AUTHOR=Xia Cheng-Wan , Gan Rong-lin , Pan Jiong-ru , Hu Shi-qi , Zhou Qun-zhi , Chen Shen , Zhang Lei , Hu Qin-Gang , Wang Yu-Xin 

TITLE=Lugol’s Iodine-Enhanced Micro-CT: A Potential 3-D Imaging Method for Detecting Tongue Squamous Cell Carcinoma Specimens in Surgery

JOURNAL=Frontiers in Oncology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.550171

DOI=10.3389/fonc.2020.550171

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>A positive surgical margin (PSM) following oral cancer resection results in local recurrence and poor prognosis. Mono-block tumor specimens, especially from the tumor base, are difficult to evaluate. This inaccurate sampling ultimately leads to a false pathological diagnosis. Lugol’s iodine (I<sub>2</sub>-IK)-enhanced micro-CT is an emerging method to image tumor specimens. This study explores the feasibility of I<sub>2</sub>-IK-enhanced micro-CT to evaluate the surgical margin for tongue squamous cell carcinoma (TSCC) specimens and to further seek optimal staining parameters.</p></sec><sec><title>Methods</title><p>Rabbit tongue tissues and human TSCC samples were imaged <italic>via</italic> I<sub>2</sub>-IK-enhanced micro-CT. The optimal I<sub>2</sub>-IK concentration and staining time were determined before clinical application using tissue shrinkage, micro-CT image quality, and effect on pathological diagnosis as assessment criteria. Next, 6 TSCC specimens were used to verify the process feasibility of surgical margin imaging with the optimal parameters. Finally, the possible reason by which I<sub>2</sub>-IK could enhance micro-CT imaging was validated <italic>in vitro</italic>.</p></sec><sec><title>Results</title><p>I<sub>2</sub>-IK staining influenced specimen shrinkage, micro-CT image quality, and pathological image quality in a concentration- and time-dependent manner. After comprehensively considering these indicators, 3% I<sub>2</sub>-IK staining for 48 and 12 h were found to be optimal for rabbit tongue tissues and TSCC samples, respectively. This method could provide a detailed 3-D structure of TSCC samples compared with H&amp;E sections. Moreover, tumor and normal tissues could be differentiated by their glycogen content, which has high affinity with I<sub>2</sub>-IK.</p></sec><sec><title>Conclusions</title><p>I<sub>2</sub>-IK-enhanced micro-CT could, thus, indicate the tumor margin and assist pathological sampling in patients with TSCC postoperation.</p></sec>