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

an original study

Authors

  • Jiaxin Yu Nanjing University, Research Institute of Stomatology, Affiliated Hospital of Medical School, Nanjing Stomatological Hospital, Department of Oral and Maxillofacial Trauma Orthognathic Plastic Surgery, Nanjing, China
  • Zhouyu Gu Nanjing University, Research Institute of Stomatology, Affiliated Hospital of Medical School, Nanjing Stomatological Hospital, Department of Oral and Maxillofacial Trauma Orthognathic Plastic Surgery, Nanjing, China.
  • Lichan Wang Nanjing University, Research Institute of Stomatology, Affiliated Hospital of Medical School, Nanjing Stomatological Hospital, Department of Oral and Maxillofacial Trauma Orthognathic Plastic Surgery, Nanjing, China.
  • Qian Zhang Nanjing University, Research Institute of Stomatology, Affiliated Hospital of Medical School, Nanjing Stomatological Hospital, Department of Oral and Maxillofacial Trauma Orthognathic Plastic Surgery, Nanjing, China.
  • Qingang Hu Nanjing University, Research Institute of Stomatology, Affiliated Hospital of Medical School, Nanjing Stomatological Hospital, Department of Oral and Maxillofacial Trauma Orthognathic Plastic Surgery, Nanjing, China.
  • Chengwan Chia Nanjing University, Research Institute of Stomatology, Affiliated Hospital of Medical School, Nanjing Stomatological Hospital, Department of Oral and Maxillofacial Trauma Orthognathic Plastic Surgery, Nanjing, China. https://orcid.org/0000-0003-3937-2605
  • Yuxin Wang Nanjing University, Research Institute of Stomatology, Affiliated Hospital of Medical School, Nanjing Stomatological Hospital, Department of Oral and Maxillofacial Trauma Orthognathic Plastic Surgery, Nanjing, China. https://orcid.org/0000-0002-1629-4176

DOI:

https://doi.org/10.1590/

Keywords:

Micro-computed Tomography, Lugol's Iodine, Oral squamous cell carcinoma, Depth of invasion, Cultivation Program for Junior Talents of Nanjing Stomatological School, Medical School of Nanjing University

Abstract

Objectives:  Depth of invasion (DOI) in oral squamous cell carcinoma (OSCC) guides treatment and prognosis but lacks three-dimensional (3D) insight. Thus, this study aimed to investigate the feasibility and accuracy of Lugol's iodine-enhanced micro-computed tomography (CT) for the 3D measurement of DOI in OSCC samples.

Methodology:  In total, 50 in vitro OSCC samples from Nanjing Stomatological Hospital (July 2022 to January 2024) were subjected to micro-CT imaging with a slice thickness of 50 μm following 3% Lugol iodine staining for 12 h, followed by pathological examination and staining. The panoramic diagnostic scanner digitally measured pathological DOI. The micro-CT DOI was measured by evaluating the voxel value of the boundary of the tumor lesion and comparing it with the pathological examination results. Experienced physicians analyzed both measurements, and statistical analyses were performed to determine their correlation.

Results:  Lugol iodine-enhanced micro-CT imaging distinguishes various tissue structures, such as tumor tissue, epithelial tissue, muscle tissue, blood vessel structure, and other major tissue structures in 3D space. This imaging technique found and localized micro-tumor lesions (1.82×1.5×1 mm3) when in conjunction with pathological sections. Statistical analysis indicated a strong correlation between pathological DOI and micro-CT DOI (P<.001; r=0.986). During DOI measurement, Lugol iodine-enhanced micro-CT imaging effectively compensated for the loss of 3D space information in the pathological measurements, improving the accuracy of the DOI measurement.

Conclusions:  Lugol iodine-enhanced micro-CT improves OSCC DOI 3D measurements, enhances pathological staging accuracy, and aids treatment decisions and prognosis.

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Published

2025-01-13

Issue

Vol. 33 (2025)

Section

Original Articles

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How to Cite

Yu, J., Gu, Z., Wang , L., Zhang , Q., Hu , Q., Chia, C., & Wang, Y. (2025). Three-dimensional measurement of the depth of invasion in oral squamous cell carcinoma samples using Lugol’s iodine-enhanced micro-computed tomography: an original study. Journal of Applied Oral Science, 33, e20240304. https://doi.org/10.1590/