Optical coherence tomography combined with convolutional neural networks can differentiate between intrahepatic cholangiocarcinoma and liver parenchyma ex vivo

Zeitschrift für Gastroenterologie, vol. 61, pp. e603

Abstract

Purpose Surgical resection with complete tumor excision (R0) provides the best chance of long-term survival for patients with intrahepatic cholangiocarcinoma (iCCA). A non-invasive imaging technology, which could provide quick intraoperative assessment of resection margins, as an adjunct to histological examination, is optical coherence tomography (OCT). In this study, we investigated the ability of OCT combined with convolutional neural networks (CNN), to differentiate iCCA from normal liver parenchyma ex vivo . Methods Consecutive adult patients undergoing elective liver resections for iCCA between June 2020 and April 2021 (n=11) were included in this study. Areas of interest from resection specimens were scanned ex vivo , before formalin fixation, using a table-top OCT device at 1310 nm wavelength. Scanned areas were marked and histologically examined, providing a diagnosis for each scan. An Xception CNN was trained, validated, and tested in matching OCT scans to their corresponding histological diagnoses, through a 5×5 stratified cross-validation process. Results Twenty-four three-dimensional scans (corresponding to approx. 85,603 individual) from ten patients were included in the analysis. In 5×5 cross-validation, the model achieved a mean F1-score, sensitivity, and specificity of 0.94, 0.94, and 0.93, respectively. Conclusion Optical coherence tomography combined with CNN can differentiate iCCA from liver parenchyma ex vivo . Further studies are necessary to expand on these results and lead to innovative in vivo OCT applications, such as intraoperative or endoscopic scanning. Publication History Article published online: 28 August 2023 © 2023. Thieme. All rights reserved. Georg Thieme Verlag Rüdigerstraße 14, 70469 Stuttgart, Germany

Authors 17

1. Laura I. Wolff Aachen

   Universitätsklinikum Aachen

   Affiliation as printed

   Uniklinik RWTH Aachen, Allgemein-, Viszeral-, und Transplantationschirurgie, Aachen, Deutschland

2. Enno Hachgenei Aachen Fraunhofer Institute for Production Technology IPT

   Fraunhofer Institute for Production Technology IPT

   Affiliation as printed

   Fraunhofer Institute for Production Technology IPT, Production Metrology, Aachen, Deutschland

3. Paul Goßmann Aachen

   Universitätsklinikum Aachen

   Affiliation as printed

   Uniklinik RWTH Aachen, Allgemein-, Viszeral-, und Transplantationschirurgie, Aachen, Deutschland

4. Mariia Druzenko Aachen

   Universitätsklinikum Aachen

   Affiliation as printed

   Uniklinik RWTH Aachen, Allgemein-, Viszeral-, und Transplantationschirurgie, Aachen, Deutschland

5. Maik Frye Aachen Fraunhofer Institute for Production Technology IPT

   Fraunhofer Institute for Production Technology IPT

   Affiliation as printed

   Fraunhofer Institute for Production Technology IPT, Production Quality, Aachen, Deutschland

6. Niels König Aachen Fraunhofer Institute for Production Technology IPT

   Fraunhofer Institute for Production Technology IPT

   Affiliation as printed

   Fraunhofer Institute for Production Technology IPT, Production Metrology, Aachen, Deutschland

7. Robert Heinrich Schmitt Aachen Fraunhofer Institute for Production Technology IPT Laboratory for Machine Tools and Production Engineering (WZL)

   Fraunhofer Institute for Production Technology IPT · RWTH Aachen University

   Affiliation as printed

   Fraunhofer Institute for Production Technology IPT, Production Metrology, Aachen, Deutschland

   RWTH Aachen University, Laboratory for Machine Tools and Production Engineering (WZL), Aachen, Deutschland

8. Alexandros Chrysos Aachen

   Universitätsklinikum Aachen

   Affiliation as printed

   Uniklinik RWTH Aachen, Allgemein-, Viszeral-, und Transplantationschirurgie, Aachen, Deutschland

9. K. Jöchle Aachen

   Universitätsklinikum Aachen

   Affiliation as printed

   Uniklinik RWTH Aachen, Allgemein-, Viszeral-, und Transplantationschirurgie, Aachen, Deutschland

10. Daniel Truhn Aachen

    Universitätsklinikum Aachen

    Affiliation as printed

    Uniklinik RWTH Aachen, Diagnostische und Interventionelle Radiologie, Aachen, Deutschland

11. Jakob Nikolas Kather Aachen Medizinische Klinik III

    Universitätsklinikum Aachen · Else Kröner Fresenius Center for Digital Health

    Affiliation as printed

    Carus Technical University Dresden, Else Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav, Dresden, Deutschland

    Uniklinik RWTH Aachen, Medizinische Klinik III, Aachen, Deutschland

12. Nadine Therese Gaisa Aachen

    Universitätsklinikum Aachen

    Affiliation as printed

    Uniklinik RWTH Aachen, Pathologie, Aachen, Deutschland

13. Danny David Jonigk Aachen

    Universitätsklinikum Aachen · German Center for Lung Research

    Affiliation as printed

    German Center of Lungs Research (DZL, BREATH), Gießen, Deutschland

    Uniklinik RWTH Aachen, Pathologie, Aachen, Deutschland

14. Tom Florian Ulmer Aachen

    Universitätsklinikum Aachen

    Affiliation as printed

    Uniklinik RWTH Aachen, Allgemein-, Viszeral-, und Transplantationschirurgie, Aachen, Deutschland

15. Ulf P. Neumann Aachen

    Universitätsklinikum Aachen

    Affiliation as printed

    Uniklinik RWTH Aachen, Allgemein-, Viszeral-, und Transplantationschirurgie, Aachen, Deutschland

16. S.A. Lang Aachen

    Universitätsklinikum Aachen

    Affiliation as printed

    Uniklinik RWTH Aachen, Allgemein-, Viszeral-, und Transplantationschirurgie, Aachen, Deutschland

17. Iakovos Amygdalos Aachen

    Universitätsklinikum Aachen

    Affiliation as printed

    Uniklinik RWTH Aachen, Allgemein-, Viszeral-, und Transplantationschirurgie, Aachen, Deutschland