More precise cancer diagnosis thanks to 3D computed tomography

The new 3D tissue analysis of thyroid tumors is still unfamiliar to pathologists. Instead of cutting the removed tissue into thin slices and viewing them two-dimensionally under the microscope as before, they can now examine the entire tissue sample virtually on the screen and rotate it as required to identify pathological changes. This has been made possible by so-called non-invasive histopathological 3D imaging. “The special thing about this method is that it can analyze complete biopsy blocks of a tumor in three dimensions in a short time without changing or destroying the tissue. This means that the sample can still be used for further molecular biological examinations,” says Robert Zboray, group leader at Empa's Center for X-ray Analysis, who developed this technology.

A major advantage of 3D analysis is that it also detects tumor characteristics in the deeper tissue layers that may be overlooked by conventional methods. “When encapsulated thyroid tumors grow aggressively and quickly, they often break into the surrounding healthy tissue and even invade blood vessels. Such vascular invasions are therefore often an indication of the malignancy and severity of the tumor,” explains Zboray. An early and more precise diagnosis enables doctors to act more quickly and in a more targeted manner, thus improving the patient's prognosis.

In collaboration with the University and Inselspital Bern, Zboray and his team examined a thyroid tumor sample from a patient who had recently died. This patient had been hospitalized in 2011 for a tumor that was classified as benign but later recurred in a malignant form. “Conventional sectional analysis missed capsular hernias deep in the tissue, which we were able to identify retrospectively using our method,” says Zboray. Based on this finding, a retrospective study of such recurrence cases is now being carried out, in which samples from patients across Europe are being examined who, despite initially harmless findings, later developed serious tumors. The study has so far been supported by the Mirto Foundation and the Bank Vontobel Donation Foundation. However, further funding is currently being sought.

According to Robert Zboray, the new 3D tissue analysis can be seamlessly integrated into the clinical workflow and ideally complements conventional sectional analysis. “Established procedures are firmly anchored in everyday medical practice. Our technology is not intended to disrupt these processes, but to offer additional benefits.” The development of new technologies for personalized medicine is also the goal of “Personalized Health and Related Technologies” (PHRT), a strategic research focus of the institutions of the ETH Domain, in which the project is embedded.

The technology also appears to be promising for other tumor types such as prostate cancer or lung cancer. Thanks to funding from the Swiss National Science Foundation (SNSF), Zboray can now test his three-dimensional histology technique in the metastasis of colorectal cancer. He would also like to replace complex molecular analyses with simpler imaging methods. “If we succeed in correlating the molecular “fingerprints” of the pathologically altered cell functions in the tumor tissues with imaging texture features in the micrometer range, we could link our technology directly to the underlying genetic changes in the future,” says Zboray, formulating his vision.

Empa's Zukunftsfonds is looking for private donations for outstanding research projects, such as the retrospective study mentioned above. If you would also like to support Empa's research, you can find further information here: https://www.empa.ch/web/zukunftsfonds