Advances in real‐time fiber‐optic Raman spectroscopy for early cancer diagnosis: Pushing the frontier into clinical endoscopic applications

Fiber-optics IoT healthcare system based on deep reinforcement learning combinatorial constraint scheduling for hybrid telemedicine applications

Telemedicine is an emerging development in the healthcare domain, where the Internet of Things (IoT) fiber optics technology assists telemedicine applications to improve overall digital healthcare performances for society. Telemedicine applications are bowel disease monitoring based on fiber optics laser endoscopy, gastrointestinal disease fiber optics lights, remote doctor-patient communication, and remote surgeries. However, many existing systems are not effective and their approaches based on deep reinforcement learning have not obtained optimal results. This paper presents the fiber optics IoT healthcare system based on deep reinforcement learning combinatorial constraint scheduling for hybrid telemedicine applications. In the proposed system, we propose the adaptive security deep q-learning network (ASDQN) algorithm methodology to execute all telemedicine applications under their given quality of services (deadline, latency, security, and resources) constraints. For the problem solution, we have exploited different fiber optics endoscopy datasets with images, video, and numeric data for telemedicine applications. The objective is to minimize the overall latency of telemedicine applications (e.g., local, communication, and edge nodes) and maximize the overall rewards during offloading and scheduling on different nodes. The simulation results show that ASDQN outperforms all telemedicine applications with their QoS and objectives compared to existing state action reward state (SARSA) and deep q-learning network (DQN) policy during execution and scheduling on different nodes.

Label-Free Fiber-Optic Raman Spectroscopy for Intravascular Coronary Atherosclerosis and Plaque Detection

The rupture of atherosclerotic plaques remains one of the leading causes of morbidity and mortality worldwide. The plaques have certain pathological characteristics including a fibrous cap, inflammation, and extensive lipid deposition in a lipid core. Various invasive and noninvasive imaging techniques can interrogate structural aspects of atheroma; however, the composition of the lipid core in coronary atherosclerosis and plaques cannot be accurately detected. Fiber-optic Raman spectroscopy has the capability of in vivo rapid and accurate biomarker detection as an emerging omics technology. Previous studies demonstrated that an intravascular Raman spectroscopic technique may assess and manage the therapeutic and medication strategies intraoperatively. The Raman spectral information identified plaque depositions consisting of lipids, triglycerides, and cholesterol esters as the major components by comparing normal region and early plaque formation region with histology. By focusing on the composition of plaques, we could identify the subgroups of plaques accurately and rapidly by Raman spectroscopy. Collectively, this fiber-optic Raman spectroscopy opens up new opportunities for coronary atherosclerosis and plaque detection, which would assist optimal surgical strategy and instant postoperative decision-making. In this paper, we will review the advancement of label-free fiber-optic Raman probe spectroscopy and its applications of coronary atherosclerosis and atherosclerotic plaque detection.

Label-Free Optical Technologies to Enhance Noninvasive Endoscopic Imaging of Early-Stage Cancers

White light endoscopic imaging allows for the examination of internal human organs and is essential in the detection and treatment of early-stage cancers. To facilitate diagnosis of precancerous changes and early-stage cancers, label-free optical technologies that provide enhanced malignancy-specific contrast and depth information have been extensively researched. The rapid development of technology in the past two decades has enabled integration of these optical technologies into clinical endoscopy. In recent years, the significant advantages of using these adjunct optical devices have been shown, suggesting readiness for clinical translation. In this review, we provide an overview of the working principles and miniaturization considerations and summarize the clinical and preclinical demonstrations of several such techniques for early-stage cancer detection. We also offer an outlook for the integration of multiple technologies and the use of computer-aided diagnosis in clinical endoscopy.

RamanSPy: An Open-Source Python Package for Integrative Raman Spectroscopy Data Analysis

Raman spectroscopy is a nondestructive and label-free chemical analysis technique, which plays a key role in the analysis and discovery cycle of various branches of science. Nonetheless, progress in Raman spectroscopic analysis is still impeded by the lack of software, methodological and data standardization, and the ensuing fragmentation and lack of reproducibility of analysis workflows thereof. To address these issues, we introduce RamanSPy, an open-source Python package for Raman spectroscopic research and analysis. RamanSPy provides a comprehensive library of tools for spectroscopic analysis that supports day-to-day tasks, integrative analyses, the development of methods and protocols, and the integration of advanced data analytics. RamanSPy is modular and open source, not tied to a particular technology or data format, and can be readily interfaced with the burgeoning ecosystem for data science, statistical analysis, and machine learning in Python. RamanSPy is hosted at https://github.com/barahona-research-group/RamanSPy, supplemented with extended online documentation, available at https://ramanspy.readthedocs.io, that includes tutorials, example applications, and details about the real-world research applications presented in this paper.

Optical fiber biosensors toward in vivo detection

This review takes stock of the various optical fiber-based biosensors that could be used for in vivo applications. We discuss the characteristics that biosensors must have to be suitable for such applications and the corresponding transduction modes. In particular, we focus on optical fiber biosensors based on fluorescence, evanescent wave, plasmonics, interferometry, and Raman phenomenon. The operational principles, implemented solutions, and performances are described and debated. The different sensing configurations, such as the side- and tip-based fiber biosensors, are illustrated, and their adaptation for in vivo measurements is discussed. The required implementation of multiplexed biosensing on optical fibers is shown. In particular, the use of multi-fiber assemblies, one of the most optimal configurations for multiplexed detection, is discussed. Different possibilities for multiple localized functionalizations on optical fibers are presented. A final section is devoted to the practical in vivo use of fiber-based biosensors, covering regulatory, sterilization, and packaging aspects. Finally, the trends and required improvements in this promising and emerging field are analyzed and discussed.

Photonics-powered augmented reality skin electronics for proactive healthcare: multifaceted opportunities

Rapid technological advancements have created opportunities for new solutions in various industries, including healthcare. One exciting new direction in this field of innovation is the combination of skin-based technologies and augmented reality (AR). These dermatological devices allow for the continuous and non-invasive measurement of vital signs and biomarkers, enabling the real-time diagnosis of anomalies, which have applications in telemedicine, oncology, dermatology, and early diagnostics. Despite its many potential benefits, there is a substantial information vacuum regarding using flexible photonics in conjunction with augmented reality for medical purposes. This review explores the current state of dermal augmented reality and flexible optics in skin-conforming sensing platforms by examining the obstacles faced thus far, including technical hurdles, demanding clinical validation standards, and problems with user acceptance. Our main areas of interest are skills, chiroptical properties, and health platform applications, such as optogenetic pixels, spectroscopic imagers, and optical biosensors. My skin-enhanced spherical dichroism and powerful spherically polarized light enable thorough physical inspection with these augmented reality devices: diabetic tracking, skin cancer diagnosis, and cardiovascular illness: preventative medicine, namely blood pressure screening. We demonstrate how to accomplish early prevention using case studies and emergency detection. Finally, it addresses real-world obstacles that hinder fully realizing these materials' extraordinary potential in advancing proactive and preventative personalized medicine, including technical constraints, clinical validation gaps, and barriers to widespread adoption.

Spectral insights: Navigating the frontiers of biomedical and microbiological exploration with Raman spectroscopy

Raman spectroscopy (RS), a powerful analytical technique, has gained increasing recognition and utility in the fields of biomedical and biological research. Raman spectroscopic analyses find extensive application in the field of medicine and are employed for intricate research endeavors and diagnostic purposes. Consequently, it enjoys broad utilization within the realm of biological research, facilitating the identification of cellular classifications, metabolite profiling within the cellular milieu, and the assessment of pigment constituents within microalgae. This article also explores the multifaceted role of RS in these domains, highlighting its distinct advantages, acknowledging its limitations, and proposing strategies for enhancement.

In-situ background-free Raman probe using double-cladding anti-resonant hollow-core fibers

This study presents the development of an in-situ background-free Raman fiber probe, employing two customized double-cladding anti-resonant hollow-core fibers (AR-HCFs). The Raman background noise measured in the AR-HCF probe is lower than that of a conventional multi-mode silica fiber by two orders of magnitude. A plug-in device for fiber coupling optics was designed that was compatible with a commercially available confocal Raman microscope, enabling in-situ Raman detection. The numerical aperture (NA) of both AR-HCF claddings exceeds 0.2 substantially enhancing the collection efficiency of Raman signals at the distal end of the fiber probe. The performance of our Raman fiber probe is demonstrated by characterizing samples of acrylonitrile-butadiene-styrene (ABS) plastics, alumina ceramics, and ethylene glycol solution.

Application of a Novel Miniaturized Histopathologic Microscope for Ex Vivo Identifying Cerebral Glioma Margins Rapidly During Surgery: A Parallel Control Study

PURPOSE

The purpose of our study is to assess the clinical performance of the DiveScope, a novel handheld histopathologic microscope in rapidly differentiating glioma from normal brain tissue during neurosurgery.

METHODS

Thirty-two ex vivo specimens from 18 patients were included in the present study. The excised suspicious tissue was sequentially stained with sodium fluorescein and methylene blue and scanned with DiveScope during surgery. The adjacent tissue was sent to the department of pathology for frozen section examination. They would eventually be sent to the pathology department later for hematoxylin and eosin staining for final confirmation. The positive likelihood ratio, negative likelihood ratio, sensitivity, specificity, and area under the curve of the device were calculated. In addition, the difference in time usage between DiveScope and frozen sections was compared for the initial judgment.

RESULTS

The sensitivity and specificity of the DiveScope after analyzing hematoxylin and eosin -staining sections, were 88.29% and 100%, respectively. In contrast, the sensitivity and specificity of the frozen sections histopathology were 100% and 75%, respectively. The area under the curve of the DiveScope and the frozen sections histopathology was not significant ( P =0.578). Concerning time usage, DiveScope is significantly much faster than the frozen sections histopathology no matter the size of tissue.

CONCLUSION

Compared with traditional pathological frozen sections, DiveScope was faster and displayed an equal accuracy for judging tumor margins intraoperatively.

Evaluation of near-infrared Raman spectroscopy in the differentiation of cortical bone, trabecular bone, and Bio-Oss bone graft: an ex-vivo study

OBJECTIVE

We evaluated the ability of near-infrared Raman spectroscopy (near-IR RS) to differentiate among cortical bone, trabecular bone, and Bio-Oss, a bovinebone-based graft material.

STUDY DESIGN

We obtained a thinly sliced section of the mandible to collect cortical and trabecular bone samples and placed compacted Bio-Oss bone graft into a partially edentulous mandible in a dry human skull to obtain a comparable Bio-Oss sample. We performed near-IR RS of the 3 samples and evaluated the resultant Raman spectra to evaluate their differences.

RESULTS

We identified 3 sets of spectroscopic markers that differentiated Bio-Oss from human bone. The first consisted of significant shifts in the location of the 960 cm-1 phosphate (PO43-) peak and a reduction in its width, suggesting that Bio-Oss is more crystalline than bone. The second was the reduced carbonate content of Bio-Oss compared to bone, as determined from the 1070 cm-1/960 cm-1 peak area ratio. The final marker was the lack of collagen-associated peaks in Bio-Oss compared to cortical and trabecular bone.

CONCLUSIONS

Near-IR RS can reliably differentiate human cortical and trabecular bone from Bio-Oss via 3 sets of spectral markers associated with mineral crystallinity, carbonate content, and collagen content that differ significantly between them. Integrating this modality into dental practice may assist in implant treatment planning.

Development of a two-beveled-fiber polarized fiber-optic Raman probe coupled with a ball lens for in vivo superficial epithelial Raman measurements in endoscopy

We report on the development of a two-beveled-fiber polarized (TBFP) fiber-optic Raman probe coupled with a ball lens for in vivo superficial epithelial Raman measurements in endoscopy. The two-beveled fibers positioned symmetrically along a ball lens, in synergy with paired parallel-polarized polarizers integrated between the fibers and the ball lens, maximize the Raman signal excitation and collection from the superficial epithelium where gastrointestinal (GI) precancer arises. Monte Carlo (MC) simulations and two-layer tissue phantom experiments show that the probe developed detects ∼90% of the Raman signal from the superficial epithelium. The suitability of the probe developed for rapid (<3 s) superficial epithelial Raman measurements is demonstrated on fresh swine esophagus, stomach, and colon tissues, followed by their differentiation with high accuracies (92.1% for esophagus [sensitivity: 89.3%, specificity: 93.2%], 94.1% for stomach [sensitivity: 86.2%, specificity: 97.2%], and 94.1% for colon [sensitivity: 93.2%, specificity: 94.7%]). The presented results suggest the great potential of the developed probe for enhancing in vivo superficial epithelial Raman measurements in endoscopy.

Intraoperative assessment of resection margins by Raman spectroscopy to guide oral cancer surgery

Patients with oral cavity cancer are almost always treated with surgery. The goal is to remove the tumor with a margin of more than 5 mm of surrounding healthy tissue. Unfortunately, this is only achieved in about 15% to 26% of cases. Intraoperative assessment of tumor resection margins (IOARM) can dramatically improve surgical results. However, current methods are laborious, subjective, and logistically demanding. This hinders broad adoption of IOARM, to the detriment of patients. Here we present the development and validation of a high-wavenumber Raman spectroscopic technology, for quick and objective intraoperative measurement of resection margins on fresh specimens. It employs a thin fiber-optic needle probe, which is inserted into the tissue, to measure the distance between a resection surface and the tumor. A tissue classification model was developed to discriminate oral cavity squamous cell carcinoma (OCSCC) from healthy oral tissue, with a sensitivity of 0.85 and a specificity of 0.92. The tissue classification model was then used to develop a margin length prediction model, showing a mean difference between margin length predicted by Raman spectroscopy and histopathology of -0.17 mm.

Development of a multi-needle fiberoptic Raman spectroscopy technique for simultaneous multi-site deep tissue Raman measurements in the brain

We report on the development of a multi-needle fiberoptic Raman spectroscopy (MNF-RS) technique for simultaneous multi-site deep Raman measurements in brain tissue. The multi-needle fiberoptic Raman probe is designed and fabricated using a number of 100 µm core diameter, aluminum-coated fibers under a coaxial laser excitation and Raman collection scheme, enabling simultaneous collection of deep tissue Raman spectra from a number of tissue sites. We have also developed a Raman retrieval algorithm based on the transformation matrix of each individual needle fiber probe projected to different pixels of a charge-coupled device (CCD) for recovering the tissue Raman spectra collected by each needle fiber probe, allowing simultaneous multi-channel detection by a single Raman spectrometer. High-quality tissue Raman spectra of different tissue types (e.g., muscle, fat, gray matter, and white matter in porcine brain) can be acquired in both the fingerprint (900-1800 cm-1) and high-wavenumber (2800-3300 cm-1) regions within sub-second times using the MNF-RS technique. We also demonstrate that by advancing the multi-needle fiberoptic Raman probe into deep porcine brain, tissue Raman spectra can be acquired simultaneously from different brain regions (e.g., cortex, thalamus, midbrain, and cerebellum). The significant biochemical differences across different brain tissues can also be distinguished, suggesting the promising potential of the MNF-RS technique for label-free neuroscience study at the molecular level.

Performance assessment of probe-based Raman spectroscopy systems for biomedical analysis

We present a methodology for evaluating the performance of probe-based Raman spectroscopy systems for biomedical analysis. This procedure uses a biological standard sample and data analysis approach to circumvent many of the issues related to accurately measuring and comparing the signal quality of Raman spectra between systems. Dairy milk is selected as the biological standard due to its similarity to tissue spectral properties and because its homogeneity eliminates the dependence of probe orientation on the measured spectrum. A spectral dataset is first collected from milk for each system configuration, followed by a model-based correction step to remove photobleaching artifacts and accurately calculate SNR. Results demonstrate that the proposed strategy, unlike current methods, produces an experimental SNR that agrees with the theoretical value. Four preconfigured imaging spectrographs that share similar manufacturer specifications were compared, showing that their capabilities to detect biological Raman spectra widely differ in terms of throughput and stray light rejection. While the methodology is used to compare spectrographs in this case, it can be adapted for other purposes, such as optimizing the design of a custom-built Raman spectrometer, evaluating inter-probe variability, or examining how altering system subcomponents affects signal quality.

Shifted-excitation Raman difference spectroscopy for improving in vivo detection of nasopharyngeal carcinoma

A strong fluorescence background is one of the common interference factors of Raman spectroscopic analysis in biological tissue. This study developed an endoscopic shifted-excitation Raman difference spectroscopy (SERDS) system for real-time in vivo detection of nasopharyngeal carcinoma (NPC) for the first time. Owing to the use of the SERDS method, the high-quality Raman signals of nasopharyngeal tissue could be well extracted and characterized from the complex raw spectra by removing the fluorescence interference signals. Significant spectral differences relating to proteins, phospholipids, glucose, and DNA were found between 42 NPC and 42 normal tissue sites. Using linear discriminant analysis, the diagnostic accuracy of SERDS for NPC detection was 100%, which was much higher than that of raw Raman spectroscopy (75.0%), showing the great potential of SERDS for improving the accurate in vivo detection of NPC.

Development of a coaxial DCF-GRIN fiberoptic Raman probe for enhancing in vivo epithelial tissue Raman measurements

We report on the development of a novel, to the best of our knowledge, coaxial double-clad-fiber (DCF) and graded-index (GRIN) fiberoptic Raman probe for enhancing epithelial tissue Raman measurements in vivo. The ultra-thin (140 µm outer diameter) DCF-GRIN fiberoptic Raman probe is designed and fabricated with an efficient coaxial optical configuration, whereby a GRIN fiber is spliced onto the DCF to enhance both the excitation/collection efficiency and depth-resolved selectivity. We demonstrate that the DCF-GRIN Raman probe can be used to acquire high-quality in vivo Raman spectra from various oral tissues (e.g., buccal mucosa, labial mucosa, gingiva, mouth floor, palate, and tongue) covering both the fingerprint (800-1800 cm^-1) and high-wavenumber (2800-3600 cm^-1) regions within sub-seconds. The subtle biochemical differences between different epithelial tissues in the oral cavity can also be detected with high sensitivity, suggesting the potential of the DCF-GRIN fiberoptic Raman probe for in vivo diagnosis and characterization in epithelial tissue.

Miniaturized 7-in-1 fiber-optic Raman probe

This Letter reports a miniature 7-in-1 fiber-optic Raman probe that eliminates the inelastic background Raman signal from a long-fused silica fiber. Its foremost purpose is to enhance a method for investigating extraordinarily tiny substances and effectively capturing Raman inelastic backscattered signals using optical fibers. We successfully used our home-built fiber taper device to combine seven multimode fibers into a single fiber taper with a probe diameter of approximately 35 µm. By experimentally comparing the traditional bare fiber-based Raman spectroscopy system with the miniaturized tapered fiber-optic Raman sensor using liquid solutions, the novel probe's capability is demonstrated. We observed that the miniaturized probe effectively removed the Raman background signal originating from the optical fiber and confirmed expected outcomes for a series of common Raman spectra.

In vivo spectroscopy: optical fiber probes for clinical applications

INTRODUCTION

Fiber optic probe based in-vivo spectroscopy techniques are fast and highly objective methods for intraoperative diagnoses and minimally invasive surgical interventions for all procedures where endoscopic observations are carried out for cancers of different types. The Raman spectral features provide molecular fingerprint-type information and can reveal the subjects' pathological state in label-free manner, making endoscopy multiplexed fiber optic probe-based devices with the potential for translation from bench to bedside for routine applications.

AREAS COVERED

This review provides a general overview of different fiber-optic probes for in-vivo measurements with emphasis on Raman spectroscopy for biomedical application. Various aspects such as fiber-optic probe, radiation source, detector, and spectrometer for extracting optimum spectral features have also been discussed.

EXPERT OPINION

: Optical spectroscopy-based fiber probe systems with "Chip-on-Tip" technology, combined with machine learning, can in the near future, become a complimentary diagnostic tool to magnetic resonance imaging (MRI), computed tomography (CT) scan, ultrasound, etc. Hyperspectral imaging and fluorescence-based devices are in the advanced stage of technology readiness level (TRL), and with advances in lasers and miniature spectroscopy systems, probe-based Raman devices are also coming up.

Reactive oxygen species-responsive and Raman-traceable hydrogel combining photodynamic and immune therapy for postsurgical cancer treatment

Combining immune checkpoint blockade (ICB) therapy with photodynamic therapy (PDT) holds great potential in treating immunologically “cold” tumors, but photo-generated reactive oxygen species (ROS) can inevitably damage co-administered ICB antibodies, hence hampering the therapeutic outcome. Here we create a ROS-responsive hydrogel to realize the sustained co-delivery of photosensitizers and ICB antibodies. During PDT, the hydrogel skeleton poly(deca-4,6-diynedioic acid) (PDDA) protects ICB antibodies by scavenging the harmful ROS, and at the same time, triggers the gradual degradation of the hydrogel to release the drugs in a controlled manner. More interestingly, we can visualize the ROS-responsive hydrogel degradation by Raman imaging, given the ultrastrong and degradation-correlative Raman signal of PDDA in the cellular silent window. A single administration of the hydrogel not only completely inhibits the long-term postoperative recurrence and metastasis of 4T1-tumor-bearing mice, but also effectively restrains the growth of re-challenged tumors. The PDDA-based ROS-responsive hydrogel herein paves a promising way for the durable synergy of PDT and ICB therapy.

Combined immune checkpoint blockade (ICB) and photodynamic therapies have huge potential but suffer from possible damage of the antibodies. Here, the authors create a ROS-responsive hydrogel that protects the ICB antibodies and allows for sustained co-delivery and demonstrate restrained regrowth of tumours in vivo.

Rapid identification of human muscle disease with fibre optic Raman spectroscopy

We demonstrate the use of fibre optic Raman spectroscopy for the rapid identification of muscle disorders.

Micro-Lensed Negative-Curvature Fibre Probe for Raman Spectroscopy

We developed a novel miniature micro-lensed fibre probe for Raman spectroscopy. The fibre probe consists of a single negative-curvature fibre (NCF) and a spliced, cleaved, micro-lensed fibre cap. Using a single NCF, we minimized the Raman background generated from the silica and maintained the diameter of the probe at less than 0.5 mm. In addition, the cap provided fibre closure by blocking the sample from entering the hollow parts of the fibre, enabling the use of the probe in in vivo applications. Moreover, the micro-lensed cap offered an improved collection efficiency (1.5-times increase) compared to a cleaved end-cap. The sensing capabilities of the micro-lensed probe were demonstrated by measuring different concentrations of glucose in aqueous solutions.

Development and characterization of a disposable submillimeter fiber optic Raman needle probe for enhancing real-time in vivo deep tissue and biofluids Raman measurements

We report on the development and characterization of disposable submillimeter fiber optic Raman needle probe for enhancing real-time in vivo tissue and biofluids Raman measurements. The submillimeter Raman probe is designed and fabricated using an aluminum-coated multimode fiber tapered with a semispherical lens, resulting in the coaxial laser excitation/Raman collection configuration for maximizing tissue and biofluid Raman measurements. We demonstrate that, with the use of the Raman needle probe associated with the structured background subtraction algorithms developed, high quality tissue Raman spectra covering both the fingerprint (FP) (800-1800cm^-1) and high-wavenumber (HW) (2800-3300cm^-1) regions can be acquired within subseconds from different tissue types (e.g., skin, muscle, fat, cartilage, liver, and brain) and biofluids (e.g., blood, urine). By advancing the Raman needle probe into the murine brain tissue model, high quality depth-resolved deep tissue Raman spectra can also be acquired rapidly. This work shows that the submillimeter fiberoptic Raman needle probe is capable of achieving real-time collection of deep tissue and biofluids FP/HW Raman spectra with high signal to noise ratios. This opens a new avenue with dual functioning of Raman optical biopsy and fine needle aspiration biopsy for enhancing in vivo deep tissue and biofluids diagnosis and characterization in different organs.