Use of Raman spectroscopy to screen diabetes mellitus with machine learning tools

Type 2 diabetes mellitus (DM2) is one of the most widely prevalent diseases worldwide and is currently screened by invasive techniques based on enzymatic assays that measure plasma glucose concentration in a laboratory setting. A promising plan of action for screening DM2 is to identify molecular signatures in a non-invasive fashion. This work describes the application of portable Raman spectroscopy coupled with several supervised machine-learning techniques, to discern between diabetic patients and healthy controls (Ctrl), with a high degree of accuracy. Using artificial neural networks (ANN), we accurately discriminated between DM2 and Ctrl groups with 88.9-90.9% accuracy, depending on the sampling site. In order to compare the ANN performance to more traditional methods used in spectroscopy, principal component analysis (PCA) was carried out. A subset of features from PCA was used to generate a support vector machine (SVM) model, albeit with decreased accuracy (76.0-82.5%). The 10-fold cross-validation model was performed to validate both classifiers. This technique is relatively low-cost, harmless, simple and comfortable for the patient, yielding rapid diagnosis. Furthermore, the performance of the ANN-based method was better than the typical performance of the invasive measurement of capillary blood glucose. These characteristics make our method a promising screening tool for identifying DM2 in a non-invasive and automated fashion.

Cross-section and feasibility study on the non-invasive evaluation of muscle hemodynamic responses in Duchenne muscular dystrophy by using a near-infrared diffuse optical technique

Duchenne muscular dystrophy (DMD) is an X-linked debilitating muscular disease that may decrease nitric oxide (NO) production and lead to functional muscular ischemia. Currently, the 6-minute walk test (6-MWT) and the North Star Ambulatory Assessment (NSAA) are the primary outcome measures in clinical trials, but they are severely limited by the subjective consciousness and mood of patients, and can only be used in older and ambulatory boys. This study proposed using functional near-infrared spectroscopy (fNIRS) to evaluate the dynamic changes in muscle hemodynamic responses (gastrocnemius and forearm muscle) during a 6-MWT and a venous occlusion test (VOT), respectively. Muscle oxygenation of the forearm was evaluated non-invasively before, during and after VOT in all participants (included 30 DMD patients and 30 age-matched healthy controls), while dynamic muscle oxygenation of gastrocnemius muscle during 6-MWT was determined in ambulatory participants (n = 18) and healthy controls (n = 30). The results reveal that impaired muscle oxygenation was observed during 6-MWT in DMD patients that may explain why the DMD patients walked shorter distances than healthy controls. Moreover, the results of VOT implied that worsening muscle function was associated with a lower supply of muscle oxygenation and may provide useful information on the relationship between muscular oxygen consumption and supply for the clinical diagnosis of DMD. Therefore, the method of fNIRS with VOT possesses great potential in future evaluations of DMD patients that implies a good feasibility for clinical application such as for monitoring disease severity of DMD.

Combining high wavenumber and fingerprint Raman spectroscopy for the detection of prostate cancer during radical prostatectomy

For prostate cancer (PCa) patients, radical prostatectomy (complete removal of the prostate) is the only curative surgical option. To date, there is no clinical technique allowing for real-time assessment of surgical margins to minimize the extent of residual cancer. Here, we present a tissue interrogation technique using a dual excitation wavelength Raman spectroscopy system capable of sequentially acquiring fingerprint (FP) and high wavenumber (HWN) Raman spectra. Results demonstrate the ability of the system to detect PCa in post-prostatectomy specimens. In total, 477 Raman spectra were collected from 18 human prostate slices. Each area measured with Raman spectroscopy was characterized as either normal or cancer based on histopathological analyses, and each spectrum was classified based on supervised learning using support vector machines (SVMs). Based on receiver operating characteristic (ROC) analysis, FP (area under the curve [AUC] = 0.89) had slightly superior cancer detection capabilities compared with HWN (AUC = 0.86). Optimal performance resulted from combining the spectral information from FP and HWN (AUC = 0.91), suggesting that the use of these two spectral regions may provide complementary molecular information for PCa detection. The use of leave-one-(spectrum)-out (LOO) or leave-one-patient-out (LOPO) cross-validation produced similar classification results when combining FP with HWN. Our findings suggest that the application of machine learning using multiple data points from the same patient does not result in biases necessarily impacting the reliability of the classification models.

Robust layer segmentation of esophageal OCT images based on graph search using edge-enhanced weights

Automatic segmentation of esophageal layers in OCT images is crucial for studying esophageal diseases and computer-assisted diagnosis. This work aims to improve the current techniques to increase the accuracy and robustness for esophageal OCT image segmentation. A two-step edge-enhanced graph search (EEGS) framework is proposed in this study. Firstly, a preprocessing scheme is applied to suppress speckle noise and remove the disturbance in the esophageal structure. Secondly, the image is formulated into a graph and layer boundaries are located by graph search. In this process, we propose an edge-enhanced weight matrix for the graph by combining the vertical gradients with a Canny edge map. Experiments on esophageal OCT images from guinea pigs demonstrate that the EEGS framework is more robust and more accurate than the current segmentation method. It can be potentially useful for the early detection of esophageal diseases.

Label-free real-time ultrasensitive monitoring of non-small cell lung cancer cell interaction with drugs

The timely discovery of cancer cell resistance in clinical processing and the accurate calculation of drug dosage to reduce and inhibit tumour growth factor in cancer patients are promising technologies in cancer therapy. Here, an optofluidic resonator effectively detects drug interactions with cancer cell processing in real time and enables the calculation of label-free drug-non-small cell lung cancer (NSCLC) epidermal growth factor receptor (EGFR) and binding ratios using molecular fluorescence intensity. According to clinical test and in vivo experimental data, the efficiencies of gefitinib and erlotinib are only 37% and 12% compared to AZD9291, and 0.300 μg of EGFR inactivation requires 0.484 μg of AZD9291, 0.815 μg of gefitinib and 1.348 μg of erlotinib. Experimental results show that the present method allows for the performance detection of drug resistance and for the evaluation of dosage usage.

Label-free and stable serum analysis based on Ag-NPs/PSi surface-enhanced Raman scattering for noninvasive lung cancer detection

Surface-enhanced Raman scattering (SERS) has a broad application prospect in the field of tumor detection owing to its ultrahigh detective sensitivity. However, SERS analysis of serum remain a challenge in terms of repeatability and stability due to the maldistribution of the silver nanoparticles (Ag-NPs)-serum. With the aim to make up for this shortcoming, we report a new method for obtaining stable serum Raman signals utilizing the ordered arrays of pyramidal silicon (PSi) and Ag-NPs. We prove the practicability of this method by detecting the samples of serum from 50 lung cancer patients and 50 normal healthy people. Principal component analysis (PCA) of the serum SERS spectra shows that the spectral data of the two sample groups can form obvious and completely separated clusters. The receiver operating characteristic curve provides the sensitivity (100%) and specificity (90%) from the PCA-LDA method. This research indicates that a stable and label-free analysis technique of serum SERS based on Ag-NPs/PSi and PCA-LDA is promising for noninvasive lung cancer diagnoses.

Label-free fluorescence lifetime spectroscopy detects radiation-induced necrotic changes in live brain in real-time

Current clinical imaging modalities do not reliably identify brain tissue regions with necrosis following radiotherapy. This creates challenges for stereotaxic biopsies and surgical-decision making. Time-resolved fluorescence spectroscopy (TRFS) provides a means to rapidly identify necrotic tissue by its distinct autofluorescence signature resulting from tissue breakdown and altered metabolic profiles in regions with radiation damage. Studies conducted in a live animal model of radiation necrosis demonstrated that necrotic tissue is characterized by respective increases of 27% and 108% in average lifetime and redox ratio, when compared with healthy tissue. Moreover, radiation-damaged tissue not visible by MRI but confirmed by histopathology, was detected by TRFS. Current results demonstrate the ability of TRFS to identify radiation-damaged brain tissue in real-time and indicates its potential to assist with surgical guidance and MRI-guided biopsy procedures.

On the dysfunctional hemoglobins and cyanosis connection: practical implications for the clinical detection and differentiation of methemoglobinemia and sulfhemoglobinemia

Methemoglobinemia and sulfhemoglobinemia are potentially life-threatening blood-related disorders characterized by similar symptoms and markedly distinct treatment procedures. In this paper, we investigate the causal relationship between these conditions and the onset of cyanosis, which is typically associated with a purple or bluish skin coloration. More specifically, we perform controlled experiments to elicit cyanotic appearances resulting from different severity levels of these disorders and varying physiological conditions. We note that such experiments cannot be induced in living subjects without posing risks to their health. Accordingly, we have resorted to an in silico experimental approach supported by biophysical data reported in the literature. Besides bringing new insights about cyanotic chromatic variations elicited by methemoglobinemia and sulfhemoglobinemia, our investigation provides the basis for the proposition of a cost-effective protocol for the noninvasive detection and differentiation of these disorders. Our experimental results indicate that its sensitivity range is wider than what is provided by similar protocols employed in these tasks. Moreover, it has lower operational requirements than laboratory tests ordered to enable the diagnosis of these conditions. We believe that these aspects make the proposed protocol particularly suitable for deployment at the point of care of medical settings with limited access to laboratory resources.

Multiwavelength time-resolved near-infrared spectroscopy of the adult head: assessment of intracerebral and extracerebral absorption changes

An optical technique based on diffuse reflectance measurement combined with indocyanine green (ICG) bolus tracking is extensively tested as a method for the clinical assessment of brain perfusion at the bedside. We report on multiwavelength time-resolved diffuse reflectance spectroscopy measurements carried out on the head of a healthy adult during the intravenous administration of a bolus of ICG. Intracerebral and extracerebral changes in absorption were estimated from an analysis of changes in statistical moments (total number of photons, mean time of flight and variance) of the distributions of times of flight (DTOF) of photons recorded simultaneously at 16 wavelengths from the range of 650-850 nm using sensitivity factors estimated by diffusion approximation based on a layered model of the studied medium. We validated the proposed method in a series of phantom experiments and in-vivo measurements. The results obtained show that changes in the concentration of the ICG can be assessed as a function of time of the experiment and depth in the tissue. Thus, the separation of changes in ICG concentration appearing in intra- and extracerebral tissues can be estimated from optical data acquired at a single source-detector pair of fibers/fiber bundles positioned on the surface of the head.

Prediction of the anti-glioma therapeutic effects of temozolomide through in vivo molecular imaging of MMP expression

Currently, there is no effective way to assess the therapeutic response of temozolomide (TMZ) for the glioma. In this study, the human U87MG-fLuc glioma animal models were set up and the antitumor efficacy of TMZ was evaluated using bioluminescence imaging (BLI) and MRI. Then, bioluminescence tomography (BLT) was reconstructed using an adaptive sparsity matching pursuit (ASMP) algorithm. Second, the expression level of the MMP-750 probe was examined with or without TMZ treatment using FMI. Third, the expression of MMP2 and MMP3 was specifically examined after treatment. The results showed that TMZ effectively inhibited glioma growth. The targeted imaging of MMP-750 was decreased during the treatment of glioma with TMZ. Moreover, the MMP2 and MMP3 expression was found to correlate with the inhibition effect of TMZ. Our study indicated that the therapeutic effects of TMZ can be effectively evaluated at an early stage using molecular imaging, and MMP targeting the fluorescence probe could be utilized for the prediction and assessment of the therapeutic effects of TMZ.

Near-simultaneous quantification of glucose uptake, mitochondrial membrane potential, and vascular parameters in murine flank tumors using quantitative diffuse reflectance and fluorescence spectroscopy

The shifting metabolic landscape of aggressive tumors, with fluctuating oxygenation conditions and temporal changes in glycolysis and mitochondrial metabolism, is a critical phenomenon to study in order to understand negative treatment outcomes. Recently, we have demonstrated near-simultaneous optical imaging of mitochondrial membrane potential (MMP) and glucose uptake in non-tumor window chambers, using the fluorescent probes tetramethylrhodamine ethyl ester (TMRE) and 2-N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino)-2-deoxyglucose (2-NBDG). Here, we demonstrate a complementary technique to perform near-simultaneous in vivo optical spectroscopy of tissue vascular parameters, glucose uptake, and MMP in a solid tumor model that is most often used for therapeutic studies. Our study demonstrates the potential of optical spectroscopy as an effective tool to quantify the vascular and metabolic characteristics of a tumor, which is an important step towards understanding the mechanisms underlying cancer progression, metastasis, and resistance to therapies.

Assessment of the radiotherapy effect for nasopharyngeal cancer using plasma surface-enhanced Raman spectroscopy technology

Nasopharyngeal cancer (NPC) is a malignant tumor of the head and neck, which is extremely sensitive to radiotherapy. The aim of this study is to evaluate the feasibility of a label-free nanobiosensor based on plasma surface-enhanced Raman spectroscopy (SERS) to assess the radiotherapy effect in NPC. Here, SERS measurements were performed on plasma samples from 40 pre-treatment and post-treatment NPC as well as 30 healthy volunteers. Results demonstrate that the spectral characteristic of post-treatment samples is obviously different from that of pre-treatment ones, owing to the changes of biomolecules in plasma induced by radiotherapy. Classification sensitivities of 83.3%, 61.8% and 95.1%, and specificities of 91.2%, 67.4% and 93% can be achieved for separating pre- and post-treatment samples, post-treatment and normal samples, and pre-treatment and normal samples, respectively, suggesting the great potential of plasma SERS method as a rapid and convenient tool for radiotherapy assessment and cancer screening in NPC.

A spread spectrum approach to time-domain near-infrared diffuse optical imaging using inexpensive optical transceiver modules

We introduce a compact time-domain system for near-infrared spectroscopy using a spread spectrum technique. The proof-of-concept single channel instrument utilises a low-cost commercially available optical transceiver module as a light source, controlled by a Kintex 7 field programmable gate array (FPGA). The FPGA modulates the optical transceiver with maximum-length sequences at line rates up to 10Gb/s, allowing us to achieve an instrument response function with full width at half maximum under 600ps. The instrument is characterised through a set of detailed phantom measurements as well as proof-of-concept in vivo measurements, demonstrating performance comparable with conventional pulsed time-domain near-infrared spectroscopy systems.

Terahertz time-domain spectroscopy for non-invasive assessment of water content in biological samples

We apply terahertz time-domain spectroscopy for the quantitative non-invasive assessment of the water content in biological samples, such as Carpinus caroliniana tree leaves and pork muscles. The developed experimental terahertz time-domain spectroscopy system operates both in transmission and reflection modes. The Landau-Looyenga-Lifshitz-based model is used for the calculation of the water concentration within the samples. The results of the water concentration measurements are compared with the results of the gravimetric measurements. The obtained results show that the water content in biological samples can be measured non-invasively, with a high accuracy, utilizing terahertz waves in transmission and reflection modes.

Multiscale nonlinear microscopy and widefield white light imaging enables rapid histological imaging of surgical specimen margins

The ability to histologically assess surgical specimens in real-time is a long-standing challenge in cancer surgery, including applications such as breast conserving therapy (BCT). Up to 40% of women treated with BCT for breast cancer require a repeat surgery due to postoperative histological findings of close or positive surgical margins using conventional formalin fixed paraffin embedded histology. Imaging technologies such as nonlinear microscopy (NLM), combined with exogenous fluorophores can rapidly provide virtual H&E imaging of surgical specimens without requiring microtome sectioning, facilitating intraoperative assessment of margin status. However, the large volume of typical surgical excisions combined with the need for rapid assessment, make comprehensive cellular resolution margin assessment during surgery challenging. To address this limitation, we developed a multiscale, real-time microscope with variable magnification NLM and real-time, co-registered position display using a widefield white light imaging system. Margin assessment can be performed rapidly under operator guidance to image specific regions of interest located using widefield imaging. Using simulated surgical margins dissected from human breast excisions, we demonstrate that multi-centimeter margins can be comprehensively imaged at cellular resolution, enabling intraoperative margin assessment. These methods are consistent with pathology assessment performed using frozen section analysis (FSA), however NLM enables faster and more comprehensive assessment of surgical specimens because imaging can be performed without freezing and cryo-sectioning. Therefore, NLM methods have the potential to be applied to a wide range of intra-operative applications.

Fast localization method of an anomaly in tissue based on differential optical density

The position of the source-detector (S-D) relative to an anomaly has an important influence on the detection effect in non-invasive near-infrared spectroscopy-based methods. In this study, a single-source multi-detector structure was designed in order to realize the rapid localization of anomalies within tissue. This method uses finite element analysis of the optical density distribution for different horizontal positions, depths and diameters of anomalies. The difference in optical density between the detectors was then calculated. The simulation results show that the horizontal position of the anomaly in the tissue can be quickly located according to the differential optical density difference curves formed by the multiple detectors. The Gaussian fitting feature of these curves shows strong correlation with the horizontal positions, depths and diameters of the anomaly. Through the differential optical density difference curves, rapid localization within the region of interest can be achieved. This method provides an important reference for sources and detectors location for tumor detection, brain function optical imaging and other fields using near infrared spectroscopy, and improves its detection accuracy.

Intravital imaging of a pulmonary endothelial surface layer in a murine sepsis model

Direct intravital imaging of an endothelial surface layer (ESL) in pulmonary microcirculation could be a valuable approach to investigate the role of a vascular endothelial barrier in various pathological conditions. Despite its importance as a marker of endothelial cell damage and impairment of the vascular system, in vivo visualization of ESL has remained a challenging technical issue. In this work, we implemented a pulmonary microcirculation imaging system integrated to a custom-design video-rate laser scanning confocal microscopy platform. Using the system, a real-time cellular-level microscopic imaging of the lung was successfully performed, which facilitated a clear identification of individual flowing erythrocytes in pulmonary capillaries. Subcellular level pulmonary ESL was identified in vivo by fluorescence angiography using a dextran conjugated fluorophore to label blood plasma and the red blood cell (RBC) exclusion imaging analysis. Degradation of ESL width was directly evaluated in a murine sepsis model in vivo, suggesting an impairment of pulmonary vascular endothelium and endothelial barrier dysfunction.

Intra-class variability in diffuse reflectance spectroscopy: application to porcine adipose tissue

Optical diffuse reflectance spectroscopy (DRS) has great potential in the study, diagnosis, and discrimination of biological tissues. Discrimination is based on massive measurements that conform training sets. These sets are then used to classify tissues according to the biomedical application. Classification accuracy depends strongly on the training dataset, which typically comes from different samples of the same class, and from different points of the same sample. The variability of these measurements is not usually considered and is assumed to be purely random, although it could greatly influence the results. In this work, spectral variations within and between samples of different animals of ex-vivo porcine adipose tissue are evaluated. Algorithms for normalization, dimensionality reduction by principal component analysis, and variability control are applied. The PC analysis shows the dataset variability, even when a variability removal algorithm is applied. The projected data appear grouped by animal in the PC space. Mahalanobis distance is calculated for every group, and an ANOVA test is performed in order to estimate the variability. The results confirm that the variability is not random and is dependent at least on the anatomical location and the specific animal. The variability magnitude is significant, particularly if the classification accuracy is needed to be high. As a consequence, it should be taken generally into account in classification problems.

Measuring water contents in animal organ tissues using terahertz spectroscopic imaging

We investigated the water contents in several organ tissues such as the liver, spleen, kidney, and brain tissue of rats using the terahertz spectroscopic imaging technique. The water contents of the tissues were determined by using a simple equation containing the absorption coefficients of fresh and lyophilized tissues and water. We compared the measured water contents with the difference in mass of tissues before and after lyophilization. All results showed a good match except for the kidney, which has several Bowman's capsules.

Investigation of the influence of sampling schemes on quantitative dynamic fluorescence imaging

Dynamic optical data from a series of sampling intervals can be used for quantitative analysis to obtain meaningful kinetic parameters of probe in vivo. The sampling schemes may affect the quantification results of dynamic fluorescence imaging. Here, we investigate the influence of different sampling schemes on the quantification of binding potential (BP) with theoretically simulated and experimentally measured data. Three groups of sampling schemes are investigated including the sampling starting point, sampling sparsity, and sampling uniformity. In the investigation of the influence of the sampling starting point, we further summarize two cases by considering the missing timing sequence between the probe injection and sampling starting time. Results show that the mean value of BP exhibits an obvious growth trend with an increase in the delay of the sampling starting point, and has a strong correlation with the sampling sparsity. The growth trend is much more obvious if throwing the missing timing sequence. The standard deviation of BP is inversely related to the sampling sparsity, and independent of the sampling uniformity and the delay of sampling starting time. Moreover, the mean value of BP obtained by uniform sampling is significantly higher than that by using the non-uniform sampling. Our results collectively suggest that a suitable sampling scheme can help compartmental modeling of dynamic fluorescence imaging provide more accurate results and simpler operations.

Label-free light-sheet microfluidic cytometry for the automatic identification of senescent cells

Label-free microfluidic cytometry is of increasing interest for single cell analysis due to its advantages of high-throughput, miniaturization, as well as noninvasive detection. Here we develop a next generation label-free light-sheet microfluidic cytometer for single cell analysis by two-dimensional (2D) light scattering measurements. Our cytometer integrates light sheet illumination with a disposable hydrodynamic focusing unit, which can achieve 3D hydrodynamic focusing of a sample fluid to a diameter of 19 micrometer without microfabrication. This integration also improves the signal to noise ratio (SNR) for the acquisition of 2D light scattering patterns from label-free cells. Particle sizing with submicron resolution is achieved by our light-sheet flow cytometer, where Euclidean distance-based similarity measures are performed. Label-free, automatic classification of senescent and normal cells is achieved with a high accuracy rate by incorporating our light-sheet flow cytometry with support vector machine (SVM) algorithms. Our light-sheet microfluidic cytometry with a microfabrication-free hydrodynamic focusing unit may find wide applications for automatic and label-free clinical diagnosis.

Diffuse reflectance spectroscopy of human liver tumor specimens - towards a tissue differentiating optical biopsy needle using light emitting diodes

Significant numbers of liver biopsies fail to yield representative tissue samples. This study was conducted to evaluate the ability of LED-based diffuse reflectance spectroscopy to discriminate tumors from liver parenchyma. Ex vivo spectra were acquired from malignant lesions and liver parenchyma of 32 patients who underwent liver resection using a white light source and several LEDs. Integrated spectra of two combined LEDs with emission peaks at 470 nm and 515 nm were classified with 98.4% sensitivity and 99.2% specificity. The promising results could yield to a simple handheld and cost-efficient tool for real-time tissue differentiation implemented in a biopsy needle.

Application of a near-infrared laser tweezers Raman spectroscopy system for label-free analysis and differentiation of diabetic red blood cells

A home-made near-infrared laser tweezers Raman spectroscopy (LTRS) system was applied to detect hemoglobin variation in red blood cells (RBCs) from diabetes without exogenous labeling. Results showed significant spectral differences existed between the diabetic and normal RBCs, including the peaks dominated by protein components (e.g. 1003 cm^-1) and heme groups (e.g. 753 cm^-1) in RBCs, and accurate classification results for diabetes detection were obtained by linear discriminant analysis with 100% sensitivity (i.e. no false negatives in the study). This work indicated the great promise of LTRS as a label-free RBC analytical tool for improving the accurate detection of type II diabetes.

Discrimination of lymphoma using laser-induced breakdown spectroscopy conducted on whole blood samples

Lymphoma is a significant cancer that affects the human lymphatic and hematopoietic systems. In this work, discrimination of lymphoma using laser-induced breakdown spectroscopy (LIBS) conducted on whole blood samples is presented. The whole blood samples collected from lymphoma patients and healthy controls are deposited onto standard quantitative filter papers and ablated with a 1064 nm Q-switched Nd:YAG laser. 16 atomic and ionic emission lines of calcium (Ca), iron (Fe), magnesium (Mg), potassium (K) and sodium (Na) are selected to discriminate the cancer disease. Chemometric methods, including principal component analysis (PCA), linear discriminant analysis (LDA) classification, and k nearest neighbor (kNN) classification are used to build the discrimination models. Both LDA and kNN models have achieved very good discrimination performances for lymphoma, with an accuracy of over 99.7%, a sensitivity of over 0.996, and a specificity of over 0.997. These results demonstrate that the whole-blood-based LIBS technique in combination with chemometric methods can serve as a fast, less invasive, and accurate method for detection and discrimination of human malignancies.

Surface-enhanced Raman scattering for the detection of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a multi-factorial heterogeneous syndrome that affects many women of reproductive age. This work demonstrates how the surface-enhanced Raman scattering (SERS) technique can be used to differentiate between PCOS and non-PCOS patients. We determine that the use of SERS, in conjunction with partial least squares (PLS) and principal component analysis (PCA), allows us to detect PCOS in patient samples. Although the role of chemerin in the pathogenesis of PCOS patients is not clear, this work enables us to measure their chemerin levels using the PLS regression method.

Pneumatic low-coherence interferometry otoscope to quantify tympanic membrane mobility and middle ear pressure

Pneumatic otoscopy to assess the mobility of the tympanic membrane (TM) is a highly recommended diagnostic method of otitis media (OM), a widespread middle ear infection characterized by the fluid accumulation in the middle ear. Nonetheless, limited depth perception and subjective interpretation of small TM displacements have challenged the appropriate and efficient examination of TM dynamics experienced during OM. In this paper, a pneumatic otoscope integrated with low coherence interferometry (LCI) was adapted with a controlled pressure-generating system to record the pneumatic response of the TM and to estimate middle ear pressure (MEP). Forty-two ears diagnosed as normal (n = 25), with OM (n = 10), or associated with an upper respiratory infection (URI) (n = 7) were imaged with a pneumatic LCI otoscope with an axial, transverse, and temporal resolution of 6 µm, 20 µm, and 1 msec, respectively. The TM displacement under pneumatic pressure transients (a duration of 0.5 sec with an intensity of ± 150 daPa) was measured to compute two metrics (compliance and amplitude ratio). These metrics were correlated with peak acoustic admittance and MEP from tympanometry and statistically compared via Welch's t-test. As a result, the compliance represents pneumatic TM mobility, and the amplitude ratio estimates MEP. The presence of a middle ear effusion (MEE) significantly decreased compliance (p<0.001). The amplitude ratio of the OM group was statistically less than that of the normal group (p<0.01), indicating positive MEP. Unlike tympanometry, pneumatic LCI otoscopy quantifies TM mobility as well as MEP regardless of MEE presence. With combined benefits of pneumatic otoscopy and tympanometry, pneumatic LCI otoscopy may provide new quantitative metrics for understanding TM dynamics and diagnosing OM.

Investigation of tissue cellularity at the tip of the core biopsy needle with optical coherence tomography

We report the development and the pre-clinical testing of a new technology based on optical coherence tomography (OCT) for investigating tissue composition at the tip of the core biopsy needle. While ultrasound, computed tomography, and magnetic resonance imaging are routinely used to guide needle placement within a tumor, they still do not provide the resolution needed to investigate tissue cellularity (ratio between viable tumor and benign stroma) at the needle tip prior to taking a biopsy core. High resolution OCT imaging, however, can be used to investigate tissue morphology at the micron scale, and thus to determine if the biopsy core would likely have the expected composition. Therefore, we implemented this capability within a custom-made biopsy gun and evaluated its capability for a correct estimation of tumor tissue cellularity. A pilot study on a rabbit model of soft tissue cancer has shown the capability of this technique to provide correct evaluation of tumor tissue cellularity in over 85% of the cases. These initial results indicate the potential benefit of the OCT-based approach for improving the success of the core biopsy procedures.

Label-free fiber optic optrode for the detection of class C β-lactamases expressed by drug resistant bacteria

This paper reports the experimental assessment of an automated optical assay based on label free optical fiber optrodes for the fast detection of class C β-lactamases (AmpC BLs), actually considered as one of the most important sources of resistance to β-lactams antibiotics expressed by resistant bacteria. Reflection-type long period fiber gratings (RT-LPG) have been used as highly sensitive label free optrodes, while a higher affine boronic acid-based ligand was here selected to enhance the overall assay performances compared to those obtained in our first demonstration. In order to prove the feasibility analysis towards a fully automated optical assay, an engineered system was developed to simultaneously manipulate and interrogate multiple fiber optic optrodes in the different phases of the assay. The automated system tested in AmpC solutions at increasing concentrations demonstrated a limit of detection (LOD) of 6 nM, three times better when compared with the results obtained in our previous work. Moreover, the real effectiveness of the proposed optical assay has been also confirmed in complex matrices as the case of lysates of Escherichia coli overexpressing AmpC.

Active thermodynamic contrast imaging for label-free tumor detection in a murine xenograft tumor model

Passive thermal imaging provides a limited differentiation between a tumor and neighboring tissue based on the temperature difference. We propose active thermodynamic contrast imaging (ATCI) with convection thermal modulators to provide more physiologically relevant parameters with high contrast such as the rate of temperature change, and thermal recovery time for tumor detection with a murine xenograft tumor model. With early stage tumors, we found the average rate of temperature change was higher in the tumor (0.22 ± 0.06 [Formula: see text]/sec) than that of neighboring tissue (0.13 ± 0.01 [Formula: see text]/sec) with heating modulation. With established tumors (volume > 100 mm³), this tendency was greater. On the other hand, the thermal recovery time was shorter in tumor tissue (τ = 7.30 ± 0.59 sec) than that of neighboring tissue (τ = 11.91 ± 2.22 sec). We also found distinct thermal contrast with cooling modulation. These data suggest ATCI is a potential tumor detection modality for clinical application with its inherently label-free and physiology-based approach. Furthermore, this strategy may find applications in endoscopic tumor detection in the future.

Comparison of four methods of surface roughness assessment of corneal stromal bed after lamellar cutting

Corneal lamellar cutting with a blade or femtosecond laser (FSL) is commonly used during refractive surgery and corneal grafts. Surface roughness of the cutting plane influences postoperative visual acuity but is difficult to assess reliably. For the first time, we compared chromatic confocal microscopy (CCM) with scanning electron microscopy, atomic force microscopy (AFM) and focus-variation microscopy (FVM) to characterize surfaces of variable roughness after FSL cutting. The small area allowed by AFM hinders conclusive roughness analysis, especially with irregular cuts. FVM does not always differentiate between smooth and rough surfaces. Finally, CCM allows analysis of large surfaces and differentiates between surface states.

High sensitivity optical measurement of skin gloss

We demonstrate a low-cost optical method for measuring the gloss properties with improved sensitivity in the low gloss regime, relevant for skin gloss properties. The gloss estimation method is based on, on the one hand, the slope of the intensity gradient in the transition regime between specular and diffuse reflection and on the other on the sum over the intensities of pixels above threshold, derived from a camera image obtained using unpolarized white light illumination. We demonstrate the improved sensitivity of the two proposed methods using Monte Carlo simulations and experiments performed on ISO gloss calibration standards with an optical prototype. The performance and linearity of the method was compared with different professional gloss measurement devices based on the ratio of specular to diffuse intensity. We demonstrate the feasibility for in-vivo skin gloss measurements by quantifying the temporal evolution of skin gloss after application of standard paraffin cream bases on skin. The presented method opens new possibilities in the fields of cosmetology and dermatopharmacology for measuring the skin gloss and resorption kinetics and the pharmacodynamics of various external agents.

Computer-aided classification of sickle cell retinopathy using quantitative features in optical coherence tomography angiography

As a new optical coherence tomography (OCT) imaging modality, there is no standardized quantitative interpretation of OCT angiography (OCTA) characteristics of sickle cell retinopathy (SCR). This study is to demonstrate computer-aided SCR classification using quantitative OCTA features, i.e., blood vessel tortuosity (BVT), blood vessel diameter (BVD), vessel perimeter index (VPI), foveal avascular zone (FAZ) area, FAZ contour irregularity, parafoveal avascular density (PAD). It was observed that combined features show improved classification performance, compared to single feature. Three classifiers, including support vector machine (SVM), k-nearest neighbor (KNN) algorithm, and discriminant analysis, were evaluated. Sensitivity, specificity, and accuracy were quantified to assess the performance of each classifier. For SCR vs. control classification, all three classifiers performed well with an average accuracy of 95% using the six quantitative OCTA features. For mild vs. severe stage retinopathy classification, SVM shows better (97% accuracy) performance, compared to KNN algorithm (95% accuracy) and discriminant analysis (88% accuracy).

Leukemia cells detection based on electroporation assisted surface-enhanced Raman scattering

In this study, an electroporation-based surface-enhanced Raman scattering (SERS) technique was employed to differentiate the human myeloid leukemia cells from the normal human bone marrow mononuclear cells with the aim to develop a fast and label-free method for leukemia cell screening. The Ag nanoparticles were delivered into living cells by electroporation, and then high quality SERS spectra were successfully obtained from 60 acute promyelocytic leukemia cells (HL60 cell line), 60 chronic myelogenous leukemia cells (K562 cell line) and 60 normal human bone marrow mononuclear cells (BMC). Principal component analysis (PCA) combined with linear discriminant analysis (LDA) differentiated the leukemia cell SERS spectra (HL60 plus K562) from normal cell SERS spectra (BMC) with high sensitivity (98.3%) and specificity (98.3%). Furthermore, partial least squares (PLS) approach was employed to develop a diagnostic model. The model successfully predicted the unidentified subjects with a diagnostic accuracy of 96.7%. This exploratory work demonstrates that the electroporation-based SERS technique combined with PCA-LDA and PLS diagnostic algorithms possesses great promise for cancer cell screening.

High-sensitivity detection of cardiac troponin I with UV LED excitation for use in point-of-care immunoassay

High-sensitivity cardiac troponin assay development enables determination of biological variation in healthy populations, more accurate interpretation of clinical results and points towards earlier diagnosis and rule-out of acute myocardial infarction. In this paper, we report on preliminary tests of an immunoassay analyzer employing an optimized LED excitation to measure on a standard troponin I and a novel research high-sensitivity troponin I assay. The limit of detection is improved by factor of 5 for standard troponin I and by factor of 3 for a research high-sensitivity troponin I assay, compared to the flash lamp excitation. The obtained limit of detection was 0.22 ng/L measured on plasma with the research high-sensitivity troponin I assay and 1.9 ng/L measured on tris-saline-azide buffer containing bovine serum albumin with the standard troponin I assay. We discuss the optimization of time-resolved detection of lanthanide fluorescence based on the time constants of the system and analyze the background and noise sources in a heterogeneous fluoroimmunoassay. We determine the limiting factors and their impact on the measurement performance. The suggested model can be generally applied to fluoroimmunoassays employing the dry-cup concept.

Evaluating platelet aggregation dynamics from laser speckle fluctuations

Platelets are key to maintaining hemostasis and impaired platelet aggregation could lead to hemorrhage or thrombosis. We report a new approach that exploits laser speckle intensity fluctuations, emanated from a drop of platelet-rich-plasma (PRP), to profile aggregation. Speckle fluctuation rate is quantified by the speckle intensity autocorrelation, g₂(t), from which the aggregate size is deduced. We first apply this approach to evaluate polystyrene bead aggregation, triggered by salt. Next, we assess dose-dependent platelet aggregation and inhibition in human PRP spiked with adenosine diphosphate and clopidogrel. Additional spatio-temporal speckle analyses yield 2-dimensional maps of particle displacements to visualize platelet aggregate foci within minutes and quantify aggregation dynamics. These findings demonstrate the unique opportunity for assessing platelet health within minutes for diagnosing bleeding disorders and monitoring anti-platelet therapies.

Optical detection and monitoring of pigmented skin lesions

A method is presented for discriminating between malignant and benign pigmented skin lesions based on multispectral and multi-angle images. It is discussed how to retrieve maps of physiology properties and morphometric parameters from recorded images using a bio-optical model, radiative transfer calculations, and nonlinear inversion, and how to employ automated zooming to extract lesion and surrounding masks. Training and validation of a classification scheme for separation between benign and malignant tissue yielded sensitivity/specificity ranging from 97%/97% for application to a small dataset comprised of lesions not used for training and validation to 99%/93% for application to a larger dataset.

Plum pudding random medium model of biological tissue toward remote microscopy from spectroscopic light scattering

Biological tissue has a complex structure and exhibits rich spectroscopic behavior. There has been no tissue model until now that has been able to account for the observed spectroscopy of tissue light scattering and its anisotropy. Here we present, for the first time, a plum pudding random medium (PPRM) model for biological tissue which succinctly describes tissue as a superposition of distinctive scattering structures (plum) embedded inside a fractal continuous medium of background refractive index fluctuation (pudding). PPRM faithfully reproduces the wavelength dependence of tissue light scattering and attributes the "anomalous" trend in the anisotropy to the plum and the powerlaw dependence of the reduced scattering coefficient to the fractal scattering pudding. Most importantly, PPRM opens up a novel venue of quantifying the tissue architecture and microscopic structures on average from macroscopic probing of the bulk with scattered light alone without tissue excision. We demonstrate this potential by visualizing the fine microscopic structural alterations in breast tissue (adipose, glandular, fibrocystic, fibroadenoma, and ductal carcinoma) deduced from noncontact spectroscopic measurement.

Automatic and robust segmentation of endoscopic OCT images and optical staining

We report a generic method for automatic segmentation of endoscopic optical coherence tomography (OCT) images. In this method, OCT images are first processed with L₁ -L₀ norm minimization based de-noising and smoothing algorithms to increase the signal-to-noise ratio (SNR) and enhance the contrast between adjacent layers. The smoothed images are then formulated into cost graphs based on their vertical gradients. After that, tissue-layer segmentation is performed with the shortest path search algorithm. The efficacy and capability of this method are demonstrated by automatically and robustly identifying all five interested layers of guinea pig esophagus from in vivo endoscopic OCT images. Furthermore, thanks to the ultrahigh resolution, high SNR of endoscopic OCT images and the high segmentation accuracy, this method permits in vivo optical staining histology and facilitates quantitative analysis of tissue geometric properties, which can be very useful for studying tissue pathologies and potentially aiding clinical diagnosis in real time.

Endoscopic optical coherence tomography: technologies and clinical applications [Invited]

In this paper, we review the current state of technology development and clinical applications of endoscopic optical coherence tomography (OCT). Key design and engineering considerations are discussed for most OCT endoscopes, including side-viewing and forward-viewing probes, along with different scanning mechanisms (proximal-scanning versus distal-scanning). Multi-modal endoscopes that integrate OCT with other imaging modalities are also discussed. The review of clinical applications of endoscopic OCT focuses heavily on diagnosis of diseases and guidance of interventions. Representative applications in several organ systems are presented, such as in the cardiovascular, digestive, respiratory, and reproductive systems. A brief outlook of the field of endoscopic OCT is also discussed.

Evaluation of non-thermal plasma-induced anticancer effects on human colon cancer cells

Non-thermal atmospheric-pressure plasma has been introduced in various applications such as sterilization, wound healing, blood coagulation, and other biomedical applications. The most attractive application of non-thermal atmospheric-pressure plasma is in cancer treatment, where the plasma is used to produce reactive oxygen species (ROS) to facilitate cell apoptosis. We investigate the effects of different durations of exposure to dielectric-barrier discharge (DBD) plasma on colon cancer cells using measurement of cell viability and ROS levels, western blot, immunocytochemistry, and Raman spectroscopy. Our results suggest that different kinds of plasma-treated cells can be differentiated from control cells using the Raman data.

Brain tumor delineation enhanced by moxifloxacin-based two-photon/CARS combined microscopy

Delineating brain tumor margin is critical for maximizing tumor removal while sparing adjacent normal tissue for better clinical outcome. We describe the use of moxifloxacin-based two-photon (TP)/coherent anti-Stokes Raman scattering (CARS) combined microscopy for differentiating normal mouse brain tissue from metastatic brain tumor tissue based on histoarchitectural and biochemical differences. Moxifloxacin, an FDA-approved compound, was used to label cells in the brain, and moxifloxacin-based two-photon microscopy (TPM) revealed tumor lesions with significantly high cellular density and invading edges in a metastatic brain tumor model. Besides, label-free CARS microscopy showed diminishing of lipid signal due to the destruction of myelin at the tumor site compared to a normal brain tissue site resulting in a complementary contrast for tumor detection. This study demonstrates that moxifloxacin-based TP/CARS combined microscopy might be advantageous for tumor margin identification in the brain that has been a long-standing challenge in the operating room.

Statistical properties of dynamic speckles from flowing Brownian scatterers in the vicinity of the image plane in optical coherence tomography

A closed-form analytical expression is obtained for the spatio-temporal correlation function of the scattered radiation detected in fiber-based optical coherence tomography (OCT), assuming a clean optical system arrangement in the OCT sample arm. It is shown that the transverse flow component causes purely translational speckle motion with the predicted speckle velocity 2x higher than the velocity of the flowing particles as would be observed in the image plane under incoherent illumination. It is also shown that both speckle velocity and speckle radius do not depend on the position of the scattering volume relative to the focal plane, hence the derived correlation function is independent of the position of the scattering volume relative to the focal plane. Although the analytical results are obtained for a clean optical system arrangement, they can be used with high accuracy in most practical implementations of fiber based OCT. Validation experiments in control scattering phantoms with varying liquid viscosities show excellent agreement with the developed theoretical model, under both no-flow and flow conditions. Accurate viscosity determinations enabled by this methodology may have applications to non-invasive glucose measurements in medicine.

Detection theory for accurate and non-invasive skin cancer diagnosis using dynamic thermal imaging

Skin cancer is the most common cancer in the United States with over 3.5M annual cases. Presently, visual inspection by a dermatologist has good sensitivity (> 90%) but poor specificity (< 10%), especially for melanoma, which leads to a high number of unnecessary biopsies. Here we use dynamic thermal imaging (DTI) to demonstrate a rapid, accurate and non-invasive imaging system for detection of skin cancer. In DTI, the lesion is cooled down and the thermal recovery is recorded using infrared imaging. The thermal recovery curves of the suspected lesions are then utilized in the context of continuous-time detection theory in order to define an optimal statistical decision rule such that the sensitivity of the algorithm is guaranteed to be at a maximum for every prescribed false-alarm probability. The proposed methodology was tested in a pilot study including 140 human subjects demonstrating a sensitivity in excess of 99% for a prescribed specificity in excess of 99% for detection of skin cancer. To the best of our knowledge, this is the highest reported accuracy for any non-invasive skin cancer diagnosis method.

Early biomarker for radiation-induced wounds: day one post-irradiation assessment using hemoglobin concentration measured from diffuse optical reflectance spectroscopy

Normal tissue radiation toxicities are evaluated subjectively and cannot predict the development of severe side-effects. Using a hand-held diffuse reflectance optical spectroscopy probe, we measured optical parameters in mouse skin 1-4 days after irradiation. Using a radiation toxicity model and a therapeutic mitigator described previously [BMC Cancer14, 614 (2014)], we found that hemoglobin (Hb) levels increased sharply 24 h after irradiation only in the irradiated group without the mitigator. This group also had the largest peak wound areas after 14 days. We conclude that increased Hb one day after skin irradiation predicts the severity of the subsequent irradiation-induced wound.

Simulation of nanoparticle-mediated near-infrared thermal therapy using GATE

Application of nanotechnology for biomedicine in cancer therapy allows for direct delivery of anticancer agents to tumors. An example of such therapies is the nanoparticle-mediated near-infrared hyperthermia treatment. In order to investigate the influence of nanoparticle properties on the spatial distribution of heat in the tumor and healthy tissues, accurate simulations are required. The Geant4 Application for Emission Tomography (GATE) open-source simulation platform, based on the Geant4 toolkit, is widely used by the research community involved in molecular imaging, radiotherapy and optical imaging. We present an extension of GATE that can model nanoparticle-mediated hyperthermal therapy as well as simple heat diffusion in biological tissues. This new feature of GATE combined with optical imaging allows for the simulation of a theranostic scenario in which the patient is injected with theranostic nanosystems that can simultaneously deliver therapeutic (i.e. hyperthermia therapy) and imaging agents (i.e. fluorescence imaging).

In vivo pentamodal tomographic imaging for small animals

Multimodality molecular imaging emerges as a powerful strategy for correlating multimodal information. We developed a pentamodal imaging system which can perform positron emission tomography, bioluminescence tomography, fluorescence molecular tomography, Cerenkov luminescence tomography and X-ray computed tomography successively. Performance of sub-systems corresponding to different modalities were characterized. In vivo multimodal imaging of an orthotopic hepatocellular carcinoma xenograft mouse model was performed, and acquired multimodal images were fused. The feasibility of pentamodal tomographic imaging system was successfully validated with the imaging application on the mouse model. The ability of integrating anatomical, metabolic, and pharmacokinetic information promises applications of multimodality molecular imaging in precise medicine.

Quantitative characteristics of sickle cell retinopathy in optical coherence tomography angiography

Early detection is an essential step for effective intervention of sickle cell retinopathy (SCR). Emerging optical coherence tomography angiography (OCTA) provides excellent three-dimensional (3D) resolution to enable label-free, noninvasive visualization of retinal vascular structures, promising improved sensitivity in detecting SCR. However, quantitative analysis of SCR characteristics in OCTA images is yet to be established. In this study, we conducted comprehensive analysis of six OCTA parameters, including blood vessel tortuosity, vessel diameter, vessel perimeter index (VPI), area of foveal avascular zone (FAZ), contour irregularity of FAZ and parafoveal avascular density. Compared to traditional retinal thickness analysis, five of these six OCTA parameters show improved sensitivity for SCR detection than retinal thickness. It is observed that the most sensitive parameters were the contour irregularity of FAZ in the superficial layer and avascular density in temporal regions, while the area of FAZ, tortuosity and mean diameter of the vessel were moderately sensitive.

Clinically compatible flexible wide-field multi-color fluorescence endoscopy with a porcine colon model

Early detection of structural or molecular changes in dysplastic epithelial tissues is crucial for cancer screening and surveillance. Multi-targeting molecular endoscopic fluorescence imaging may improve noninvasive detection of precancerous lesions in the colon. Here, we report the first clinically compatible, wide-field-of-view, multi-color fluorescence endoscopy with a leached fiber bundle scope using a porcine model. A porcine colon model that resembles the human colon is used for the detection of surrogate tumors composed of multiple biocompatible fluorophores (FITC, ICG, and heavy metal-free quantum dots (hfQDs)). With an ex vivo porcine colon tumor model, molecular imaging with hfQDs conjugated with MMP14 antibody was achieved by spraying molecular probes on a mucosa layer that contains xenograft tumors. With an in vivo porcine colon embedded with surrogate tumors, target-to-background ratios of 3.36 ± 0.43, 2.70 ± 0.72, and 2.10 ± 0.13 were achieved for FITC, ICG, and hfQD probes, respectively. This promising endoscopic technology with molecular contrast shows the capacity to reveal hidden tumors and guide treatment strategy decisions.

Golden angle based scanning for robust corneal topography with OCT

Corneal topography allows the assessment of the cornea's refractive power which is crucial for diagnostics and surgical planning. The use of optical coherence tomography (OCT) for corneal topography is still limited. One limitation is the susceptibility to disturbances like blinking of the eye. This can result in partially corrupted scans that cannot be evaluated using common methods. We present a new scanning method for reliable corneal topography from partial scans. Based on the golden angle, the method features a balanced scan point distribution which refines over measurement time and remains balanced when part of the scan is removed. The performance of the method is assessed numerically and by measurements of test surfaces. The results confirm that the method enables numerically well-conditioned and reliable corneal topography from partially corrupted scans and reduces the need for repeated measurements in case of abrupt disturbances.

En face coherence microscopy [Invited]

En face coherence microscopy or flying spot or full field optical coherence tomography or microscopy (FF-OCT/FF-OCM) belongs to the OCT family because the sectioning ability is mostly linked to the source coherence length. In this article we will focus our attention on the advantages and the drawbacks of the following approaches: en face versus B scan tomography in terms of resolution, coherent versus incoherent illumination and influence of aberrations, and scanning versus full field imaging. We then show some examples to illustrate the diverse applications of en face coherent microscopy and show that endogenous or exogenous contrasts can add valuable information to the standard morphological image. To conclude we discuss a few domains that appear promising for future development of en face coherence microscopy.