Three-dimensional measurement of the depth of invasion in oral squamous cell carcinoma samples using Lugol’s iodine-enhanced micro-computed tomography

Abstract

Abstract Purpose Depth of invasion (DOI) in oral squamous cell carcinoma (OSCC) guides treatment and prognosis but lacks three-dimensional (3D) insight. We used Lugol’s iodine-enhanced micro-computed tomography (CT) for 3D analysis. Methods Fifteen in vitro OSCC samples from Nanjing Stomatological Hospital (July to December 2022) were micro-CT imaged with a slice thickness of 50 µm following 3% Lugol’s iodine staining for 12 h and then pathologically sectioned and stained. The panoramic diagnostic scanner measured pathological DOI digitally. The micro-CT DOI was measured by evaluating the CT value of the boundary of the tumor lesion and comparison with the pathological examination results. Experienced physicians analyzed both measurements, and a statistical analysis was performed to determine their correlation. Results Lugol’s iodine-enhanced micro-CT imaging can clearly distinguish various tissue structures, such as tumor tissue, epithelial tissue, muscle tissue, blood vessel structure, and other major tissue structures in three-dimensional space. This imaging technique can help identify and localize suspicious micro-tumor lesions (1.82 × 1.5 × 1 mm) when used in conjunction with pathological sections. The statistical analysis results indicate a strong correlation between pathological DOI and micro-CT DOI (p < 0.001), with a correlation coefficient of 0.995. During the measurement of DOI information, Lugol’s iodine-enhanced micro-CT imaging effectively compensates for the loss of three-dimensional space information in pathological measurements, thereby improving the accuracy of DOI measurement. Conclusion Lugol’s iodine-enhanced micro-CT improves OSCC DOI 3D measurement, enhances pathological staging accuracy, and aids treatment decisions and prognosis.