Early detection of gastric cancer via high-resolution terahertz imaging system

Terahertz (THz) wave has demonstrated a good prospect in recent years, but the resolution is still one of the problems that restrict the application of THz technology in medical imaging. Paraffin-embedded samples are mostly used in THz medical imaging studies, which are thicker and significantly different from the current gold standard slice pathological examination in sample preparation. In addition, THz absorption in different layers of normal and cancerous tissues also remains to be further explored. In this study, we constructed a high-resolution THz imaging system to scan non-tumorous adjacent tissue slices and gastric cancer (GC) tissue slices. In this system, a THz quantum cascade laser emitted a pulsed 3 THz signal and the transmitted THz wave was received by a THz detector implemented in a 65 nm CMOS process. The slice thickness was only 20 μm, which was close to that of the medical pathology examination. We successfully found THz transmittance differences between different layers of normal gastric tissues based on THz images, and the resolution could reach 60 μm for the first time. The results indicated that submucosa had a lower THz transmittance than that of mucosa and muscular layer in non-tumorous adjacent tissue. However, in GC tissue, THz transmittance of mucosa and submucosa was similar, caused by the decreased transmittance of mucosa, where the cancer occurs. Therefore, we suppose that the similar terahertz transmittance between gastric mucosa and submucosa may indicate the appearance of cancerization. The images obtained from our THz imaging system were clearer than those observed with naked eyes, and can be directly compared with microscopic images. This is the first application of THz imaging technology to identify non-tumorous adjacent tissue and GC tissue based on the difference in THz wave absorption between different layers in the tissue. Our present work not only demonstrated the potential of THz imaging to promote early diagnosis of GC, but also suggested a new direction for the identification of normal and cancerous tissues by analyzing differences in THz transmittance between different layers of tissue.