Point-of-care diagnosis of tissue fibrosis: a review of advances in vibrational spectroscopy with machine learning.

Histopathology is the gold standard for diagnosing fibrosis, but its routine use is constrained by the need for additional stains, time, personnel and resources. Vibrational spectroscopy is a novel technique that offers an alternative atraumatic approach, with short scan times, while providing metabolic and morphological data. This review evaluates vibrational spectroscopy for the assessment of fibrosis, with a focus on point-of-care capabilities. OVID Medline, Embase and Cochrane databases were systematically searched using PRISMA guidelines for search terms including vibrational spectroscopy, human tissue and fibrosis. Studies were stratified based on imaging modality and tissue type. Outcomes recorded included tissue type, machine learning technique, metrics for accuracy and author conclusions. Systematic review yielded 420 articles, of which 14 were relevant. Ten of these articles considered mid-infrared spectroscopy, three dealt with Raman spectroscopy and one with near-infrared spectroscopy. The metrics for detecting fibrosis were Pearson correlation coefficients ranging from 0.65-0.98; sensitivity from 76-100%; specificity from 90-99%; area under receiver operator curves from 0.83-0.98; and accuracy of 86-99%. Vibrational spectroscopy identified fibrosis in myeloproliferative neoplasms in bone, cirrhotic and hepatocellular carcinoma in liver, end-stage heart failure in cardiac tissue and following laser ablation for acne in skin. It also identified interstitial fibrosis as a predictor of early renal transplant rejection in renal tissue. Vibrational spectroscopic techniques can therefore accurately identify fibrosis in a range of human tissues. Emerging data show that it can be used to quantify, classify and provide data about the nature of fibrosis with a high degree of accuracy with potential scope for point-of-care use.

Predições da espectroscopia no infravermelho próximo podem determinar a digestibilidade e o consumo alimentar de cordeiros confinados / Near-IR spectroscopy predictions can determine the digestibility and feed intake from feedlot lambs

O presente trabalho teve como objetivo validar a eficácia do método de espectroscopia de reflectância do infravermelho proximal (NIRS) em predizer o consumo e a digestibilidade da MS e nutrientes de dietas para cordeiros confinados, em comparação ao método convencional de laboratório. Amostras das dietas fornecidas, sobras e fezes de 40 cordeiros Santa Inês foram submetidas a ambos os métodos e analisadas quanto aos teores de MS, MM, FDN, FDA, PB e EE, para futuros cálculos do consumo e da digestibilidade. A maioria dos coeficientes de correlação do modelo ficou na faixa de 0,66 a 0,81, mostrando-se adequados para a predição quantitativa. Os maiores coeficientes foram observados para teores de PB das dietas (0,85) e sobras (0,87). Foram encontradas altas correlações entre os métodos na predição do consumo (média de 0,93) e digestibilidade (média de 0,90) das dietas. As correlações entre as variáveis obtidas pela predição do NIRS e pelo método convencional foram adequadas, demonstrando que, independentemente do método, os teores nutricionais das dietas, das sobras e das fezes podem ser utilizados para calcular o consumo e a digestibilidade da MS e dos nutrientes das dietas para cordeiros confinados, sendo recomendado o método NIRS pela precisão, pela rapidez e pelo baixo custo em relação ao método convencional.(AU)

This research was carried out to validate the effectiveness of the Near-IR spectroscopy method in predicting intake and digestibility of DM and nutrients of diets for feedlot lambs, in order to compare with the conventional laboratory method. Samples of diets, ort,s and feces of forty Santa Ines lambs were subjected to both methods and analyzed for DM, MM, NDF, ADF, CP, and EE for future calculations for intake and digestibility. Most of the model's correlation coefficient was in the range of 0.66 to 0.81, being suitable for quantitative prediction. Highest values for CP content of 0.85 (diets) and 0.87 (orts) were observed. There were high correlations between the methods to predicting intake (average values of 0.93) and digestibility (average values of 0.93). Correlations between the variables obtained by the prediction of NIRS and the conventional method were adequate, showing that regardless of the method, the nutritional content of diets, orts and feces can be used to calculate the intake and digestibility of DM and nutrients of lambs' diets. The Near-IR spectroscopy method is recommended for accuracy, speed and low cost compared to conventional method.(AU)

Recent advances and applications of gas chromatography vacuum ultraviolet spectroscopy.

The vacuum ultraviolet spectrophotometer was developed recently as an alternative to existing gas chromatography detectors. This detector measures the absorption of gas-phase chemical species in the range of 120-240 nm, where all chemical compounds present unique absorption spectra. Therefore, qualitative analysis can be performed and quantification follows standard Beer-Lambert law principles. Different fields of application, such as petrochemical, food, and environmental analysis have been explored. Commonly demonstrated is the capability for facile deconvolution of co-eluting analytes. The concept of additive absorption for co-eluting analytes has also been advanced for classification and speciation of complex mixtures using a data treatment procedure termed time interval deconvolution. Furthermore, pseudo-absolute quantitation can be performed for system diagnosis, as well as potentially calibrationless quantitation. In this manuscript an overview of these features, the vacuum ultraviolet spectrophotometer instrumentation, and performance capabilities are given. A discussion of the applications of the vacuum ultraviolet detector is provided by describing and discussing the papers published thus far since 2014.

Magnetic Resonance Imaging and Spectroscopy in Cancer Theranostic Imaging.

With its exquisite anatomical resolution and wide-ranging functional imaging capabilities, magnetic resonance imaging (MRI) has found multiple applications in detection, staging, and monitoring treatment response in cancer. The metabolic information provided by magnetic resonance spectroscopy (MRS) is being actively investigated to complement MRI parameters, as well as existing biomarkers, in cancer detection and in monitoring response to treatment. Located at the interface of detection and therapy, theranostic imaging is a rapidly expanding new field that is showing significant promise for precision medicine of cancer. Innovations in the development of novel nanoparticles decorated with imaging reporters that can be used to deliver therapeutic cargo to specific cells and environments have provided new roles for MRI and MRS in theranostic imaging.

Screening, early detection, education, and trends for melanoma: current status (2007-2013) and future directions: Part II. Screening, education, and future directions.

New evidence has accumulated over the past several years that supports improved melanoma outcomes associated with both clinician and patient screening. Population-based and workplace studies conducted in Australia and the Unites States, respectively, have shown decreases in the incidence of thick melanoma and overall melanoma mortality, and a year-long statewide screening program in Germany has shown a nearly 50% reduction in mortality 5 years after the screening ended. Current melanoma screening guidelines in the United States are inconsistent among various organizations, and therefore rates of both physician and patient skin examinations are low. As policymaking organizations update national screening recommendations in the United States, the latest research reviewed in part II of this continuing medical education article should be considered to establish the most effective recommendations. Patient and provider education will be necessary to ensure that appropriate patients receive recommended screening.

Optical endomicroscopy and the road to real-time, in vivo pathology: present and future.

Epithelial cancers account for substantial mortality and are an important public health concern. With the need for earlier detection and treatment of these malignancies, the ability to accurately detect precancerous lesions has an increasingly important role in controlling cancer incidence and mortality. New optical technologies are capable of identifying early pathology in tissues or organs in which cancer is known to develop through stages of dysplasia, including the esophagus, colon, pancreas, liver, bladder, and cervix. These diagnostic imaging advances, together as a field known as optical endomicroscopy, are based on confocal microscopy, spectroscopy-based imaging, and optical coherence tomography (OCT), and function as "optical biopsies," enabling tissue pathology to be imaged in situ and in real time without the need to excise and process specimens as in conventional biopsy and histopathology. Optical biopsy techniques can acquire high-resolution, cross-sectional images of tissue structure on the micron scale through the use of endoscopes, catheters, laparoscopes, and needles. Since the inception of these technologies, dramatic technological advances in accuracy, speed, and functionality have been realized. The current paradigm of optical biopsy, or single-area, point-based images, is slowly shifting to more comprehensive microscopy of larger tracts of mucosa. With the development of Fourier-domain OCT, also known as optical frequency domain imaging or, more recently, volumetric laser endomicroscopy, comprehensive surveillance of the entire distal esophagus is now achievable at speeds that were not possible with conventional OCT technologies. Optical diagnostic technologies are emerging as clinically useful tools with the potential to set a new standard for real-time diagnosis. New imaging techniques enable visualization of high-resolution, cross-sectional images and offer the opportunity to guide biopsy, allowing maximal diagnostic yields and appropriate staging without the limitations and risks inherent with current random biopsy protocols. However, the ability of these techniques to achieve widespread adoption in clinical practice depends on future research designed to improve accuracy and allow real-time data transmission and storage, thereby linking pathology to the treating physician. These imaging advances are expected to eventually offer a see-and-treat paradigm, leading to improved patient care and potential cost reduction. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5372548637202968.

New imaging techniques and opportunities in endoscopy.

Gastrointestinal endoscopy is undergoing major improvements, which are driven by new available technologies and substantial refinements of optical features. In this Review, we summarize available and evolving imaging technologies that could influence the clinical algorithm of endoscopic diagnosis. Detection, characterization and confirmation are essential steps required for proper endoscopic diagnosis. Optical and nonoptical methods can help to improve each step; these improvements are likely to increase the detection rate of neoplasias and reduce unnecessary endoscopic treatments. Furthermore, functional and molecular imaging are emerging as new diagnostic tools that could provide an opportunity for personalized medicine, in which endoscopy will define disease outcome or predict the response to targeted therapy.

Advances in optical spectroscopy and imaging of breast lesions.

A review is presented of recent advances in optical imaging and spectroscopy and the use of light for addressing breast cancer issues. Spectroscopic techniques offer the means to characterize tissue components and obtain functional information in real time. Three-dimensional optical imaging of the breast using various illumination and signal collection schemes in combination with image reconstruction algorithms may provide a new tool for cancer detection and treatment monitoring.

Neutron spectrometry for radiation protection.

The various instruments used for neutron spectrometry can be divided into four categories. Within each of these categories, the underlying measurement principle for all devices is essentially the same. The applications of the instruments within each group to spectrometry for radiation protection are reviewed.

Spectrophotometric determination of penicillamine and carbocisteine based on formation of metal complexes.

A simple spectrophotometric method was developed for the determination of penicillamine and carbocisteine. The method depends on complexation of penicillamine with Ni, Co and Pb ions in acetate buffer pH of 6.3, 6.5 and 5.3, respectively, and carbocisteine with Cu and Ni ions in borate buffer pH of 6.7; 1-70 microg/ml of these drugs could be determined by measuring the absorbance of each complex at its specific lambdamax. The results obtained are in good agreement with those obtained using the official methods. The proposed method was successfully applied for the determination of these compounds in their dosage forms. Also, the molar ratio and stability constant of the metal complexes were calculated and a proposal of the reaction pathway was postulated.

Introductory lecture: from biomolecules to biodiagnostics: spectroscopy does it all.

Optical spectroscopy and imaging have been used in medicine since medicine was first practised. However, the more sophisticated instrumental methods now under development have made little impact on clinical medicine. In this paper a brief overview of the development of optical diagnostics is presented, highlighted by some successful pre-clinical applications. The reasons for the slow penetration of optical diagnostics into clinical practice are discussed.

Noninvasive analysis of conjunctival microcirculation during carotid artery surgery reveals microvascular evidence of collateral compensation and stenosis-dependent adaptation.

OBJECTIVE: Hemodynamically relevant internal carotid artery (ICA) stenosis is a major cause of ischemic stroke. Despite its long-term benefit, carotid endarterectomy may also be associated with severe neurologic deficits. Intraoperative and early recognition of ischemia in the region of the ICA may reduce this risk. To date, direct imaging and quantitative analysis of microvascular structures and function in the human ICA region have not been possible. We purposed to visualize and quantify ischemia/reperfusion-induced microcirculatory changes in the terminal vascular bed of the ICA in patients undergoing unilateral ICA endarterectomy. METHODS: Sequential analysis of the ipsilateral and contralateral conjunctival microcirculation was performed with orthogonal polarized spectral imaging in 33 patients undergoing unilateral ICA endarterectomy because of moderate or severe ICA stenosis (North American Symptomatic Carotid Endarterectomy Trial score, 75% +/- 13%), before clamping the ICA (baseline), during clamping of the external carotid artery and ICA, during reperfusion of the ICA (intraluminal shunt), during the second clamping of the ICA (shunt removal), after declamping (reperfusion) of the external carotid artery and ICA, and 15 to 20 minutes after the second ICA reperfusion. RESULTS: During ICA clamping for shunt placement, ipsilateral and contralateral conjunctival capillary perfusion was significantly decreased, but it was completely restored after reperfusion with carotid shunting. Reclamping of the ICA for shunt removal caused microvascular dysfunction, which was significantly less pronounced than that observed during the first clamping. The individual degree of ICA stenosis was inversely correlated with the ipsilateral and contralateral decrease in conjunctival functional capillary density during the first ICA clamping. CONCLUSIONS: These results suggest adaptive mechanisms of capillary perfusion with increasing stenosis and development of collateral compensatory circulation in the vascular region of the human ICA. Conjunctival orthogonal polarized spectral imaging during unilateral ICA reconstruction enables continuous noninvasive analysis of bilateral conjunctival microcirculation in the terminal region of the ICA and enables monitoring for efficient carotid shunt perfusion during and after endarterectomy.