Fig 1.
Attenuation, phase-contrast, and histology images of sample 1.
(A) The absorption-based image reveals adipose tissue (at) appearing dark and areas of breast tissue. The tumor tissue cannot be further differentiated. The absorption-based image shows low contrast of all structures except for adipose tissue (at). The attenuation data is displayed in a linear range of [-60,60] HU. (B) The phase-contrast image of the same region shows a round shaped central part of the invasive tumor marked with an ‘x’ with surrounding DCIS. The bright delineation of duct walls in dilated ducts containing DCIS can be observed (arrows). (C) The histology section (HE staining) shows an invasive ductal cancer (violet, labeled with ‘x’) surrounded by DCIS and dilated mammary ducts (pink). The arrows indicate dilated ducts with intraductal carcinoma. The tumor area is embedded in an area of adipose tissue (at). (D) 200-fold magnification of the histology part indicated by the rectangle in (C) visualizes dilated ducts (violet) and an atypical epithelium that fills up completely or partially the lumen of the ducts. The DCIS areas marked by the asterisks depict central necrosis.
Fig 2.
Attenuation, phase-contrast, and histology images of sample 2.
(A) The absorption-based image shows low contrast of all structures except for adipose tissue (at). The attenuation data is displayed in a linear range of [-60,60] HU. (B) The phase-contrast image of the same region corresponding to (A) shows dilated ducts delineated with a bright wall. Exemplary ducts are marked by arrows. The duct labeled by the ‘d’ marks a normal ductal wall with high phase-contrast signal intensity, whereas the corresponding lumen is of lower signal intensity. In contrast, the DCIS area (asterisk and arrows) shows irregular shape of the ductal wall and lumen due to the multilayer epithelium. The phase-contrast data is displayed in a linear range of [-100,100] HUp. (C) The corresponding histological section (overview, HE stained) visualizes areas of fibrous tissue with violet ductal structures in different directions. The triangular tissue structure in the upper part of the slice represents an area of low grade DCIS (asterisk), which can also be seen in the phase-contrast image (B).
Fig 3.
Histopathologic slices of sample 2 in different magnifications.
(A) In 10-fold magnification, the details of the duct marked by the asterisk cannot be visualized. This duct is the same as depicted in the histology image in Fig 2C labeled by the ‘d’. The arrow shows an exemplary DCIS structure. (B) The 100-fold magnification visualizes the normal epithelial structure. The lumen of the ducts is partially filled by debris labeled by the ‘x’. (C) The 200-fold magnification displays the epithelial monolayer in the duct in further detail.
Fig 4.
Attenuation, phase-contrast, and histology images of sample 3.
(A) The absorption-based image clearly depicts microcalcifications (frame) but shows low contrast of the vessel wall (asterisk) and very little contrast of the soft tissue component of the DCIS area. The attenuation data is displayed in a linear range of [-60,60] HU. (B) The phase-contrast image visualizes a clear depiction of the vessel wall (asterisk). The calcifying DCIS region shows moderate soft tissue contrast. The phase-contrast data is displayed in a linear range of [-100,100] HUp. (C) The histological section (HE stained, overview) of sample 3 reveals a tubular structure in the left part of the section representing a vessel with a tortous segment in the lower border of the section (asterisk). Areas of calcifying DCIS can be seen in the right part of the section (frame).
Fig 5.
Attenuation, phase-contrast, and histology images of sample 4.
(A) The absorption images reveal no differentiation of ductal structures and glandular tissue. The microcalcifications are well depicted. The attenuation data is displayed in a linear range of [-60,60] HU. (B) The phase-contrast image visualizes an overall higher signal in the haemorrhagic area but low contrast of the dilated ducts in the areas of DCIS (encircled regions). Bright delineation of duct walls is visible in both areas and the microcalcifications are clearly depicted. The phase-contrast data is displayed in a linear range of [-100,100] HUp. (C) Histological section (overview, HE stained) showing haemorrhage in an area of dilated ducts with normal monolayer epithelium (arrows) and regions of ducts with multilayer epithelium and microcalcifications representing DCIS (circles).
Fig 6.
Histology slices of sample 4 in detailed magnification.
(A) The histological section in overview (HE stained) indicates an area of dilated ducts with an atypical epithelium (framed violet ducts). (B) The magnification view (40 ×) clearly demonstrates dilated ducts filled up with violet stained epithelial cells (frame) and surrounding fibrous tissue (pink). These ducts filled with blood clots, which can be identified in the phase-contrast image in Fig 5B, show a normal flat monolayer epithelium. (C) The magnification view (100 ×) of the framed region reveals central necrosis within the intraductal proliferations and a high grade nuclearity of the epithelial cells showing clear evidence for the presence of DCIS.