Courtesy of Prof Inke Näthke and Prof Sandy Cochran, this image shows precancerous changes in intestinal tissue detected by microultrasound scanning. Altered properties of precancerous tissue not identified by conventional pathological approaches (two-dimensional sections) can be measured with microultrasound (right), as confirmed with three-dimensional high-resolution microscopy (left). Measuring these premalignant changes using microultrasound provides a potential means to detect microscopically abnormal regions in large tissue samples, independent of visual examination or biopsies, allowing detection of early tumours in colorectal cancer patients and early treatment.
In colorectal cancer, inactivation of a single gene (Apc) is common to more than 90% of tumours. The ApcMin/+ mouse model of colorectal cancer mimics a genetic condition (Familial Adenomatous Polyposis) in humans who present with numerous polyps that progress to cancer if left untreated. Intestinal tissue from ApcMin/+ mice revealed superficial polyps when viewed at 10X magnification (A). The arrow connecting the polyps visible at ‘i’ and ‘ii’ shows the region of polyp that was resected and sectioned to allow visual examination in cross section (B). 580 individual 45 MHz ultrasound B-mode scans obtained by scanning over the tissue sample prior to sectioning generated a 3-D composite image in which the polyps appear as hyper-echoic ‘hot’ spots when mapped to a relative heat map (C). Ultrasound B-scan along the tissue cross-section shows polyps marked ‘i’ and ‘ii’ as areas of high reflectivity localized superficially (D). High intensity signal on the underside of the tissue corresponds to the muscle layer that surrounds the intestine (white asterisks).
The image is taken from a recent study published in Nature Scientific Reports:
Fatehullah A, Sharma S, Newton IP, Langlands AJ, Lay H, Nelson SA, McMahon RK, McIlvenny N, Appleton PL, Cochran S, Näthke IS. Increased variability in Apc Min/+ intestinal tissue can be measured with microultrasound. Nature Scientific Reports 2016; 6:29570.
Profs Näthke and Cochran work on the EPSRC-funded Sonopill programme developing swallowable, ultrasonic endoscopic capsules with multimodality sensing for the detection and treatment of gastrointestinal disease.