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Kouri MA, Spyratou E, Karnachoriti M, Kalatzis D, Danias N, Arkadopoulos N, Seimenis I, Raptis YS, Kontos AG, Efstathopoulos EP. Raman Spectroscopy: A Personalized Decision-Making Tool on Clinicians' Hands for In Situ Cancer Diagnosis and Surgery Guidance. Cancers (Basel) 2022; 14:1144. [PMID: 35267451 PMCID: PMC8909093 DOI: 10.3390/cancers14051144] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/23/2022] Open
Abstract
Accurate in situ diagnosis and optimal surgical removal of a malignancy constitute key elements in reducing cancer-related morbidity and mortality. In surgical oncology, the accurate discrimination between healthy and cancerous tissues is critical for the postoperative care of the patient. Conventional imaging techniques have attempted to serve as adjuvant tools for in situ biopsy and surgery guidance. However, no single imaging modality has been proven sufficient in terms of specificity, sensitivity, multiplexing capacity, spatial and temporal resolution. Moreover, most techniques are unable to provide information regarding the molecular tissue composition. In this review, we highlight the potential of Raman spectroscopy as a spectroscopic technique with high detection sensitivity and spatial resolution for distinguishing healthy from malignant margins in microscopic scale and in real time. A Raman spectrum constitutes an intrinsic "molecular finger-print" of the tissue and any biochemical alteration related to inflammatory or cancerous tissue state is reflected on its Raman spectral fingerprint. Nowadays, advanced Raman systems coupled with modern instrumentation devices and machine learning methods are entering the clinical arena as adjunct tools towards personalized and optimized efficacy in surgical oncology.
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Affiliation(s)
- Maria Anthi Kouri
- Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (M.A.K.); (E.S.); (M.K.)
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
- Medical Physics Program, Department of Physics and Applied Physics, Kennedy College of Sciences, University of Massachusetts Lowell, 265 Riverside Street, Lowell, MA 01854, USA
| | - Ellas Spyratou
- Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (M.A.K.); (E.S.); (M.K.)
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Iroon Politechniou 9, 15780 Athens, Greece; (Y.S.R.); (A.G.K.)
| | - Maria Karnachoriti
- Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (M.A.K.); (E.S.); (M.K.)
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Iroon Politechniou 9, 15780 Athens, Greece; (Y.S.R.); (A.G.K.)
| | - Dimitris Kalatzis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Nikolaos Danias
- 4th Department of Surgery, School of Medicine, Attikon University Hospital, University of Athens, 1 Rimini Street, 12462 Athens, Greece; (N.D.); (N.A.)
| | - Nikolaos Arkadopoulos
- 4th Department of Surgery, School of Medicine, Attikon University Hospital, University of Athens, 1 Rimini Street, 12462 Athens, Greece; (N.D.); (N.A.)
| | - Ioannis Seimenis
- Medical School, National and Kapodistrian University of Athens, 75 Mikras Assias Street, 11527 Athens, Greece;
| | - Yannis S. Raptis
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Iroon Politechniou 9, 15780 Athens, Greece; (Y.S.R.); (A.G.K.)
| | - Athanassios G. Kontos
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Iroon Politechniou 9, 15780 Athens, Greece; (Y.S.R.); (A.G.K.)
| | - Efstathios P. Efstathopoulos
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
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Fraser-Miller SJ, Rooney JS, Lau M, Gordon KC, Schultz M. Can Coupling Multiple Complementary Methods Improve the Spectroscopic Based Diagnosis of Gastrointestinal Illnesses? A Proof of Principle Ex Vivo Study Using Celiac Disease as the Model Illness. Anal Chem 2021; 93:6363-6374. [PMID: 33844904 DOI: 10.1021/acs.analchem.0c04963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Spectroscopic methods are a promising approach for providing a point-of-care diagnostic method for gastrointestinal mucosa associated illnesses. Such a tool is desired to aid immediate decision making and to provide a faster pathway to appropriate treatment. In this pilot study, Raman, near-infrared, low frequency Raman, and autofluoresence spectroscopic methods were explored alone and in combination for the diagnosis of celiac disease. Duodenal biopsies (n = 72) from 24 participants were measured ex vivo using the full suite of studied spectroscopic methods. Exploratory principal component analysis (PCA) highlighted the origin of spectral differences between celiac and normal tissue with celiac biopsies tending to have higher protein relative to lipid signals and lower carotenoid spectral signals than the samples with normal histology. Classification of the samples based on the histology and overall diagnosis was carried out for all combinations of spectroscopic methods. Diagnosis based classification (majority rule of class per participant) yielded sensitivities of 0.31 to 0.77 for individual techniques, which was increased up to 0.85 when coupling multiple techniques together. Likewise, specificities of 0.50 to 0.67 were obtained for individual techniques, which was increased up to 0.78 when coupling multiple techniques together. It was noted that the use of antidepressants contributed to false positives, which is believed to be associated with increased serotonin levels observed in the gut mucosa in both celiac disease and the use of selective serotonin reuptake inhibitors (SSRIs); however, future work with greater numbers is required to confirm this observation. Inclusion of two additional spectroscopic methods could improve the accuracy of diagnosis (0.78) by 7% over Raman alone (0.73). This demonstrates the potential for further exploration and development of a multispectroscopic system for disease diagnosis.
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Affiliation(s)
- Sara J Fraser-Miller
- Dodd-Walls Centre for Photonic and Quantum Technologies, Department of Chemistry, University of Otago, Dunedin 9054, New Zealand
| | - Jeremy S Rooney
- Dodd-Walls Centre for Photonic and Quantum Technologies, Department of Chemistry, University of Otago, Dunedin 9054, New Zealand
| | - Michael Lau
- Southern Community Laboratories, Dunedin 9016, New Zealand
| | - Keith C Gordon
- Dodd-Walls Centre for Photonic and Quantum Technologies, Department of Chemistry, University of Otago, Dunedin 9054, New Zealand
| | - Michael Schultz
- Gastroenterology Research Unit, Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin 9054, New Zealand.,Mercy Hospital, Dunedin 9010, New Zealand.,Gastroenterology Department, Southern District Health Board, Dunedin 9016, New Zealand
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Heng HPS, Shu C, Zheng W, Lin K, Huang Z. Advances in real‐time fiber‐optic Raman spectroscopy for early cancer diagnosis: Pushing the frontier into clinical endoscopic applications. TRANSLATIONAL BIOPHOTONICS 2020. [DOI: 10.1002/tbio.202000018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Howard Peng Sin Heng
- Optical Bioimaging Laboratory, Department of Biomedical Engineering, Faculty of Engineering National University of Singapore Singapore Singapore
- NUS Graduate School for Integrative Sciences and Engineering National University of Singapore Singapore Singapore
| | - Chi Shu
- Optical Bioimaging Laboratory, Department of Biomedical Engineering, Faculty of Engineering National University of Singapore Singapore Singapore
| | - Wei Zheng
- Optical Bioimaging Laboratory, Department of Biomedical Engineering, Faculty of Engineering National University of Singapore Singapore Singapore
| | - Kan Lin
- Optical Bioimaging Laboratory, Department of Biomedical Engineering, Faculty of Engineering National University of Singapore Singapore Singapore
| | - Zhiwei Huang
- Optical Bioimaging Laboratory, Department of Biomedical Engineering, Faculty of Engineering National University of Singapore Singapore Singapore
- NUS Graduate School for Integrative Sciences and Engineering National University of Singapore Singapore Singapore
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Zheng Q, Kang W, Chen C, Shi X, Yang Y, Yu C. Diagnosis accuracy of Raman spectroscopy in colorectal cancer: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e16940. [PMID: 31441886 PMCID: PMC6716686 DOI: 10.1097/md.0000000000016940] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The clinical significance of Raman spectroscopy (RS) in colorectal cancer (CRC) patients still remains underestimated. We performed this meta-analysis to elucidate the diagnostic value in CRC patients. METHODS We systematically searched electronic databases for published articles. Fixed effect model and random effect model were used to calculate the pooled sensitivity, specificity, diagnostic accuracy, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and positive posttest probability (PPP) of CRC. Meta-regression and subgroup analysis were conducted to assess potential source of heterogeneity. We also used Egger linear regression tests to assess risk of publication bias. RESULTS Thirteen studies had been included (679 patients: 186 with premalignant lesions and 493 with malignant lesions). The pooled sensitivity, specificity, diagnostic accuracy, PLR, NLR, DOR and PPP for CRC screening using RS were 0.94 (0.92-0.96), 0.94 (0.88-0.97), 0.96 (0.94-0.98), 16.44 (7.80-34.63), 0.062 (0.043-0.090), 263.65 (99.03-701.96) and 86%, respectively. CONCLUSION RS is a potentially useful tool for future CRC screening. It also offers potentially early detection for CRC patients.
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Affiliation(s)
- Qiang Zheng
- Department of Gastrointestinal Surgery, Department of General Surgery, the First Affiliated Hospital of Anhui Medical University
| | - Weibiao Kang
- Department of Gastrointestinal Surgery, Department of General Surgery, the First Affiliated Hospital of Anhui Medical University
| | - Changyu Chen
- Department of General Surgery, First Affiliated Hospital of Anhui Traditional Medical University, Hefei, China
| | - Xinxin Shi
- Department of Gastrointestinal Surgery, Department of General Surgery, the First Affiliated Hospital of Anhui Medical University
| | - Yang Yang
- Department of Gastrointestinal Surgery, Department of General Surgery, the First Affiliated Hospital of Anhui Medical University
| | - Changjun Yu
- Department of Gastrointestinal Surgery, Department of General Surgery, the First Affiliated Hospital of Anhui Medical University
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Santos IP, Barroso EM, Bakker Schut TC, Caspers PJ, van Lanschot CGF, Choi DH, van der Kamp MF, Smits RWH, van Doorn R, Verdijk RM, Noordhoek Hegt V, von der Thüsen JH, van Deurzen CHM, Koppert LB, van Leenders GJLH, Ewing-Graham PC, van Doorn HC, Dirven CMF, Busstra MB, Hardillo J, Sewnaik A, Ten Hove I, Mast H, Monserez DA, Meeuwis C, Nijsten T, Wolvius EB, Baatenburg de Jong RJ, Puppels GJ, Koljenović S. Raman spectroscopy for cancer detection and cancer surgery guidance: translation to the clinics. Analyst 2018; 142:3025-3047. [PMID: 28726868 DOI: 10.1039/c7an00957g] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Oncological applications of Raman spectroscopy have been contemplated, pursued, and developed at academic level for at least 25 years. Published studies aim to detect pre-malignant lesions, detect cancer in less invasive stages, reduce the number of unnecessary biopsies and guide surgery towards the complete removal of the tumour with adequate tumour resection margins. This review summarizes actual clinical needs in oncology that can be addressed by spontaneous Raman spectroscopy and it provides an overview over the results that have been published between 2007 and 2017. An analysis is made of the current status of translation of these results into clinical practice. Despite many promising results, most of the applications addressed in scientific studies are still far from clinical adoption and commercialization. The main hurdles are identified, which need to be overcome to ensure that in the near future we will see the first Raman spectroscopy-based solutions being used in routine oncologic diagnostic and surgical procedures.
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Affiliation(s)
- Inês P Santos
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
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6
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Classification of Healthy and Cancer States of Colon Epithelial Tissues Using Opto-magnetic Imaging Spectroscopy. J Med Biol Eng 2018. [DOI: 10.1007/s40846-018-0414-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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7
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Cordero E, Latka I, Matthäus C, Schie I, Popp J. In-vivo Raman spectroscopy: from basics to applications. JOURNAL OF BIOMEDICAL OPTICS 2018; 23:1-23. [PMID: 29956506 DOI: 10.1117/1.jbo.23.7.071210] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 05/23/2018] [Indexed: 05/20/2023]
Abstract
For more than two decades, Raman spectroscopy has found widespread use in biological and medical applications. The instrumentation and the statistical evaluation procedures have matured, enabling the lengthy transition from ex-vivo demonstration to in-vivo examinations. This transition goes hand-in-hand with many technological developments and tightly bound requirements for a successful implementation in a clinical environment, which are often difficult to assess for novice scientists in the field. This review outlines the required instrumentation and instrumentation parameters, designs, and developments of fiber optic probes for the in-vivo applications in a clinical setting. It aims at providing an overview of contemporary technology and clinical trials and attempts to identify future developments necessary to bring the emerging technology to the clinical end users. A comprehensive overview of in-vivo applications of fiber optic Raman probes to characterize different tissue and disease types is also given.
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Affiliation(s)
- Eliana Cordero
- Leibniz-Institut für Photonische Technologien e.V., Germany
| | - Ines Latka
- Leibniz-Institut für Photonische Technologien e.V., Germany
| | - Christian Matthäus
- Leibniz-Institut für Photonische Technologien e.V., Germany
- Institut für Physikalische Chemie, Friedrich-Schiller-Univ. Jena, Germany
- Abbe Ctr. of Photonics, Germany
| | - Iwan Schie
- Leibniz-Institut für Photonische Technologien e.V., Germany
| | - Jürgen Popp
- Leibniz-Institut für Photonische Technologien e.V., Germany
- Institute für Physikalische Chemie, Friedrich-Schiller-Univ. Jena, Germany
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8
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Upchurch E, Griffiths S, Lloyd GR, Isabelle M, Kendall C, Barr H. Developments in optical imaging for gastrointestinal surgery. Future Oncol 2017; 13:2363-2382. [PMID: 29121775 DOI: 10.2217/fon-2017-0181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
To improve outcomes for patients with cancer, in terms of both survival and a reduction in the morbidity and mortality that results from surgical resection and treatment, there are two main areas that require improvement. Accurate early diagnosis of the cancer, at a stage where curative and, ideally, minimally invasive treatment is achievable, is desired as well as identification of tumor margins, lymphatic and distant disease, enabling complete, but not unnecessarily extensive, resection. Optical imaging is making progress in achieving these aims. This review discusses the principles of optical imaging, focusing on fluorescence and spectroscopy, and the current research that is underway in GI tract carcinomas.
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Affiliation(s)
- Emma Upchurch
- Biophotonics Research Unit, Gloucestershire Royal Hospital, Great Western Road, Gloucester, UK, GL1 3NN.,Department of Upper GI Surgery, Gloucestershire Royal Hospital, Great Western Road, Gloucester, UK, GL1 3NN
| | - Shelly Griffiths
- Department of Upper GI Surgery, Gloucestershire Royal Hospital, Great Western Road, Gloucester, UK, GL1 3NN
| | - Gavin-Rhys Lloyd
- Biophotonics Research Unit, Gloucestershire Royal Hospital, Great Western Road, Gloucester, UK, GL1 3NN
| | - Martin Isabelle
- Renishaw plc, New Mills, Wotton-under-Edge, Gloucestershire, UK, GL12 8JR
| | - Catherine Kendall
- Biophotonics Research Unit, Gloucestershire Royal Hospital, Great Western Road, Gloucester, UK, GL1 3NN
| | - Hugh Barr
- Biophotonics Research Unit, Gloucestershire Royal Hospital, Great Western Road, Gloucester, UK, GL1 3NN.,Department of Upper GI Surgery, Gloucestershire Royal Hospital, Great Western Road, Gloucester, UK, GL1 3NN
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9
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Zhao J, Zeng H, Kalia S, Lui H. Using Raman Spectroscopy to Detect and Diagnose Skin Cancer In Vivo. Dermatol Clin 2017; 35:495-504. [PMID: 28886805 DOI: 10.1016/j.det.2017.06.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Raman spectroscopy provides a noninvasive bedside tool that captures unique optical signals via molecular vibrations in tissue samples. Raman theory was discovered at the beginning of the twentieth century, but it was not until the past few decades that it has been used to differentiate skin neoplasms. We provide a brief description of Raman spectroscopy for in vivo skin cancer diagnosis, including the physical principles underlying Raman spectroscopy, its advantages, typical spectra of skin pathologies, and its clinical application for aiding skin cancer diagnosis.
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Affiliation(s)
- Jianhua Zhao
- Photomedicine Institute, Department of Dermatology and Skin Science, Vancouver Coastal Health Research Institute, The University of British Columbia, 835 West 10th Avenue, Vancouver, British Columbia V5Z 4E8, Canada; Imaging Unit, Integrative Oncology Department, The BC Cancer Agency Research Center, 675 West 10th Avenue, Vancouver, British Columbia V5Z 1L3, Canada
| | - Haishan Zeng
- Photomedicine Institute, Department of Dermatology and Skin Science, Vancouver Coastal Health Research Institute, The University of British Columbia, 835 West 10th Avenue, Vancouver, British Columbia V5Z 4E8, Canada; Imaging Unit, Integrative Oncology Department, The BC Cancer Agency Research Center, 675 West 10th Avenue, Vancouver, British Columbia V5Z 1L3, Canada
| | - Sunil Kalia
- Photomedicine Institute, Department of Dermatology and Skin Science, Vancouver Coastal Health Research Institute, The University of British Columbia, 835 West 10th Avenue, Vancouver, British Columbia V5Z 4E8, Canada; Imaging Unit, Integrative Oncology Department, The BC Cancer Agency Research Center, 675 West 10th Avenue, Vancouver, British Columbia V5Z 1L3, Canada
| | - Harvey Lui
- Photomedicine Institute, Department of Dermatology and Skin Science, Vancouver Coastal Health Research Institute, The University of British Columbia, 835 West 10th Avenue, Vancouver, British Columbia V5Z 4E8, Canada; Imaging Unit, Integrative Oncology Department, The BC Cancer Agency Research Center, 675 West 10th Avenue, Vancouver, British Columbia V5Z 1L3, Canada.
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10
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Wan QS, Wang T, Zhang KH. Biomedical optical spectroscopy for the early diagnosis of gastrointestinal neoplasms. Tumour Biol 2017; 39:1010428317717984. [PMID: 28671054 DOI: 10.1177/1010428317717984] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Gastrointestinal cancer is a leading contributor to cancer-related morbidity and mortality worldwide. Early diagnosis currently plays a key role in the prognosis of patients with gastrointestinal cancer. Despite the advances in endoscopy over the last decades, missing lesions, undersampling and incorrect sampling in biopsies, as well as invasion still result in a poor diagnostic rate of early gastrointestinal cancers. Accordingly, there is a pressing need to develop non-invasive methods for the early detection of gastrointestinal cancers. Biomedical optical spectroscopy, including infrared spectroscopy, Raman spectroscopy, diffuse scattering spectroscopy and autofluorescence, is capable of providing structural and chemical information about biological specimens with the advantages of non-destruction, non-invasion and reagent-free and waste-free analysis and has thus been widely investigated for the diagnosis of oesophageal, gastric and colorectal cancers. This review will introduce the advances of biomedical optical spectroscopy techniques, highlight their applications for the early detection of gastrointestinal cancers and discuss their limitations.
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Affiliation(s)
- Qin-Si Wan
- Department of Gastroenterology, Jiangxi Institute of Gastroenterology & Hepatology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ting Wang
- Department of Gastroenterology, Jiangxi Institute of Gastroenterology & Hepatology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Kun-He Zhang
- Department of Gastroenterology, Jiangxi Institute of Gastroenterology & Hepatology, The First Affiliated Hospital of Nanchang University, Nanchang, China
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11
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Ding H, Dupont AW, Singhal S, Scott LD, Guha S, Younes M, Bi X. In vivo analysis of mucosal lipids reveals histological disease activity in ulcerative colitis using endoscope-coupled Raman spectroscopy. BIOMEDICAL OPTICS EXPRESS 2017; 8:3426-3439. [PMID: 28717578 PMCID: PMC5508839 DOI: 10.1364/boe.8.003426] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/05/2017] [Accepted: 06/07/2017] [Indexed: 05/05/2023]
Abstract
The goal of this study is to evaluate endoscopic Raman spectroscopy as a noninvasive technique to determine histological inflammatory status of colitis. Colon mucosal composition was investigated in vivo from patients with ulcerative colitis (UC) and from age- and body mass index (BMI) matched controls using endoscope-coupled Raman spectroscopy. The results were co-registered with histological assessment of inflammatory status at the same locations. Substantial decreases (50-60%) in the content of phosphotidylcholines (PCs) and total lipids were observed in inflamed colon tissue (histology grade 1, 2 and 3) compared to those from the quiescent (histology grade 0) and from the controls. No significant difference was observed in lipids or PC contents between control and grade 0, or among grades 1 - 3. The degree of lipid unsaturation increased in the inflamed tissue regardless of disease severity. The inflammation-associated alterations in lipids and PC are observed independent of BMI or the anatomical locations for data collection. Multivariate analysis using support vector machine (SVM) algorithm classified the spectra of the controls or the inactive colitis from those of inflamed tissue with a sensitivity of 83.5% and 97.1% respectively. Our results showed that mucosal lipid content is related to the microscopic disease activity, and thus could serve as a valuable spectral marker to differentiate active colitis from the quiescent.
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Affiliation(s)
- Hao Ding
- Center for Precision Biomedicine, Institute of Molecular Medicine, McGovern Medical School, the University of Texas Health Science Center at Houston, 1881 East Road, Houston, TX 77054, USA
| | - Andrew W. Dupont
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, McGovern Medical School, the University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, Texas 77030, USA
| | - Shashideep Singhal
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, McGovern Medical School, the University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, Texas 77030, USA
| | - Larry D. Scott
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, McGovern Medical School, the University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, Texas 77030, USA
| | - Sushovan Guha
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, McGovern Medical School, the University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, Texas 77030, USA
| | - Mamoun Younes
- Department of Pathology & Laboratory Medicine, McGovern Medical School, the University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, Texas 77030, USA
| | - Xiaohong Bi
- Center for Precision Biomedicine, Institute of Molecular Medicine, McGovern Medical School, the University of Texas Health Science Center at Houston, 1881 East Road, Houston, TX 77054, USA
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12
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Vogler N, Bocklitz T, Subhi Salah F, Schmidt C, Bräuer R, Cui T, Mireskandari M, Greten FR, Schmitt M, Stallmach A, Petersen I, Popp J. Systematic evaluation of the biological variance within the Raman based colorectal tissue diagnostics. JOURNAL OF BIOPHOTONICS 2016; 9:533-541. [PMID: 26687775 DOI: 10.1002/jbio.201500237] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 10/29/2015] [Accepted: 11/17/2015] [Indexed: 06/05/2023]
Abstract
Being among the most common cancers worldwide screening and early diagnosis of colorectal cancer is of high interest for the health system, the patients and for research. Raman microspectroscopy as a label-free, non-invasive and non-destructive technique is a promising tool for an early diagnosis. However, to ensure a reliable diagnosis specially designed statistical analysis workflows are required. Several statistical approaches have been introduced leading to varying results in the overall accuracy, sensitivity and specificity. In this study a systematic evaluation of different statistical analysis approaches has been performed using a colon cancer mouse model with genotypic identical individuals. Based on the inter-individual Raman spectral variances a measure for the biological variance can be estimated. By applying a leave-one-individual-out cross-validation a clinically relevant discrimination of healthy tissue versus adenoma and carcinoma with an accuracy of 95% is shown. Furthermore, the transfer of a model from tissue to biopsy specimen is demonstrated.
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Affiliation(s)
- Nadine Vogler
- Leibniz Institute of Photonic Technology, 07745, Jena, Germany
| | - Thomas Bocklitz
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller University Jena, 07743, Jena, Germany.
| | - Firas Subhi Salah
- Institute of Pathology, Jena University Hospital, 07743, Jena, Germany
- Iraqi Centre for Cancer and Medical Genetics Research, Al-Mustansiriya University, Baghdad, Iraq
| | - Carsten Schmidt
- Clinic for Internal Medicine IV, Jena University Hospital, 07747, Jena, Germany
| | - Rolf Bräuer
- Institute of Pathology, Jena University Hospital, 07743, Jena, Germany
| | - Tiantian Cui
- Institute of Pathology, Jena University Hospital, 07743, Jena, Germany
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | - Florian R Greten
- Institute for Tumor Biology and Experimental Therapy, Georg-Speyer-Haus, 60596, Frankfurt, Germany
| | - Michael Schmitt
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller University Jena, 07743, Jena, Germany
| | - Andreas Stallmach
- Clinic for Internal Medicine IV, Jena University Hospital, 07747, Jena, Germany
| | - Iver Petersen
- Institute of Pathology, Jena University Hospital, 07743, Jena, Germany
| | - Jürgen Popp
- Leibniz Institute of Photonic Technology, 07745, Jena, Germany
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller University Jena, 07743, Jena, Germany
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13
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Stevens O, Iping Petterson IE, Day JCC, Stone N. Developing fibre optic Raman probes for applications in clinical spectroscopy. Chem Soc Rev 2016; 45:1919-34. [PMID: 26956027 DOI: 10.1039/c5cs00850f] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Raman spectroscopy has been shown by various groups over the last two decades to have significant capability in discriminating disease states in bodily fluids, cells and tissues. Recent development in instrumentation, optics and manufacturing approaches has facilitated the design and demonstration of various novel in vivo probes, which have applicability for myriad of applications. This review focusses on key considerations and recommendations for application specific clinical Raman probe design and construction. Raman probes can be utilised as clinical tools able to provide rapid, non-invasive, real-time molecular analysis of disease specific changes in tissues. Clearly the target tissue location, the significance of spectral changes with disease and the possible access routes to the region of interest will vary for each clinical application considered. This review provides insight into design and construction considerations, including suitable probe designs and manufacturing materials compatible with Raman spectroscopy.
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Affiliation(s)
- Oliver Stevens
- Biomedical Physics, School of Physics and Astronomy, University of Exeter, Exeter, Devon EX4 4QL, UK.
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Wang W, Short M, Tai IT, Zeng H. Disposable sheath that facilitates endoscopic Raman spectroscopy. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:25001. [PMID: 26836206 DOI: 10.1117/1.jbo.21.2.025001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 12/22/2015] [Indexed: 06/05/2023]
Abstract
In vivo endoscopic Raman spectroscopy of human tissue using a fiber optic probe has been previously demonstrated. However, there remain several technical challenges, such as a robust control over the laser radiation dose and measurement repeatability during endoscopy. A decrease in the signal to noise was also observed due to aging of Raman probe after repeated cycles of harsh reprocessing procedures. To address these issues, we designed and tested a disposable, biocompatible, and sterile sheath for use with a fiber optic endoscopic Raman probe. The sheath effectively controls contamination of Raman probes between procedures, greatly reduces turnaround time, and slows down the aging of the Raman probes. A small optical window fitted at the sheath cap maintained the measurement distance between Raman probe end and tissue surface. To ensure that the sheath caused a minimal amount of fluorescence and Raman interference, the optical properties of materials for the sheath, optical window, and bonding agent were studied. The easy-to-use sheath can be manufactured at a moderate cost. The sheath strictly enforced a maximum permissible exposure standard of the tissue by the laser and reduced the spectral variability by 1.5 to 8.5 times within the spectral measurement range.
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Affiliation(s)
- Wenbo Wang
- BC Cancer Agency Research Centre, Imaging Unit-Integrative Oncology Department, 675 West 10th Avenue, Vancouver, British Columbia, V5Z 1L3, CanadabUniversity of British Columbia, Faculty of Applied Science, Department of Biomedical Engineering, KAIS 5500
| | - Michael Short
- BC Cancer Agency Research Centre, Imaging Unit-Integrative Oncology Department, 675 West 10th Avenue, Vancouver, British Columbia, V5Z 1L3, Canada
| | - Isabella T Tai
- BC Cancer Agency, Michael Smith Genome Sciences Centre, 675 West 10th Avenue, Vancouver, British Columbia, V5Z 1L3, CanadadUniversity of British Columbia, Faculty of Medicine, Division of Gastroenterology, 2775 Laurel Street, Vancouver, British Columbia
| | - Haishan Zeng
- BC Cancer Agency Research Centre, Imaging Unit-Integrative Oncology Department, 675 West 10th Avenue, Vancouver, British Columbia, V5Z 1L3, Canada
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Zhao J, Zeng H, Kalia S, Lui H. Wavenumber selection based analysis in Raman spectroscopy improves skin cancer diagnostic specificity. Analyst 2016; 141:1034-43. [PMID: 26767205 DOI: 10.1039/c5an02073e] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Real-time Raman spectroscopy can be used to assist in assessing skin lesions suspicious for cancer. Most of the diagnostic algorithms are based on full band of the Raman spectra, either in the fingerprint region or the high wavenumber region. In this paper we explored wavenumber selection based analysis in Raman spectroscopy for skin cancer diagnosis. Wavenumber selection was implemented using windows of wavenumber and leave-one-out cross-validated stepwise regression or least and shrinkage selection operator (LASSO). The diagnostic algorithms were then generated from the selected windows of wavenumber using multivariate statistical analyses, including principal component and general discriminate analysis (PC-GDA) and partial least squares (PLS). In total a combined cohort of 645 confirmed lesions from 573 patients encompassing skin cancers, precancers and benign skin lesions were included, which were divided into training cohort (n = 518) and testing cohort (n = 127) according to the measurement time. It was found that the area under the receiver operating characteristic curve (ROC) was improved from 0.861-0.891 to 0.891-0.911 and the diagnostic specificity for fixed sensitivity 0.99-0.90 was improved from 0.17-0.65 to 0.20-0.75 with wavenumber selection based analysis.
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Affiliation(s)
- Jianhua Zhao
- Photomedicine Institute, Department of Dermatology and Skin Science, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, Canada
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16
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Short MA, Wang W, Tai IT, Zeng H. Development and in vivo testing of a high frequency endoscopic Raman spectroscopy system for potential applications in the detection of early colonic neoplasia. JOURNAL OF BIOPHOTONICS 2016; 9:44-48. [PMID: 26587679 DOI: 10.1002/jbio.201500205] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 10/09/2015] [Accepted: 10/24/2015] [Indexed: 06/05/2023]
Abstract
The objective of this study was to build and test an adjunct system to a colonoscope for in vivo measurement of Raman spectra from colon tissue for potentially improving the detection of early cancers. The novelty of this system was that low cost fibre optic probes were used, without the addition of expensive optical filters. Good quality in vivo Raman spectra were successfully obtained with a 1 s integration time in the high frequency (HF) range from normal tissue and polyps of patients during a colonoscopy. The polyps were subsequently removed, and their pathology determined. The acquired in vivo Raman spectra showed clear changes between tissue with normal and tubular adenoma pathology. Further clinical study with this low cost HF Raman probe is warranted to fully test its clinical utility.
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Affiliation(s)
- Michael A Short
- Imaging Unit - Integrative Oncology Department, BC Cancer Agency Research Centre, 675 West 10th Avenue, Vancouver, B.C., Canada, V5Z 1L3
| | - Wenbo Wang
- Imaging Unit - Integrative Oncology Department, BC Cancer Agency Research Centre, 675 West 10th Avenue, Vancouver, B.C., Canada, V5Z 1L3
| | - Isabella T Tai
- Division of Gastroenterology, University of British Columbia and Genome Sciences Centre, BC Cancer Agency Research Centre, 675 West 10th Avenue, Vancouver, B.C., Canada, V5Z 1L3
| | - Haishan Zeng
- Imaging Unit - Integrative Oncology Department, BC Cancer Agency Research Centre, 675 West 10th Avenue, Vancouver, B.C., Canada, V5Z 1L3.
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17
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Raman spectroscopy for medical diagnostics--From in-vitro biofluid assays to in-vivo cancer detection. Adv Drug Deliv Rev 2015; 89:121-34. [PMID: 25809988 DOI: 10.1016/j.addr.2015.03.009] [Citation(s) in RCA: 340] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 02/24/2015] [Accepted: 03/14/2015] [Indexed: 12/20/2022]
Abstract
Raman spectroscopy is an optical technique based on inelastic scattering of light by vibrating molecules and can provide chemical fingerprints of cells, tissues or biofluids. The high chemical specificity, minimal or lack of sample preparation and the ability to use advanced optical technologies in the visible or near-infrared spectral range (lasers, microscopes, fibre-optics) have recently led to an increase in medical diagnostic applications of Raman spectroscopy. The key hypothesis underpinning this field is that molecular changes in cells, tissues or biofluids, that are either the cause or the effect of diseases, can be detected and quantified by Raman spectroscopy. Furthermore, multivariate calibration and classification models based on Raman spectra can be developed on large "training" datasets and used subsequently on samples from new patients to obtain quantitative and objective diagnosis. Historically, spontaneous Raman spectroscopy has been known as a low signal technique requiring relatively long acquisition times. Nevertheless, new strategies have been developed recently to overcome these issues: non-linear optical effects and metallic nanoparticles can be used to enhance the Raman signals, optimised fibre-optic Raman probes can be used for real-time in-vivo single-point measurements, while multimodal integration with other optical techniques can guide the Raman measurements to increase the acquisition speed and spatial accuracy of diagnosis. These recent efforts have advanced Raman spectroscopy to the point where the diagnostic accuracy and speed are compatible with clinical use. This paper reviews the main Raman spectroscopy techniques used in medical diagnostics and provides an overview of various applications.
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Wang W, Zhao J, Short M, Zeng H. Real-time in vivo cancer diagnosis using Raman spectroscopy. JOURNAL OF BIOPHOTONICS 2015; 8:527-45. [PMID: 25220508 DOI: 10.1002/jbio.201400026] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 07/25/2014] [Accepted: 08/12/2014] [Indexed: 05/02/2023]
Abstract
Raman spectroscopy has becoming a practical tool for rapid in vivo tissue diagnosis. This paper provides an overview on the latest development of real-time in vivo Raman systems for cancer detection. Instrumentation, data handling, as well as oncology applications of Raman techniques were covered. Optic fiber probes designs for Raman spectroscopy were discussed. Spectral data pre-processing, feature extraction, and classification between normal/benign and malignant tissues were surveyed. Applications of Raman techniques for clinical diagnosis for different types of cancers, including skin cancer, lung cancer, stomach cancer, oesophageal cancer, colorectal cancer, cervical cancer, and breast cancer, were summarized. Schematic of a real-time Raman spectrometer for skin cancer detection. Without correction, the image captured on CCD camera for a straight entrance slit has a curvature. By arranging the optic fiber array in reverse orientation, the curvature could be effectively corrected.
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Affiliation(s)
- Wenbo Wang
- Imaging Unit - Integrative Oncology Department, British Columbia Cancer Agency Research Centre, 675 West 10th Avenue, Vancouver, B.C., V5Z 1L3, Canada
- Photomedicine Institute, Department of Dermatology and Skin Science, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Jianhua Zhao
- Imaging Unit - Integrative Oncology Department, British Columbia Cancer Agency Research Centre, 675 West 10th Avenue, Vancouver, B.C., V5Z 1L3, Canada
- Photomedicine Institute, Department of Dermatology and Skin Science, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Michael Short
- Imaging Unit - Integrative Oncology Department, British Columbia Cancer Agency Research Centre, 675 West 10th Avenue, Vancouver, B.C., V5Z 1L3, Canada
| | - Haishan Zeng
- Imaging Unit - Integrative Oncology Department, British Columbia Cancer Agency Research Centre, 675 West 10th Avenue, Vancouver, B.C., V5Z 1L3, Canada
- Photomedicine Institute, Department of Dermatology and Skin Science, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
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Bergholt MS, Zheng W, Lin K, Wang J, Xu H, Ren JL, Ho KY, Teh M, Yeoh KG, Huang Z. Characterizing variability of in vivo Raman spectroscopic properties of different anatomical sites of normal colorectal tissue towards cancer diagnosis at colonoscopy. Anal Chem 2014; 87:960-6. [PMID: 25495077 DOI: 10.1021/ac503287u] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This study aims to characterize the in vivo Raman spectroscopic properties of normal colorectal tissues and to assess distinctive biomolecular variations of different anatomical locations in the colorectum for cancer diagnosis. We have developed a novel 785 nm excitation fiber-optic Raman endoscope that can simultaneously acquire in vivo fingerprint (FP) spectra (800-1800 cm(-1)) and high-wavenumber (HW) Raman spectra (2800-3600 cm(-1)) from the subsurface of colorectal tissue. We applied the FP/HW Raman endoscope for in vivo tissue Raman measurements of various normal colorectal anatomical locations (i.e., ascending colon (n = 182), transverse colon (n = 249), descending colon (n = 124), sigmoid (n = 212), and rectum (n = 362)) in 50 subjects. Partial least-squares (PLS)-discriminant analysis (DA) was employed to evaluate the interanatomical variability. The normal colorectal tissue showed a subtle interanatomical variability in molecular constituents (i.e., proteins, lipids, and water content) and could be divided into three major clusterings: (1) ascending colon and transverse colon, (2) descending colon, and (3) sigmoid and rectum. The PLS-DA multiclass algorithms were able to identify different tissue sites with varying sensitivities (SE) and specificities (SP) (ascending colon: SE: 1.10%, SP: 91.02; transverse colon: SE: 14.06%, SP: 78.78; descending colon: SE: 40.32%, SP: 81.99; sigmoid: SE: 19.34%, SP: 87.90; rectum: SE: 71.55%, SP: 77.84). The interanatomical molecular variability was orders of magnitude less than neoplastic tissue transformation. Further PLS-DA modeling on in vivo FP/HW tissue Raman spectra yielded a diagnostic accuracy of 88.8% (sensitivity: 93.9% (93/99); specificity 88.3% (997/1129) for colorectal cancer detection. This work discloses that interanatomical Raman spectral variability of normal colorectal tissue is subtle compared to cancer tissue, and the simultaneous FP/HW Raman endoscopic technique has promising potential for real-time, in vivo diagnosis of colorectal cancer at the molecular level.
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Affiliation(s)
- Mads Sylvest Bergholt
- Optical Bioimaging Laboratory, Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore , Singapore 117576
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Zhao J, Short M, Braun T, Lui H, McLean D, Zeng H. Clinical Raman measurements under special ambient lighting illumination. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:111609. [PMID: 24938406 DOI: 10.1117/1.jbo.19.11.111609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 05/22/2014] [Indexed: 06/03/2023]
Abstract
One challenge in facing the application of biomedical Raman spectroscopy is that the Raman signal is acquired in a dark operation room. It is inconvenient for both the operator and the patient because it is difficult for the operator to accurately and precisely locate the target in the dark environment, and the patient feels uncomfortable in such a setting. In this note, we propose a method to implement biomedical Raman measurement with an illumination source, by multiple filtering of the illumination and the collection optics. Experimental results are demonstrated on skin Raman measurement under 785-nm excitation.
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Affiliation(s)
- Jianhua Zhao
- British Columbia Cancer Research Center, Imaging Unit-Integrative Oncology Department, 675 West 10th Avenue, Vancouver, BC V5Z 1L3, CanadabUniversity of British Columbia and Vancouver Coastal Health Research Institute, Photomedicine Institute, Department
| | - Michael Short
- British Columbia Cancer Research Center, Imaging Unit-Integrative Oncology Department, 675 West 10th Avenue, Vancouver, BC V5Z 1L3, Canada
| | - Thomas Braun
- Verisante Technology Inc., Vancouver, BC V6M 2A3, Canada
| | - Harvey Lui
- University of British Columbia and Vancouver Coastal Health Research Institute, Photomedicine Institute, Department of Dermatology and Skin Science, Vancouver, BC V5Z 4E8, Canada
| | - David McLean
- University of British Columbia and Vancouver Coastal Health Research Institute, Photomedicine Institute, Department of Dermatology and Skin Science, Vancouver, BC V5Z 4E8, Canada
| | - Haishan Zeng
- British Columbia Cancer Research Center, Imaging Unit-Integrative Oncology Department, 675 West 10th Avenue, Vancouver, BC V5Z 1L3, CanadabUniversity of British Columbia and Vancouver Coastal Health Research Institute, Photomedicine Institute, Department
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