Ex vivo imaging of basal cell carcinoma using synchrotron phase-contrast X-ray microscopy

Background/aims: There is a need for development of non-invasive methods to improve early diagnosis and screening of suspected malignant lesions. Phase-contrast X-ray microscopy (PCXM) has potential to reveal the structures inside soft tissues, and fine details can be observed without any staining or contrast-enhancing cell preparation. We aimed to investigate the possibility that PCXM can be used to explore the microscopic details of basal cell carcinoma (BCC). Methods: Paraffin blocks of specimens from patients with basal cell carcinoma were cut with 30 μm thickness for PCXM imaging. Experiments were performed at the International Consortium of Phase Contrast Imaging and Radiology (ICPCIR) (7B2) beamline of the Pohang light source in Korea. The PCXM images were achieved by using coherent hard X-rays from a synchrotron source with no monochromatization. Results: We could obtain images with clear edge enhancement by PCXM. The images taken with this technique showed clear anatomic details of organelles in normal skin such as epidermis, dermis and skin appendages. Most of cancerous lesions were clearly differentiated from adjacent normal tissues and the images closely corresponded to those obtained with low-magnification optical microscopy. Conclusion: In this pilot study, we successfully demonstrated that synchrotron PCXM could be used for radiological imaging of BCC with great anatomic details.