In vivo fluorescence spectroscopy and imaging of human skin tumours

Optical Based Methods for Water Monitoring in Biological Tissue

Skin homeostasis is strongly dependent on its hydration levels, making skin water content measurement vital across various fields, including medicine, cosmetology, and sports science. Noninvasive diagnostic techniques are particularly relevant for clinical applications due to their minimal risk of side effects. A range of optical methods have been developed for this purpose, each with unique physical principles, advantages, and limitations. This review provides an in-depth examination of optical techniques such as diffuse reflectance spectroscopy, optoacoustic spectroscopy, optoacoustic tomography, hyperspectral imaging, and Raman spectroscopy. We explore their efficacy in noninvasive monitoring of skin hydration and edema, which is characterized by an increase in interstitial fluid. By comparing the parameters, sensitivity, and clinical applications of these techniques, this review offers a comprehensive understanding of their potential to enhance diagnostic precision and improve patient care.

State-of-the-Art in Skin Fluorescent Photography for Cosmetic and Skincare Research: From Molecular Spectra to AI Image Analysis

Autofluorescence is a remarkable property of human skin. It can be excited by UV and observed in the dark using special detection systems. The method of fluorescence photography (FP) is an effective non-invasive tool for skin assessment. It involves image capturing by a camera the emission of light quanta from fluorophore molecules in the skin. It serves as a useful tool for cosmetic and skincare research, especially for the detection of pathological skin states, like acne, psoriasis, etc. To the best of our knowledge, there is currently no comprehensive review that fully describes the application and physical principles of FP over the past five years. The current review covers various aspects of the skin FP method from its biophysical basis and the main fluorescent molecules of the skin to its potential applications and the principles of FP recording and analysis. We pay particular attention to recently reported works on the automatic analysis of FP based on artificial intelligence (AI). Thus, we argue that FP is a rapidly evolving technology with a wide range of potential applications. We propose potential directions of the development of this method, including new AI algorithms for the analysis and expanding the range of applications.

[Non-invasive automated methods for the diagnosis of periorbital skin tumors]

Malignant skin tumors are the most common type of cancer in both Russia and globally. Malignant skin tumors located in the periorbital region, particularly basal cell carcinoma, pose a significant threat to the visual organ due to the high risk of local invasion, highlighting the need for early diagnosis and timely treatment. This review discusses the main methods of non-invasive instrumental diagnosis of skin tumors in the periorbital region. Key stages in the development of these methods are briefly outlined, and their most significant advantages and disadvantages are noted. The article also considers the automation of diagnostic studies, and potential challenges with its practical implementation.

Comparative study of in-vitro autofluorescence of normal versus non-melanoma-skin-cancer cells at different excitation wavelengths

In this experimental study the autofluorescence of squamous carcinoma cells, stimulated by 6 different excitation wavelengths in the range 280-533 nm, has been compared with the autofluorescence of normal control keratinocytes. Skin cells were cultivated in vitro, to isolate their characteristic autofluorescence form the more complex one that would be originated by the complete skin tissue. Autofluorescence spectra in the visible range were complemented by absorption measurements. It was observed that the control cells showed characteristic emission (and absorption) structures due to typical endogenous chromophores [FAD and NAD(P)H, lipo-pigments, porphyrins], that were severely dumped in pathological cells. The autofluorescence spectra were then elaborated by multivariate analysis: after a first exploratory data analysis by means of Principal Component Analysis, the whole dataset was used to develop classification models using partial least squares-discriminant analysis, to differentiate between normal and pathological cells. This permitted us to identify the most suitable fluorescence spectral interval, in the 550-670 nm range, to discriminate between normal and pathological behavior, independently on the excitation wavelength.

Impact of optical clearing on ex vivo human skin optical properties characterized by spatially resolved multimodal spectroscopy

A spatially resolved multimodal spectroscopic device was used on a two-layered "hybrid" model made of ex vivo skin and fluorescent gel to investigate the effect of skin optical clearing on the depth sensitivity of optical spectroscopy. Time kinetics of fluorescence and diffuse reflectance spectra were acquired in four experimental conditions: with optical clearing agent (OCA) 1 made of polyethylene glycol 400 (PEG-400), propylene glycol and sucrose; with OCA 2 made of PEG-400 and dimethyl sulfoxide (DMSO); with saline solution as control and a "dry" condition. An increase in the gel fluorescence back reflected intensity was measured after optical clearing. Effect of OCA 2 turned out to be stronger than that of OCA 1, possibly due to DMSO impact on the stratum corneum keratin conformation. Complementary experimental results showed increased light transmittance through the skin and confirmed that the improvement in the depth sensitivity of the multimodal spectroscopic approach is related not only to the dehydration and refractive indices matching due to optical clearing, but also to the mechanical compression of tissues caused by the application of the spectroscopic probe.

Noninvasive, visual examination for the presence of gunshot residue on human skin

When a firearm is discharged, the highest concentration of gunshot residue (GSR) is located on a shooter's hands, forearms, and clothing. Currently, collecting GSR from an individual's hands is accomplished with a carbon disk that is submitted for confirmatory analysis in a forensic laboratory. Presumptive chemical tests can be performed in the field, but these tests consume a portion of the GSR particles leaving a reduced amount of evidence available to be collected and sent to a forensic laboratory. An abundance of research exists for detecting GSR particles instantly on different fabrics using an alternate light source (ALS). This study expanded on that research and developed a noninvasive, visual examination to detect GSR on a suspected shooter's hands without destroying or removing any particles prior to collection. The hands of individuals who recently discharged a firearm were examined under a light source between 475 and 530 nm and an infrared (IR) camera. The fluorescent particles observed on a shooter's hands under 520 nm were similar in size and appearance to GSR particles observed on fabrics under an ALS. The fluorescent particles were collected and analyzed for GSR, and the results indicated that GSR particles were present. More testing needs to be conducted to determine if the fluorescent particles observed are inorganic or organic GSR particles. There is also potential to detect GSR under IR light; however, more research needs to be conducted to determine the composition of the particles observed after image enhancement.

Probabilistic latent semantic analysis of composite excitation-emission matrix fluorescence spectra of multicomponent system

In the present work, a simple and fast analytical procedure involving minimum user intervention was developed by combining the excitation-emission matrix fluorescence (EEMF) spectroscopy with Probabilistic latent semantic analysis (pLSA) technique. Akaike Information Criterion (AIC) was used to enable the user to automatically select the optimum model for analysing the mixtures of fluorescent components. The utility of the present work was successfully evaluated by analysing the dilute aqueous mixtures of certain fluorescent molecule such as Catechol, Hydroquinone, Indole, Tryptophan and Tyrosine of biological relevance. The developed AIC assisted pLSA model of five components explained >90% variance of spectral data sets. The identity between the pLSA retrieved spectral profiles was established using similarity index (SI) parameter in automatic manner. The SI values were found to be close to unit values for each of the five analyzed molecules. The regression parameter between the actual and pLSA predicted concentrations were found to be well within acceptable limits. Both root mean square of calibration and predictions for each of the five fluorescent molecules were found to be <1%, whereas, the square of the correlation coefficient (R²) value was found to be >0.98 suggesting the developed pLSA model was quite precise in analysing both calibration and validation set samples. The uniqueness of the developed pLSA model for EEMF spectroscopic data was successfully tested using the sequential quadratic programming (SQP) algorithm. The differences between the upper and lower bands in SQP were found to be ≤0.005. In summary, the proposed approach serve as swift and simple analytical tool for the analysis of fluorescent mixtures without involving pre-separation step.

Analysis of Tryptophan and Tyrosine in the Presence of Other Bioactive Molecules Using Generalized Rank Annihilation Method on Excitation-emission Fluorescence Spectroscopic Data Sets

Excitation-emission matrix fluorescence (EEMF) spectroscopy can describe the fluorescence activity of a molecular mixture in a single three dimensional plot describing the variation of excitation and emission spectra as function of increasing emission and excitation wavelength, respectively. Generalized rank annihilation method (GRAM) is a chemometric technique that is known to have second order advantage i.e.. it can be easily used to analyze the analyte of interest even in the presence of the unknown interferences. The present work proposes a simple and sensitive analytical procedure by exploring the advantages associated with EEMF and GRAM technique to analyze the two amino acids, tyrosine and tryptophan, in the presence of complex fluorescence background originating from other bioactive molecules. The obtained results of GRAM analysis on EEMF was found to make precise quantification of tryptophan and tyrosine in different unknown samples.

Non-negative Factor (NNF) Assisted Partial Least Square (PLS) Analysis of Excitation-Emission Matrix Fluorescence Spectroscopic Data Sets: Automating the Identification and Quantification of Multifluorophoric Mixtures

Excitation-emission matrix fluorescence spectroscopy is simple and sensitive techniques that generate the composite fluorescence fingerprints. EEMF can be used for the identification and quantification of the fluorophores without involving any pre-separation step provided a suitable data analysis approach is applied. In the present work, non-negative factor (NNF) assisted partial least square (PLS) analysis is used for the analysis of EEMF data sets acquired for the dilute aqueous mixtures of fluorophores. The proposed approach allows automatic selection of the optimum number of factors for NNF analysis by incorporating the Akaike information criterion. The proposed approach also incorporates the spectral correlation analysis for the automatic identification of the NNF retrieved EEMF spectral profiles. The NNF retrieved contribution values along with their real concentration values are subjected to PLS analysis to develop a calibration model. The proposed approach was successfully tested using EEMF data acquired for the dilute aqueous mixtures of Catechol, Hydroquinone, Indole, Tryptophan and Tyrosine. The results were evaluated using the various statistical parameters and each of them found to well within the expected limits. In summary, NNF assisted PLS analysis of EEMF technique allows automatized analysis of the multifluorophoric mixtures with minimum user inputs.

Optimizing Parallel Factor (PARAFAC) Assisted Excitation-Emission Matrix Fluorescence (EEMF) Spectroscopic Analysis of Multifluorophoric Mixtures

Parallel factor (PARAFAC) analysis is the most commonly used mathematical technique to analyse the excitation-emission matrix fluorescence (EEMF) data sets of mutifluorophoric mixtures. PARAFAC essentially performs the mathematical chromatography on the EEMF data sets and helps in extracting pure excitation, pure emission and contribution profiles of each of the fluorophores without requiring any pre-separation step. The application of PARAFAC requires the initialisation of the spectral variables that is usually achieved by performing the singular value decomposition (SVD) analysis on EEMF data sets. One of the problem with SVD based initialisation is that it orthogonalises the data sets and makes the PARAFAC modelling of the EEMF data sets computationally challenging task that needs to be taken care. To address this issue, the present introduces an alternate approach for initialising the spectral variables for performing the PARAFAC analysis. The proposed approach essentially involve initialisation of the spectral variables with random numbers in a constraint manner. The proposed approach is found to provide the desired computational economy, robustness and analytical effectiveness to the PARAFAC analysis of EEMF data sets.

Site-specific variations in cutaneous autofluorescence revealed by excitation-emission matrix spectroscopy

BACKGROUND AND PURPOSE

Although cutaneous autofluorescence has been utilized for evaluation of skin conditions, there is a paucity of data on normal human skin autofluorescence and its dependence on anatomical site. The objective of this study is to use excitation-emission matrix spectroscopy to quantify and characterize skin autofluorescence at different body sites.

METHODS

Ten anatomical sites from 30 healthy volunteers were measured with a double-grating excitation-emission matrix spectrofluorometer.

RESULTS

For the 10 body sites evaluated, there were four overall patterns of autofluorescence: skin from the head and neck exhibits high superficial and low bilayer fluorescence; the dorsal forearm and dorsal hand have both low superficial and bilayer fluorescence; the upper inner arm and back have high superficial and intermediate bilayer fluorescence; while the palm and thumbnail have both high superficial and bilayer fluorescence. The corresponding fluorescence excitation-emission peaks for these patterns were as follows: head and neck, 3 peaks at 290-300/330-350, 360-380/460-485, and 380-420/610-630 nm; dorsal forearm and dorsal hand, 2 peaks around 295-300/345-360 and 385-395/460-485 nm; upper inner arm and back, 3 peaks around 295-300/335-355, 335-340/390-410, and 375-390/455-480 nm; palm and thumbnail, 3 peaks around 285-300/345-355, 335-345/390-410, and 365-390/450-480 nm.

CONCLUSION

Cutaneous fluorescence varies in distinct patterns according to anatomical site, due to the component fluorophores present, skin thickness, and the degree of melanization and long term sun exposure. These EEM patterns for normal skin should be accounted for when interpreting fluorescence signals from disease states and can also be used to guide the selection of optimal wavebands when applying this optical modality.

Visualize the quality of frozen fish using fluorescence imaging aided with excitation-emission matrix

The quality monitoring of frozen marine products has become essential in the fishery industry, where efficient and effective quality assurance is becoming increasingly important. In this study, we proposed a novel method of evaluating fish quality by combining the fluorescence excitation-emission matrix (EEM) with imaging techniques to visualize the spatial-temporal changes of freshness indices such as K-value and taste component IMP content. The result showed that the distribution of K-value and IMP content could be visualized with accuracy of R² = 0.78 and R² = 0.83, respectively. Furthermore, this innovative approach was applied to differentiate burnt meat, which is a type of abnormal meat found in many types of fish, and it was found that burnt meat could be detected even when in a frozen condition.

Skin cancer detection using non-invasive techniques

Skin cancer is the most common form of cancer and is globally rising. Historically, the diagnosis of skin cancers has depended on various conventional techniques which are of an invasive manner. A variety of commercial diagnostic tools and auxiliary techniques are available to detect skin cancer. This article explains in detail the principles and approaches involved for non-invasive skin cancer diagnostic methods such as photography, dermoscopy, sonography, confocal microscopy, Raman spectroscopy, fluorescence spectroscopy, terahertz spectroscopy, optical coherence tomography, the multispectral imaging technique, thermography, electrical bio-impedance, tape stripping and computer-aided analysis. The characteristics of an ideal screening test are outlined, and the authors pose several points for clinicians and scientists to consider in the evaluation of current and future studies of skin cancer detection and diagnosis. This comprehensive review critically analyses the literature associated with the field and summarises the recent updates along with their merits and demerits.

Gender differences in the fluorescence of human skin in young healthy adults

BACKGROUND

Human skin naturally contains many endogenous fluorophores; therefore, fluorescence techniques can be used for monitoring of the human skin even in in vivo mode. The aim of this work was to study skin autofluorescence in vivo regarding the possible effect of gender.

MATERIALS AND METHODS

Fluorescence emission spectra of young healthy Caucasian adults in 3 anatomical regions (forehead, hand, and inner upper arm) were taken with excitation at 280, 325, or 400 nm.

RESULTS

Three emission bands were found in the spectra for both men and women: (1) an intensive band peaked at 340/280 nm (peak emission/excitation wavelength), corresponding to aromatic amino acids of proteins in epidermis; (2) a broad band with emission between 360 nm and 480 nm (excitation 325 nm) with a base peak around 390 nm and 2 side peaks at 420 and 450 nm, mainly due to collagen cross-links in dermis with a possible weak contribution of elastin and mitochondrial NADPH; (3) a weak but distinct peak at 600/400 nm corresponding presumably to skin unmetalled porphyrins.

CONCLUSION

The intensity of skin autofluorescence showed differences between genders and among anatomical regions. The 340 nm intensity was 1.4 times higher in the male group in all 3 anatomical regions studied. The highest intensity of skin autofluorescence for the peaks at 340/280 nm and 600/400 nm was found on the forehead, whereas the 390/325 nm band was most intensive on the inner upper arm in both genders.

Fluorescence detection of protein content in house dust: the possible role of keratin

We propose a fluorescence method for protein content assessment in fine house dust, which can be used as an indicator of the hygienic state of occupied rooms. The results of the measurements performed with 30 house dust samples, including ultrafiltration experiments, strongly suggest that the fluorescence emission of house dust extracts excited at 350 nm is mainly due to protein fragments, which are presumably keratin hydrolysates. This suggestion is supported by several facts: (i) Spectral band shapes for all the samples under investigation are close and correspond to that of keratin; (ii) fluorescence intensity correlates with the total protein content as provided by Lowry assay; (iii) treatment of the samples with proteinase K, which induces keratin hydrolysis, results in fluorescence enhancement without changing fluorescence band shape; and (iv) Raman spectra of keratin and fine house dust samples exhibit a very similar structure. Based on the obtained results and literature data, we propose a hypothesis that keratin is a major substrate for fluorescence species in fine house dust, which are responsible for emission at 350-nm excitation.

Autofluorescence imaging in recurrent oral squamous cell carcinoma

The survival of patients with oral cancer is decreased by locoregional recurrence after an initial multimodal treatment. In order to identify lesions in the oral cavity for a possible recurrence, clinical evaluation as well as MRI or CT scanning is advised. The evaluation of mucosa lesions is hampered by changes related to radio- and chemotherapy as well as reconstruction with tissue flaps. Several techniques for easier identification of tissue abnormalities in the oral cavity have been advocated as adjuncts in order to facilitate identification. Especially methods using altered tissue fluorescence have gained much interest during the last decade. The aim of our prospective study was to evaluate fluorescence properties of undiagnosed mucosa lesions with the VELscope device in patients with multimodal treated oral cancer prior to histological confirmation. In total, 41 patients with a history of oral squamous cell carcinomas (OSCC) (19 females and 22 males) with undiagnosed mucosa lesions where included in the study. After clinical evaluation, examination and documentation using the VELscope® device were performed. Then, an incisional biopsy was performed. An autofluorescence loss indicating a malignant or dysplastic mucosa condition could be detected in six patients (14.6 %); however, only one OSCC and one SIN revealed a complete autofluorescence loss. In four patients, OSCC was present in lesions with retained autofluorescence. Sensitivity and specificity for the VELscope® examination to identify malignant oral lesions by autofluorescence were 33.3 and 88.6 %, respectively. The positive and negative predictive values were 33.3 and 88.6 %, respectively. No statistical correlation between gender and lesion appearance versus autofluorescence loss could be detected. In contrast to mucosa lesions in patients with no prior treatment, the autofluorescence evaluation with the VELscope reveals no additional information in our analysis. Accordingly, invasive biopsies as gold standard are still needed to get sufficient evidence regarding potential malignancy in patients after multimodal treatment for oral cancer.

Discrimination among melanoma, nevi, and normal skin by using synchronous luminescence spectroscopy

Novel optical spectroscopy and imaging methods may be valuable in the early detection of cancer. This paper reports differences in the luminescence responses of pigmented skin lesions (melanomas and nevi) and apparently normal non-pigmented human skin, based on analyses of synchronous luminescence spectroscopy measurements. Measurements were performed in the excitation range of 330-545 nm, with synchronous intervals varying from 30-120 nm. Normal skin, nevi, and melanomas differ in the way they fluoresce, and these differences are more distinct in the synchronous fluorescence spectra than in the conventional emission and excitation spectra. The differences in the fluorescence characteristics of pigmented and normal skin samples were ascribed to differences in concentrations of endogenous fluorophores and chromophores. Principal component and linear discriminant analysis of the synchronous spectra measured at different synchronous intervals showed that the greatest variance among the sample groups was at the 70 nm interval spectra. These spectra were then used to create partial least squares discriminant analysis-based classification models. Evaluation of the quality of these models from the receiver operating characteristic curves showed they performed well, with a maximum value of 1 for the area under the curve for melanoma detection. Hence, synchronous luminescence spectroscopy coupled with statistical methods may be advantageous in the early detection of skin cancer.

Optimization of excitation-emission band-pass filter for visualization of viable bacteria distribution on the surface of pork meat

A novel method of optically reducing the dimensionality of an excitation-emission matrix (EEM) by optimizing the excitation and emission band-pass filters was proposed and applied to the visualization of viable bacteria on pork. Filters were designed theoretically using an EEM data set for evaluating colony-forming units on pork samples assuming signal-to-noise ratios of 100, 316, or 1000. These filters were evaluated using newly measured EEM images. The filters designed for S/N = 100 performed the best and allowed the visualization of viable bacteria distributions. The proposed method is expected to be a breakthrough in the application of EEM imaging.

Experimental validation of an inverse fluorescence Monte Carlo model to extract concentrations of metabolically relevant fluorophores from turbid phantoms and a murine tumor model

An inverse Monte Carlo based model has been developed to extract intrinsic fluorescence from turbid media. The goal of this work was to experimentally validate the model to extract intrinsic fluorescence of three biologically meaningful fluorophores related to metabolism from turbid media containing absorbers and scatterers. Experimental studies were first carried out on tissue-mimicking phantoms that contained individual fluorophores and their combinations, across multiple absorption, scattering, and fluorophore concentrations. The model was then tested in a murine tumor model to determine both the kinetics of fluorophore uptake as well as overall tissue fluorophore concentration through extraction of the intrinsic fluorescence of an exogenous contrast agent that reports on glucose uptake. Results show the model can be used to recover the true intrinsic fluorescence spectrum with high accuracy (R(2)=0.988) as well as accurately compute fluorophore concentration in both single and multiple fluorophores phantoms when appropriate calibration standards are available. In the murine tumor, the model-corrected intrinsic fluorescence could be used to differentiate drug dose injections between different groups. A strong linear correlation was observed between the extracted intrinsic fluorescence intensity and injected drug dose, compared with the distorted turbid tissue fluorescence.

Support Vector Machine on fluorescence landscapes for breast cancer diagnostics

Excitation-emission matrices (EEM) and total synchronous fluorescence spectra (SFS) of normal and malignant breast tissue specimens are measured in UV-VIS spectral region to serve as data inputs in development of Support Vector Machine (SVM) based breast cancer diagnostics tool. Various input data combinations are tested for classification accuracy using SVM prediction against histopathology findings to discover the best combination regarding diagnostics sensitivity and specificity. It is shown that with EEM data SVM provided 67% sensitivity and 62% specificity diagnostics. With SFS data SVM provided 100% sensitivity and specificity for a several input data combinations. Among these combinations those that require minimal data inputs are identified.

In vivo measurements of diffuse reflectance and time-resolved autofluorescence emission spectra of basal cell carcinomas

We present a clinical investigation of diffuse reflectance and time-resolved autofluorescence spectra of skin cancer with an emphasis on basal cell carcinoma. A total of 25 patients were measured using a compact steady-state diffuse reflectance/fluorescence spectrometer and a fibre-optic-coupled multispectral time-resolved spectrofluorometer. Measurements were performed in vivo prior to surgical excision of the investigated region. Singular value decomposition was used to reduce the dimensionality of steady state diffuse reflectance and fluorescence spectra. Linear discriminant analysis was then applied to the measurements of basal cell carcinomas (BCCs) and used to predict the tissue disease state with a leave-one-out methodology. This approach was able to correctly diagnose 87% of the BCCs. With 445 nm excitation a decrease in the spectrally averaged fluorescence lifetime was observed between normal tissue and BCC lesions with a mean value of 886 ps. Furthermore, the fluorescence lifetime for BCCs was lower than that of the surrounding healthy tissue in all cases and statistical analysis of the data revealed that this decrease was significant (p = 0.002).

New developments in fluorescence diagnostics

In the last decade, significant advances have been achieved in the direct viewing of the skin. Non-invasive analysis of various skin diseases in vivo has become possible by special skin display devices, allowing the physician to view the structure and properties of the skin in greater detail than can be achieved by simple visual examination. We review the last 100 years of fluorescence imaging development from clinical observation to advanced spectral imaging, addressing the role of fluorescence diagnostics (FD) in modern dermatology as well as the detection of autofluorescence.

Design and validation of a clinical instrument for spectral diagnosis of cutaneous malignancy

We report a probe-based portable and clinically compatible instrument for the spectral diagnosis of melanoma and nonmelanoma skin cancers. The instrument combines two modalities--diffuse reflectance and intrinsic fluorescence spectroscopy--to provide complementary information regarding tissue morphology, function, and biochemical composition. The instrument provides a good signal-to-noise ratio for the collected reflectance and laser-induced fluorescence spectra. Validation experiments on tissue phantoms over a physiologically relevant range of albedos (0.35-0.99) demonstrate an accuracy of close to 10% in determining scattering, absorption and fluorescence characteristics. We also demonstrate the ability of our instrument to collect in vivo diffuse reflectance and fluorescence measurements from clinically normal skin, dysplastic nevus, and malignant nonmelanoma skin cancer.

Synchronous fluorescence spectroscopy for the detection and characterization of cervical cancers in vitro

The objective of this study was to assess the diagnostic potential of synchronous fluorescence (SF) spectroscopy (SFS) technique for the detection and characterization of normal and different malignancy stages of moderately differentiated squamous cell carcinoma (MDSCC), poorly differentiated squamous cell carcinoma (PDSCC) cervical tissues. SF spectra were measured from 45 biopsies from 30 patients in vitro. Characteristic, highly resolved peaks and significant spectral differences between normal and MDSCC, PDSCC cervical tissues were obtained. Nine potential ratios were calculated and used as input variables for a discriminant analysis across different groups. The potentiality of the SFS technique was estimated by two discriminant analyses. Discriminant analysis I performed across normal and abnormal (including MDSCC and PDSCC) cervical tissues classified as 100% both original and the cross-validated grouped cases. In discriminant analysis II performed across the three groups, normal, MDSCC and PDSCC, 100% of both original and the cross-validated grouped cases were correctly classified. Using the SFS technique, one can obtain all the key biochemical markers such as tryptophan, collagen, hemoglobin, reduced form of nicotinamide adenine dinucleotide and flavin adenine dinucleotide in a single scan and hence they can be targeted as tumor markers in the detection of normal from abnormal cervical tissues.

Early diagnosis of melanotic melanoma based on laser-induced melanin fluorescence

Because of the increasing incidence of skin cancer, interest in using the autofluorescence of skin tissue as a noninvasive tool for early diagnosis is enforced. Focus is especially on malignant melanotic melanoma. On the basis of a newly developed method to selectively excite melanin fluorescence of skin tissue by stepwise two-photon excitation with nanosecond laser pulses at 810 nm, we have investigated information from this melanin fluorescence with respect to the differentiation of pigmented lesions. A distinct difference in the melanin fluorescence spectrum of malignant melanoma (including melanoma in situ) when compared to that of benign melanocytic lesions (i.e., common nevi) has been found for freshly excised samples as well as for histopathological samples. There is also specific fluorescence from dysplastic nevi. In this way, early detection of malignant melanoma is possible.

Laser induced autofluorescence studies of animal skin used in modeling of human cutaneous tissue spectroscopic measurements

BACKGROUND/PURPOSE

Laser-induced autofluorescence spectroscopy provides excellent possibilities for medical diagnostics of different tissue pathologies including cancer. However, to create the whole picture of pathological changes, investigators collect spectral information from patients in vivo or they study different tumor models to obtain objective information for fluorescent properties of every kind of healthy and diseased tissue. Therefore, it is very important to find the most appropriate, and close to the human skin, animal samples from the fluorescence point of view, which will allow the extrapolation of the animal data to human spectroscopic diagnostics.

METHODS

In the present work, we examined the autofluorescence properties of different animal skin tissues, which are considered as the most common skin models. A nitrogen laser was used as an excitation source. Samples of healthy mouse, chicken and pig skin in vivo and/or ex vivo were studied and were compared with results obtained from investigations of healthy human skin in vivo.

RESULTS AND CONCLUSION

Specific features of the recorded spectra are discussed and the possible origin of the obtained fluorescence signals is proposed. Quantitative evaluation of data extrapolation for each skin type is also depicted.

A hyperspectral fluorescence lifetime probe for skin cancer diagnosis

The autofluorescence of biological tissue can be exploited for the detection and diagnosis of disease but, to date, its complex nature and relatively weak signal levels have impeded its widespread application in biology and medicine. We present here a portable instrument designed for the in situ simultaneous measurement of autofluorescence emission spectra and temporal decay profiles, permitting the analysis of complex fluorescence signals. This hyperspectral fluorescence lifetime probe utilizes two ultrafast lasers operating at 355 and 440 nm that can excite autofluorescence from many different biomolecules present in skin tissue including keratin, collagen, nicotinamide adenine dinucleotide (phosphate), and flavins. The instrument incorporates an optical fiber probe to provide sample illumination and fluorescence collection over a millimeter-sized area. We present a description of the system, including spectral and temporal characterizations, and report the preliminary application of this instrument to a study of recently resected (<2 h) ex vivo skin lesions, illustrating its potential for skin cancer detection and diagnosis.

Spectrally resolved multiphoton imaging of in vivo and excised mouse skin tissues

The deep tissue penetration and submicron spatial resolution of multiphoton microscopy and the high detection efficiency and nanometer spectral resolution of a spectrograph were utilized to record spectral images of the intrinsic emission of mouse skin tissues. Autofluorescence from both cellular and extracellular structures, second-harmonic signal from collagen, and a narrowband emission related to Raman scattering of collagen were detected. Visualization of the spectral images by wavelength-to-RGB color image conversion allowed us to identify and discriminate tissue structures such as epidermal keratinocytes, lipid-rich corneocytes, intercellular structures, hair follicles, collagen, elastin, and dermal cells. Our results also showed morphological and spectral differences between excised tissue section, thick excised tissue, and in vivo tissue samples of mouse skin. Results on collagen excitation at different wavelengths suggested that the origin of the narrowband emission was collagen Raman peaks. Moreover, the oscillating spectral dependency of the collagen second-harmonic intensity was experimentally studied. Overall, spectral imaging provided a wealth of information not easily obtainable with present conventional multiphoton imaging systems.

Spectral characteristics of autofluorescence and second harmonic generation from ex vivo human skin induced by femtosecond laser and visible lasers

The spectral properties of one-photon, two-photon excited autofluorescence and second harmonic generation (SHG) from ex vivo human skin induced by a femtosecond (fs) laser and three visible lasers in backscattering geometry are systematically investigated. Our experimental results indicate that peak position of autofluorescence spectra from the dermis and epidermis shift toward long wavelengths, and the fluorescent intensity decreases when the excitation wavelength increases due to an effect of the excitation wavelength on autofluorescence signals. However, the intensity of the SHG signal in collagen has the maximal value of 800 nm excitation wavelength. This may be the result that the energy of the SHG signal is in resonance with an electronic absorption band. The two-photon excited autofluorescence and SHG intensity all obey a quadratical dependence on the excitation power. Compared with the two-photon excited fluorescence and SHG, the one-photon excited fluorescence in the dermis and epidermis exhibits different spectral characteristics. The investigation of the spectral characteristics of autofluorescence and SHG from ex vivo human skin can provide new insights into morphologic structures and biochemical components of tissues, which are vital for improving the application of laser-induced autofluorescence and SHG spectroscopy technique for noninvasive in vivo tissue diagnostics.

In vivo nonlinear spectral imaging in mouse skin

We report on two-photon autofluorescence and second harmonic spectral imaging of live mouse tissues. The use of a high sensitivity detector and ultraviolet optics allowed us to record razor-sharp deep-tissue spectral images of weak autofluorescence and short-wavelength second harmonic generation by mouse skin. Real-color image representation combined with depth-resolved spectral analysis enabled us to identify tissue structures. The results show that linking nonlinear deep-tissue imaging microscopy with autofluorescence spectroscopy has the potential to provide important information for the diagnosis of skin tissues.

Utility of the Wood's light: five cases from a pigmented lesion clinic

We demonstrate the utility of the Wood's light in a practice that specializes in the evaluation of pigmented lesions. The Wood's light assisted the physician in locating the site of a completely regressed primary cutaneous melanoma, determining the clinical borders of a lentigo maligna melanoma, differentiating between agminated naevi and a naevus spilus and detecting the recurrence of pigmentation after the excision of a dysplastic naevus, and also proved useful in monitoring a large segmental speckled atypical lentiginous naevus for change. Despite the availability of many 'high-tech' imaging and diagnostic devices designed to evaluate skin lesions, the relatively simple Wood's lamp continues to be of great value. We encourage physicians not to abandon the use of the Wood's light in their clinical practice.

Autofluorescence characterization for the early diagnosis of neoplastic changes in DMBA/TPA-induced mouse skin carcinogenesis

BACKGROUND AND OBJECTIVE

Squamous cell carcinoma (SCC), the second most common skin cancer, usually remains confined to the epidermis for some time but eventually penetrates the underlying tissues, if left untreated. The non-invasive early detection of the SCC is important for appropriate therapeutic strategies. In this study, we aim to characterize the tissue transformation in DMBA/TPA induced mouse skin tumor model using autofluorescence excitation emission matrix (EEM) in conjunction with a multivariate statistical method for early detection of the neoplastic changes.

STUDY DESIGN/MATERIALS AND METHODS

The fluorescence EEM from experimental group (n = 40; DMBA/TPA application), control group (n = 6; acetone application), and the blank group (n = 6; no application of DMBA/TPA or acetone) were measured every week using a spectrofluorometer coupled with a fiber optic bundle. The EEM was recorded at excitation wavelengths from 280 to 460 nm at 10 nm intervals and the fluorescence emission was scanned from 300 to 750 nm. The fluorescence emission characteristics corresponding to different fluorophores were extracted from the EEM and the spectral data were used in a multiple/linear discriminant statistical algorithm.

RESULTS

The changes in the fluorescence emission intensity were observed as early as the 1st week of tumor initiation by DMBA. Morphological changes as well as differences in the gross appearance of the skin surface were observed during the entire tumor initiation and promotion period of 15 weeks. The statistical analysis was performed for each excitation wavelength in the EEM and better classification accuracy was obtained for 280 and 410 nm excitations, corresponding to tryptophan and endogenous porphyrins, respectively. The statistical analysis of the combination wavelengths resulted in 11.6% increase in the overall classification accuracy when compared to the highest classification accuracy obtained with single wavelength analysis.

CONCLUSION

The intensity ratio mapping using the combination of emission intensities of key fluorophores such as tryptophan, collagen, NADH, and endogenous porphyrins from the measured EEM in conjunction with a simple multivariate statistical analysis can be used as a potential tool for the discrimination of early neoplastic changes with improved classification accuracy. Tryptophan and endogenous porphyrins may be used as biomarkers for the discrimination of early neoplastic changes when single wavelength excitations are used.

Visualization of skin penetration using confocal laser scanning microscopy

The use of skin as an alternative route for administering systemically active drugs has attracted considerable interest in recent years. However, the skin provides an excellent barrier, which limits the number of drug molecules suitable for transdermal delivery. Thus, in order to improve cutaneous delivery, it is necessary to adopt an enhancement method, either (i) passively using novel formulations, e.g. microemulsions, liposomes, and colloidal polymeric suspensions, or more conventional skin permeation enhancers, or (ii) with a physical approach, such as, iontophoresis, sonophoresis or electroporation. Although there has been much progress, the precise modes of action of the different techniques used are far from well-understood. The objective of this review, therefore, is to evaluate how confocal laser scanning microscopy may contribute to the determination of the mechanisms of diverse skin penetration enhancement strategies.

Luminescent lanthanide chelate contrast agents and detection of lesions in the hamster oral cancer model

Lanthanide chelates are a somewhat unique class of molecules that have proven to be useful in the biomedical field due to their extremely large Stokes' shift and long fluorescent lifetimes. The ability of these molecules to produce fluorescence in the low- or zero-back-ground regime makes this class of molecules excellent candidates for use as contrast agents for a wide variety of applications in biological settings. Here we present the preparation, spectroscopic characterization, and application of a new terbium chelate contrast agent, based on the 1,4,7,10-tetraazacyclododecane macrocycle (cyclen), for detection of early-stage malignant lesions in the Syrian hamster cheek pouch. Tb-P(CTMB) delivers bright blue-green luminescence when excited with low photon fluxes of UV light. As a pilot study, the DMBA-treated Golden Hamster Cheek pouch epithelial cancer model was employed and Tb-P(CTMB) was used as a topical agent for the visual detection of diseased tissue. In this preliminary study the agent tended to associate with early-stage malignant lesions, suggesting that Tb-P(CTMB) could be used as a contrast agent to aid in identifying early-stage oral cancer lesions.

Fluorescence spectral imaging of dihydroxyacetone on skin in vivo

Dihydroxyacetone (DHA) has been proposed as a potential alternative to dansyl chloride for use as a fluorescence marker on skin to assess stratum corneum turnover time in vivo. However, the fluorescence from DHA on skin has not been adequately studied. To address this void, a noninvasive, noncontact spectral imaging system is used to characterize the fluorescence spectrum of DHA on skin in vivo and to determine the optimal wavelengths over which to collect the DHA signal that minimizes the contributions from skin autofluorescence. The DHA-skin fluorescence signal dominates the 580-680 nm region of the visible spectrum when excited with ultraviolet radiation in the 320-400 nm wavelength region (UVA). An explanation of the time-dependent spectral features is proposed in terms of DHA polymerization and binding to skin.

Laser-induced fluorescence spectroscopy for in vivo diagnosis of non-melanoma skin cancers

BACKGROUND AND OBJECTIVES

Laser-induced fluorescence spectroscopy is a non-invasive technique previously used for detection of cancer in a variety of organ systems. The objective of this study was to determine whether in vivo laser-induced fluorescence spectroscopy alone at the visible excitation wavelength of 410 nm could be used to detect non-melanoma skin cancers.

STUDY DESIGN/MATERIALS AND METHODS

The system consisted of a nitrogen/dye laser tuned at 410 nm, an optical multichannel analyzer, and a fiber optic probe for excitation of tissue and collection of fluorescence emission. Two hundred and seventy nine measurements were performed from normal and abnormal tissues in 49 patients. Patients were classified as having either skin types I, II, or III. Biopsy of the abnormal tissues were then performed. Each measurement was assigned as either normal, basal cell carcinoma (BCC), squamous cell carcinoma (SCC), pre-cancerous, or benign. Total emission photon count was used as the discriminating index. A threshold value was calculated to separate normal tissue indices from indices of cancer tissues. The classification accuracy of each data point was determined using the threshold value.

RESULTS

Cancers were classified 93, 89, and 78% correctly in patients with skin types I, II, and III, respectively. Normal tissues were classified 93, 88, and 50% correctly in patients with skin types I, II, and III, respectively. Using the same threshold, pre-cancerous spectra were classified 78 and 100% correctly in skin types I and III, respectively. Benign lesions were classified 100, 46, and 27% correctly in patient with skin types I, II, and III, respectively.

CONCLUSIONS

In vivo laser induced fluorescence spectroscopy at 410 nm excitation and using the intensity of emission signal is effective for detection of BCC, SCC, and actinic keratosis, specially in patients with light colored skin.

Small animal imaging. current technology and perspectives for oncological imaging

Advances in the biomedical sciences have been accelerated by the introduction of many new imaging technologies in recent years. With animal models widely used in the basic and pre-clinical sciences, finding ways to conduct animal experiments more accurately and efficiently becomes a key factor in the success and timeliness of research. Non-invasive imaging technologies prove to be extremely valuable tools in performing such studies and have created the recent surge in small animal imaging. This review is focused on three modalities, PET, MR and optical imaging which are available to the scientist for oncological investigations in animals.

Optical imaging and automated melanoma detection: questions and answers

Early detection and prompt excision of cutaneous melanoma is of paramount importance to improve patient survival, and the clinician should be aware of the clinical features that suggest the presence of a malignant lesion. The clinical diagnosis is mainly based on observation of the colour and shape of a given skin lesion. Unfortunately, evaluation of a pigmented lesion is to a large extent subjective and is closely related to the experience of the clinician. To overcome this problem, optical imaging techniques using different instrumentation (i.e. colour video camera, epiluminescence microscopy, reflectance spectrophotometry) and computer image analysis have been proposed in an attempt to provide quantitative measurements in an objective and reproducible fashion. The different procedures employed to perform the diagnosis automatically all have a common denominator: mimicking the eye and the brain of the clinician by image processing and computerized analysis programs, respectively. Sensitivity and specificity data reported in the literature suggest that the computer-based diagnosis of melanoma does not greatly differ from the diagnostic capability of an expert clinician, and is independent of the optical acquisition method employed to analyse the lesions. Most of the computer-processed morphometric variables useful in automated diagnosis are not recognizable nor can be objectively evaluated by the human eye, except that of lesion dimension. However, several questions should be answered before assessing the actual usefulness, including the potential and limitations, of computer-based diagnostic procedures. The purpose of this study was to briefly review the different kinds of instrumentation being used to diagnose melanoma, and to raise questions and whenever possible provide answers in an attempt to establish whether there will be a future for these computerized systems.

Fluorescence in situ detection of human cutaneous melanoma: study of diagnostic parameters of the method

Multicenter study of the diagnostic parameters was conducted by three groups in Poland to determine if in situ fluorescence detection of human cutaneous melanoma based on digital imaging of spectrally resolved autofluorescence can be used as a tool for a preliminary selection of patients at increased risk of the disease. Fluorescence examinations were performed for 7228 pigmented lesions in 4079 subjects. Histopathologic examinations showed 56 cases of melanoma. A sensitivity of fluorescence detection of melanoma was 82.7% in agreement with 82.5% found in earlier work. Using as a reference only the results of histopathologic examinations obtained for 568 cases we found a specificity of 59.9% and a positive predictive value of 17.5% (melanomas versus all pigmented lesions) or 24% (melanomas versus common and dysplastic naevi). The specificity and positive predictive value found in this work are significantly lower than reported earlier but still comparable with those reported for typical screening programs. In conclusion, the fluorescence method of in situ detection of melanoma can be used in screening large populations of patients for a selection of patients who should be examined by specialists.

Autofluorescence of human skin is age-related after correction for skin pigmentation and redness

When measuring the skin fluorescence in vivo, the absorption of chromophores such as melanin and hemoglobin often contribute predominantly to the changes in fluorescence and obscure the information from the fluorophores. We measured in vivo the collagen-linked 375 nm fluorescence (excitation: 330 nm) and 455 nm fluorescence (excitation: 370 nm) from nonexposed buttock skin of healthy volunteers. Skin pigmentation and redness of the same sites were quantified by reflectance of the skin at 555 nm and 660 nm. Multiple regression analysis was used to find the correlation between the fluorescence and skin pigmentation and redness. The fluorescence was corrected for the impact of pigmentation and redness according to the equation found in the regression analyses. The age-related trend of the fluorescence was evaluated. The 375 nm fluorescence showed positive relation to age, whereas the 455 nm fluorescence showed no significant relation to age. The increasing rate of the 375 nm fluorescence (logarithm transformed) was 2% per year, which is comparable with previously published data. The results suggest that the correction of the autofluorescence intensity for skin pigmentation and redness is valid, and the 375 nm skin autofluorescence may be used as a biologic marker of skin aging in vivo.

In vivo fluorescence spectroscopy of nonmelanoma skin cancer

In vivo and ex vivo tissue autofluorescence (endogenous fluorescence) have been employed to investigate the presence of markers that could be used to detect tissue abnormalities and/or malignancies. We present a study of the autofluorescence of normal skin and tumor in vivo, conducted on 18 patients diagnosed with nonmelanoma skin cancers (NMSC). We observed that both in basal cell carcinomas (BCC) and squamous cell carcinomas (SCC) the endogenous fluorescence due to tryptophan residues was more intense in tumor than in normal tissue, probably due to epidermal thickening and/or hyperproliferation. Conversely, the fluorescence intensity associated with dermal collagen crosslinks was generally lower in tumors than in the surrounding normal tissue, probably because of degradation or erosion of the connective tissue due to enzymes released by the tumor. The decrease of collagen fluorescence in the connective tissue adjacent to the tumor loci was validated by fluorescence imaging on fresh-frozen tissue sections obtained from 33 NMSC excised specimens. Our results suggest that endogenous fluorescence of NMSC, excited in the UV region of the spectrum, has characteristic features that are different from normal tissue and may be exploited for noninvasive diagnostics and for the detection of tumor margins.