Different orders of scattering through time-resolved Mueller matrix imaging estimates of pre-malignancy in human cervical tissues

Optical imaging for early detection of cervical cancer: state of the art and perspectives

Significance

Cervical cancer is one of the major causes of death in females worldwide. HPV infection is the key cause of uncontrolled cell growth leading to cervical cancer. About 90% of cervical cancer is preventable because of the slow progression of the disease, giving a window of about 10 years for the precancerous lesion to be recognized and treated.

Aim

The present challenges for cervical cancer diagnosis are interobserver variation in clinicians' interpretation of visual inspection with acetic acid/visual inspection with Lugol's iodine, cost of cytology-based screening, and lack of skilled clinicians. The optical modalities can assist in qualitatively and quantitatively analyzing the tissue to differentiate between cancerous and surrounding normal tissues.

Approach

This work is on the recent advances in optical techniques for cervical cancer diagnosis, which promise to overcome the above-listed challenges faced by present screening techniques.

Results

The optical modalities provide substantial measurable information in addition to the conventional colposcopy and Pap smear test to clinically aid the diagnosis.

Conclusions

Recent optical modalities on fluorescence, multispectral imaging, polarization-sensitive imaging, microendoscopy, Raman spectroscopy, especially with the portable design and assisted by artificial intelligence, have a significant scope in the diagnosis of premalignant cervical cancer in future.

Characterization of cervical tissue using Mueller matrix polarimetry

The cervix is composed of layers of squamous epithelium and connective tissue. The main component of the cervical connective tissue is collagen, which has specific orientations in different parts of the cervix and provides mechanical strength. Cervical pathologies such as cervical intraepithelial neoplasia (CIN), cancer, pregnancy, and spontaneous preterm birth (sPTB) allow for structural remodeling of both squamous epithelium and connective tissue. Mueller matrix (MM) polarimetry is an optical imaging technique that uses polarized light to characterize the morphologic changes in pathological cervix. In this study, advances in MM polarimetry in characterizing cervical tissue and associated pathologies were reviewed. In particular, the basic structure of the MM polarimeter is described. The interaction of polarized light with cervical tissue in terms of polarimetric parameters such as depolarization and birefringence is discussed. The assessment of cervical pathologies including CIN, cancer, pregnancy, and sPTB with MM polarimetry and the underlying reasons that produce the contrast in optical imaging are outlined. The clinical implementation of MM polarimetry, especially the Müller polarimetry colposcope, is also discussed. Finally, the challenges for MM polarimetry in cervical clinics are also speculated.

Holistic and efficient calibration method for Mueller matrix imaging polarimeter with a high numerical aperture

High-numerical aperture (N A>0.6) Mueller matrix imaging polarimeter (MMIP) (high-NA MMIP) is urgently needed for higher resolution. Usually, the working distance of high-NA MMIP is too short to perform in situ calibration by a usual reference sample, such as polarizer and retarder plates. The polarization effects of the substrate that attach the sample are never calibrated. So, the resolution and accuracy of the MMIP is hard to further promote. In this paper, a holistic and efficient calibration method is innovated for high-NA MMIP. Two film polarizers and a film retarder as well as a blank substrate are first adopted as the reference samples in calibration. Different from the conventional eigenvalue calibration method (ECM), the holistic calibration theory and process are established. All polarimetric errors arising from the devices, subsystems, and the substrate can be calibrated in one process. The normalized measurement error is less than 0.0024 for NA 0.95 MMIP, which is an order of magnitude lower than those of NA 0.1 and 0.2 MMIPs in publications. The excellent performance of calibrated high-NA MMIP is demonstrated by tissue polarimetry with higher resolution, accuracy, and more appropriate dynamic range.

Fluorescence scattering in between excitation and emission as a depolarizing process: a Mueller matrix viewpoint

A rigorous model has been proposed to qualify fluorescence scattering through the Mueller matrix viewpoint in terms of absorption/excitation, emission, and the process in between them. The process in between the excitation and emission processes of fluorescence, irrespective of the scattering directions, has been modeled as a depolarization process. The absorption/excitation of the fluorophore molecules gets revealed through the first-row elements while the emission of fluorescence has been observed through the first column elements of the fluorescence Mueller matrix. Information of the transitions between the molecular ground and excited states gets encoded into the diagonal elements following the photon selection rule. The other off-diagonal elements of the fluorescence Mueller matrix also exhibit very small nonzero values due to the anisotropic absorption and phase changes that the ground state of the fluorophore molecules imposes on the incident polarized beam while parallelly governing the emitted beam. The comparison of the current model with the earlier model has been discussed in a detailed way. The modeling of the in-between process as the depolarizing one enables us to qualify the fluorescence detected linear and circular dichroism and luminescence and very effectively overcomes the shortcomings in the earlier model.

Toward the development of portable light emitting diode-based polarization spectroscopy tools for breast cancer diagnosis

A robust, affordable and portable light emitting diode-based diagnostic tools (POLS-NIRDx) using a polarization-sensitive (linear as well as circular polarization) technique were designed and developed to quantify the degree of linear polarization (DOLP), degree of circular polarization (DOCP). The study was performed on malignant (invasive ductal carcinoma) and adjacent normal ex-vivo biopsy tissues excised from N = 10 patients at the operating wavelengths of 850 and 940 nm. The average DOLP and DOCP values were lower for malignant than adjacent normal while operating at 850 and 940 nm. The highest accuracy was observed for DOLP (100%) and DOCP (80%) while operating at 850 nm, which reduced (80% for DOLP and 65% for DOCP) at 940 nm. This pilot study can be utilized as a differentiating factor to delineate malignant tissues from adjacent normal tissues.