Diagnostic value of micro‐CT in comparison with histology in the qualitative assessment of historical human skull bone pathologies

Abstract

Cases of pathologically changed bone might constitute a diagnostic pitfall and frequently need histological methods to be etiologically properly evaluated. With micro-computed tomography (microCT), a new epoch of 2D and 3D imaging has been launched. We evaluated the diagnostic investigation of this analytical method versus well established histological investigations of historical human bone. Pathological changes due to various etiologies (infectious, traumatic, endocrinological, neoplasia) observed in autopsy-based macerated human skulls (Galler Collection, Natural History Museum Basel, Switzerland) were investigated by microCT and compared with histological thin ground sections using polarized light. Micro-CT images visualize the architecture of the bone with high spatial resolution without preparation or destruction of the sample in the area to be sectioned. Changes in the bone surfaces as well as alterations of the diploë can be assessed. However, morphological patterns caused by reactive response, such as typical arrangements of collagen fibers, can only be visualized by the microscopic investigation of thin ground sections using polarized light. A great advantage of microCT is the high number of slices obtained so that spatial differences within the areas of the specimen become visible. Micro-CT is a valuable tool for the diagnosis of vestiges of skull bone diseases. Its advantages over histology are the fast, automated image acquisition and the fact that the specimen is not completely destroyed. Only excision of the area to be scanned is necessary, if the specimen is too large to be scanned as a whole. Further, the 3D visualization of the micro-architecture allows an easy orientation within the sample, for example, for the choice of the location of the histological slices. However, the need to differentiate woven from lamellar bone still makes histology an indispensable method.

Osseous changes due to mastoiditis in human skeletal remains

“…In contrast, sclerotically thickened walls, massive, enlarged cells, or the results of massive bone remodelling processes can be detected quite well by conventional X-ray methods. Microcomputed tomography might be a suitable alternative technique for diagnosis; however, it is expensive and time-consuming and does not achieve the quality of microscopically viewed thin-sections (Rü hli et al, 2007). An endoscopic view of one or more cells opened post mortem provides a good estimation of the state of preservation of the bone surface inside the pneumatised cells which can differ significantly from the outer bone surface and can probably lead to a first diagnosis, but is still not conclusive.…”

Paleohistology and the study of human remains: past, present and future approaches

“…The lowest values were obtained in the analysis of combined pathologies (5.3%) and bone trauma (4.3%) (e.g. Kuhn et al, 2007;Rühli et al, 2007). The low specificity of some bone histomorphometric features (Weston, 2009;Van der Merwe et al, 2010), in addition to the invasive nature of most histological techniques (Bell and Piper, 2000;Ortner, 2003;Turner-Walker and Mays, 2008;Pfeiffer and Pinto, 2012), and the high level of scientific proficiency needed to interpret bone morphology at the microscopic level (Bell and Piper, 2000;Schultz, 2012) are the factors most frequently pinpointed to justify the reduced application of paleohistology as a diagnostic technique in paleopathology.…”

“…Recently, a new method for embedding, sawing, grinding, and staining was proposed by De Boer et al (2012 and2013a) in order to study undecalcified archaeological bone samples, especially when lesions were present. In addition to the improvements in the preparation of samples, other sophisticated microscope techniques were introduced to the study of archaeological remains-namely, the atomic force microscope (Thalhammer et al, 2001), the epifluorescence microscope, microscopic computerized tomography, and the confocal laser scanning microscope Rühli et al, 2007;Maggiano et al, 2009;Šefčáková et al, 2001). …”

Avaliação de cáries proximais por meio da microtomografia, tomografia Cone Beam e radiografias digitais

“…Atualmente alguns equipamentos de µCT possuem a mesma tecnologia dos tomógrafos cone beam (RÜHLI et al, 2007). A µCT também tem a capacidade de formar imagens tridimensionais de tecidos duros, provenientes de padrões estruturais, o que é impossível na histomorfometria convencional.…”

“…Vários estudos têm usado a µCT para avaliar o tecido ósseo (CIOFFI et al, 2007;WONG, 1996;MUSCHITZ et al, 2007;RÜHLI et al, 2007;SCHWEIZER et al, 2007). A µCT permite a avaliação de diferenças espaciais nos espécimes analisados, devido a sua possibilidade em obter várias secções (MERCER; DAVIS, 2003).…”