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Clinical applications

LLTECH 2011

TABLE OF CONTENTS
CLINICAL APPLICATIONS

LLTECH 2011

BREAST

Page 3

SKIN

Page 10

CORNEA

Page 14

PROSTATE

Page 17

LUNG

Page 22

KIDNEY

Page 26

BRAIN

Page 29

HEAD & NECK

Page 34

BREAST AND LYMPH NODES

- Extemporaneous analysis for cancer surgery
- Biobanking selection

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LLTECH 2011

Healthy breast tissue

Grainy aspect of normal

fibrous tissue
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Duct with
calcification

Lobule

Adipocytes

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

Vessel
Courtesy of Hpital Tenon, Paris, France
4

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

500m

100m

Grey zones corresponding to foci

of carcinomatous cells

Grainy medium
scattering aspect:
healthy fibrous
tissue

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

500m

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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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LLTECH 2011

10

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)

11

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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14

Normal human cornea

Cross sectional view

En face views
Surface epithelium

100 m

Intermediary epithelium

Basal epithelium

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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17

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

50 m

sagittal

coronal

Coronal reconstruction

50 m

oblique
Oblique reconstruction

50 m

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Courtesy of Hpital Tenon, Paris, France

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Biopsy imaging

1 mm

1 mm

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Courtesy of Hpital Cochin, Paris, France

20

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

100 m
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Invasive

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

KIDNEY
- Biobanking selection
- Biopsy quality assessment

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26

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

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50 m

Courtesy of Weill Medical College, NY, USA

28

BRAIN AND SPINAL CORD

- Biobank selection
- In-vivo potential for surgical guidance

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29

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

Capillary

White matter
500 m
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50 m

Varlet et al 2013
(submitted) 30

Hippocampus: Coronal section (left side)

40 m

SubEpendymal
zone

Pyramidal neurons of the CA4 field

responsible for memory

CA4 field
Alveus
40 m

Stratum radiatus
of the CA1 field

Hippocampal sulcus

80 m

Stratum granulosum of the dentate gyrus

80 m
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CA1 field of the cornus ammonis

900 m
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Choroid Plexus Papilloma : Xanthomatous changes

Characteristic cauliflower-like masses

Empty papilla

50 m

Papilla filled with blood

150 m

Rare (0.5%) benign tumors

50 m

50 m

50 m

20 m

20 m

Single layer of plexus cells

Diagnosis possible directly on FF-OCT image

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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

80% of meningiomas are benign.

10 m

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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34

500 m

Glossectomy
Tumorous tongue tissue

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
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Glossectomy
Mouth floor
1 mm

500 m

Epithelial cell
nuclei

Spinous cells
500 m

500 m
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Courtesy of Institut Gustave Roussy, Villejuif, France

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Contacts

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Suite 300
Princeton, NJ 08540, USA

LLTech
Ppinire Paris Sant Cochin
29 rue du Faubourg Saint Jacques
75014 Paris

Phone: +1 609 995 3506

Phone: +33 1 82 72 61 25

www.lltechimaging.com
contact@lltech.fr

www.lltechimaging.com
LLTECH 2011

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