Visible-Near Infrared Spectroscopic Assessment of Urogenital Tissue in Premenopausal and Postmenopausal Women

Diffuse reflectance spectroscopy and imaging for non-invasive objective assessment of genitourinary syndrome of menopause: a pilot study

The genitourinary symptom of menopause (GSM) affects up to 65% of women, resulting in symptoms such as vulvovaginal dryness, discomfort, and dysuria, which significantly impacts quality of life. The current assessment methods rely on subjective questionnaires that can be influenced by individual differences, as well as invasive measurements that are time-consuming and not easily accessible. In this study, we explore the potential of a non-invasive and objective assessment tool called diffuse reflectance spectroscopy and imaging (DRSI) to evaluate tissue chromophores, including water, lipid, oxyhemoglobin, and deoxyhemoglobin. These measurements provide information about moisture content, lipid levels, oxygen saturation, and blood fraction, which can serve as surrogate markers for genital estrogen levels. Our findings reveal distinct differences in these chromophores among pre, peri, and postmenopausal subjects. By using lipid and blood fraction tissue chromophores in a K-Nearest Neighbour classifier model, we achieved a prediction accuracy of 65% compared to vaginal maturation index (VMI) that is clinically used to assess estrogen-related hormonal changes. When age was included as the third feature, the accuracy increased to 78%. We believe that by refining the study protocol and configuring the fiber probe to examine tissue chromophores both in the superficial vulva skin for epidermal water content and the deeper layers, DRSI has the potential to provide objective diagnosis and aid in monitoring the treatment outcome of GSM.

Assessing the influence of true hemolysis occurring in patient samples on emergency clinical biochemistry tests results using the VITROS® 5600 Integrated system

Hemolysis is one of the most frequent causes of pre-analytical errors in the emergency department (ED), and it can lead to inaccurate blood results and often requires repeat testing. The purpose of the present study was to evaluate the effects of true hemolysis occurring in ED blood samples on routine clinical biochemistry tests using the VITROS^® 5600 Integrated system. A total of 92 pairs of blood samples were collected from 92 ED patients. Each pair of samples included one hemolyzed sample and one successful (non-hemolyzed) redraw from the same patient. A total of 21 common laboratory analytes and the hemolytic index (HI) were examined. The degree of hemolysis (slight, mild, moderate and heavy) was determined based on the HI. A clinically significant difference in one analyte was defined as a difference greater than its Clinical Laboratory Improvement Amendments of 1988 (CLIA'88) total allowable error (TAE) limits. The results demonstrated that the mean differences in 11 serum analytes (unconjugated bilirubin, Ca²⁺, equivalent CO₂, Cl^-, creatinine, glucose, Mg²⁺, phosphorus, Na⁺, urea nitrogen and uric acid) in hemolyzed and non-hemolyzed samples were within their CLIA'88 TAE limits, while the differences in the other 10 analytes [alanine aminotransferase (ALT), albumin (ALB), amylase (AMYL), aspartate aminotransferase (AST), total bilirubin (TBIL), creatine kinase (CK), CK-myocardial band isoenzyme (CK-MB), lactate dehydrogenase (LDH), K⁺ and total protein (TP)] in paired samples in at least one of the four groups were greater than their CLIA'88 TAE limits. These results suggest that hemolysis had a notable impact on ALT, ALB, AMYL, AST, TBIL, CK, CK-MB, LDH, K⁺ and TP levels. Furthermore, for ALT, AMYL, TBIL and TP, wet chemistry methods displayed superior anti-hemolytic ability compared with dry chemistry methods. Notably, a high concentration of AST was less affected by hemolysis.

Spectral response of optical fiber probe with closely spaced fibers

Background

Optical fiber probe spectroscopy can characterize the blood content, hemoglobin oxygen saturation, water content, and scattering properties of a tissue. A narrow probe using closely spaced fibers can access and characterize a local tissue site, but analysis requires the proper light transport theory.

Methods

Monte Carlo simulations of photon transport specified the response of a two-fiber probe as a function of optical properties in a homogeneous tissue. The simulations used the dimensions of a commercial fiber probe (400-micron-diameter fibers separated by 80-microns of cladding) to calculate the response to a range of 20 absorption and 20 reduced scattering values. The 400 simulations yielded an analysis grid (lookup table) to interpolate the probe response to any given pair of absorption and scattering properties.

Results

The probe in contact with tissue is not sensitive to low absorption but sensitive to scattering, as occurs for red to near-infrared spectra. The probe is sensitive to both absorption and scattering for shorter visible spectra (purple-orange). The non-contact probe held above the tissue delivers light to/from a spot on the tissue and fails to collect light that spreads laterally to escape outside the collection spot. Such partial collection can distort the spectra.

Conclusions

Optical fiber spectroscopy using closely spaced fibers requires proper calibration. An analysis subroutine is provided for analysis of a two-fiber probe with the dimensions of a commercial probe (Ocean Insight), but the method can be applied to any probe design. A closely spaced fiber probe can document blood in the shorter visible wavelengths, but has difficulty detecting red and near-infra-red absorption. Hence detection of hydration is difficult. The strength of the closely spaced fiber probe is detecting scattering that depends on tissue structure at the micron to sub-micron scale.