LLTech Light-CT Scanner Atlas of images Clinical applications

LLTECH 2011

TABLE OF CONTENTS
CLINICAL APPLICATIONS

BREAST
SKIN CORNEA

Page 3
Page 10 Page 14

PROSTATE
LUNG KIDNEY BRAIN HEAD & NECK

Page 17
Page 22 Page 26 Page 29 Page 34

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BREAST AND LYMPH NODES

- Extemporaneous analysis for cancer surgery - Biobanking selection

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Healthy breast tissue

Grainy aspect of normal fibrous tissue

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Duct with calcification

Lobule

Adipocytes

Vessel
Courtesy of Hpital Tenon, Paris, France 4

Assayag et al, TCRT Express 1(1):e600254

Ductal Carcinoma In Situ (DCIS)

Duct with necrosis

Enlarged lobule

Histology and LightCT images reveal the enlarged abnormal lobules and ducts characteristic of DCIS

Assayag et al, TCRT Express 1(1):e600254

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Lobular carcinoma
Tumorous cells are visible in in-situ and invasive carcinoma
In-situ carcinoma cells

1 mm

100 m

Invasive carcinoma cells

100 m
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Invasive adenocarcinoma: nodular tumor

Interface of the tumourous and normal appearing part :

Tumour margin
Highly scattering thin trabeculae aspect: fibrous tissue in the tumourous part
100m

500m

Grey zones corresponding to foci of carcinomatous cells

Grainy medium scattering aspect: healthy fibrous tissue

500m

Assayag et al, TCRT Express 1(1):e600254

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Courtesy of Hpital Tenon, Paris, France 7

Normal Sentinel Node

Adipocytes in hilum Nodules containing lymphoid tissue

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Capsule

Grieve et al Proc SPIE 20138

Invaded Sentinel Node

Invaded zone

Lymphoid zone

Bright white aspect, highly scattering dense collagen meshwork

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Grieve et al Proc SPIE 20139

SKIN
- Extemporaneous margin analysis for cancer surgery - Biobanking selection

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Normal skin morphology: vertical section

a
Epidermis

Collagen

500 m

Pilosebaceous unit

Sweat gland

Adipocytes

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Dalimier and Salomon Dermatology 224, 84-92 (2012)

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Skin pathologies: basal cell carcinoma discrimination at structural level

Dense peritumoral stroma

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Dalimier and Salomon Dermatology 224, 84-92 (2012)

12

Zoom on basal cell carcinoma: discrimination at cellular level

Peritumoral stroma

High cell density

200 m

100 m

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Courtesy of Hopitaux Universitaires de Genve, Genve, Switzerland 13

CORNEA - Biobanking selection

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Normal human cornea

Cross sectional view
Surface epithelium

En face views
Intermediary epithelium Basal epithelium

100 m

100 m Bowmans layer Stromal keratocytes Endothelial cells

LightCT imaging reveals the structures of normal cornea: epithelium, Bowmans layer, stroma, Descemets membrane, and endothelium. Use of LightCT in Eye Banks would allow graft cornea integrity to be assessed prior to transplant. Current practice examines only the epithelial surface and endothelial cells under a traditional specular microscope.
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Cornea with bullous keratopathy

Histology

Optovue OCT in vivo on patient

LightCT cross section

LightCT en face
Intraepithelial edema

Subepithelial fibrosis

Sub-epithelial fibrosis

150 m

150 m

100 m

Histology, conventional OCT and Light CT views of the same region are compared.
The improvement in resolution with LightCT compared to conventional OCT is appreciated. Pathological areas of subepithelial fibrosis and intraepithelial edema are identified.

Bowmans layer is clearly visible under the area of fibrosis.

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Ghouali et al ARVO (2013) 16

PROSTATE - Biobanking selection - Biopsy quality assessment

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Human prostatic glands with hyperplasia

Zoom on hyperplasic gland

100 m

1 mm

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Courtesy of Hpital Tenon, Paris, France 18

3D imaging of glands
Stack of 150 images with 1 m step Sagittal reconstruction

sagittal

50 m

coronal

Coronal reconstruction

50 m

oblique
Oblique reconstruction

50 m

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Courtesy of Hpital Tenon, Paris, France 19

Biopsy imaging

1 mm

1 mm
Courtesy of Hpital Cochin, Paris, France 20

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Tumorous glands

200 m

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Courtesy of Hpital Cochin, Paris, France 21

LUNG - Biobanking selection - Biopsy quality assessment

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22

Cross section of rat lung

500 m

Jain et al. J Pathol Inform 2011, 2:28.

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Courtesy of Weill Medical College, NY, USA 23

Non-neoplastic human lung tissue

Collapsed lung

Alveoli Blood vessel

500 m

Jain et al. Pathology Visions 2013.

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Courtesy of Weill Medical College, NY, USA 24

Adenocarcinoma of lung with lepidic & invasive components

Invasive

Invasive

Lepidic Lepidic
500 m

Invasive

Invasive

100 m
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100 m
Courtesy of Weill Medical College, NY, USA 25

KIDNEY - Biobanking selection - Biopsy quality assessment

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Non-neoplastic kidney tissue

Glomerulus
Blood vessel Glomerulus Tubules
100 m

Tubules
100 m 200 m

Blood vessel
100 m

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Caron et al. Proc SPIE 2013

Courtesy of Weill Medical College, NY, USA 27

Chromophobe renal cell carcinoma

Sheets of cells Sheets of cells

100 m

Normal architecture is replaced by sheets of cells

50 m

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Courtesy of Weill Medical College, NY, USA 28

BRAIN AND SPINAL CORD

- Biobank selection - In-vivo potential for surgical guidance

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LightCT imaging of human epileptic brain and cerebellum identifies myelinated axon fibers, a subpopulation of neuronal cell bodies and CNS vasculature. Cortex
50 m

Neuron cell bodies (dark dots)

Axon bundles

50 m

80 m

Axons/myelin fibers
80 m

50 m

White matter
500 m
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Capillary
50 m

Varlet et al 2013 (submitted) 30

Hippocampus: Coronal section (left side)

40 m

SubEpendymal zone CA4 field Alveus

Pyramidal neurons of the CA4 field responsible for memory

40 m

Stratum radiatus of the CA1 field

Hippocampal sulcus

80 m

Stratum granulosum of the dentate gyrus

CA1 field of the cornus ammonis

80 m
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900 m 31

Choroid Plexus Papilloma : Xanthomatous changes

Characteristic cauliflower-like masses

Empty papilla

50 m

50 m

Papilla filled with blood

50 m

50 m

150 m

20 m

20 m

Rare (0.5%) benign tumors Diagnosis possible directly on FF-OCT image

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Single layer of plexus cells

Varlet et al 2013 (submitted) 32

LightCT images allow the distinction of meningiomas from meningeal haemangiopericytoma

Meningioma psammoma diagnosis possible directly on FF-OCT image Collagen bundles

50 m

Whorls

10 m

Calcification

500 m

10 m

80% of meningiomas are benign.

Collagen balls

Histologically, meningioma cells are relatively uniform, with a tendency to encircle one another, forming whorls and psammoma bodies (laminated calcific concretions). They have a tendency to calcify and are highly vascularized. Areas of fibrosis may be present.
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Varlet et al 2013 (submitted) 33

HEAD AND NECK TISSUE

- Biobanking selection - Extemporaneous margin analysis for cancer surgery - In-vivo potential for surgical guidance

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Glossectomy Tumorous tongue tissue

500 m

1 mm

Cell nuclei

500 m
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Thin trabeculae aspect of the fibrous tissue

500 m
Courtesy of Institut Gustave Roussy, Villejuif, France 35

Glossectomy Mouth floor

1 mm

500 m

Epithelial cell nuclei

Spinous cells
500 m
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500 m
Courtesy of Institut Gustave Roussy, Villejuif, France 36

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LLTech Ppinire Paris Sant Cochin 29 rue du Faubourg Saint Jacques 75014 Paris Phone: +33 1 82 72 61 25

www.lltechimaging.com contact@lltech.fr

www.lltechimaging.com LLTECH 2011

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