:
- To investigate microCT's utility in localizing lung lesions.
- To determine if microCT can guide pathology to undetected abnormalities.
- To assess microCT's role in improving lung cancer staging.
Main Methods:
- Paired ex vivo CT and microCT were performed on inflated, frozen lung lobes.
- MicroCT resolution ranged from 80 to 120 µm.
- Rigorous matching of CT, microCT, and histopathology was conducted.
Main Results:
- MicroCT-guided examination revealed 5 additional lesions (2 primary carcinomas, 2 separate nodules, 1 hyperplasia) in 57 specimens (9%).
- Two patients with separate tumor nodules had their stage upgraded from cT1 to pT3.
- MicroCT also provided insights into underlying structural lung diseases like emphysema and fibrosis.
Conclusions:
- MicroCT identified additional precancerous/cancerous lesions in 9% of lung resection specimens.
- Lobar microCT can guide pathologists to areas needing further investigation.
- This technique may facilitate more precise TNM classification, requiring prospective validation.
