Quantitative characterization of duodenal gastrinoma autofluorescence using multiphoton microscopy.

BACKGROUND: Duodenal gastrinomas (DGASTs) are neuroendocrine tumors that develop in the submucosa of the duodenum and produce the hormone gastrin. Surgical resection of DGASTs is complicated by the small size of these tumors and the tendency for them to develop diffusely in the duodenum. Endoscopic mucosal resection of DGASTs is an increasingly popular method for treating this disease due to its low complication rate but suffers from poor rates of pathologically negative margins. Multiphoton microscopy can capture high-resolution images of biological tissue with contrast generated from endogenous fluorescence (autofluorescence [AF]) through two-photon excited fluorescence (2PEF). Second harmonic generation is another popular method of generating image contrast with multiphoton microscopy (MPM) and is a light-scattering phenomenon that occurs predominantly from structures such as collagen in biological samples. Some molecules that contribute to AF change in abundance from processes related to the cancer disease process (e.g., metabolic changes, oxidative stress, and angiogenesis). STUDY DESIGN/MATERIALS AND METHODS: MPM was used to image 12 separate patient samples of formalin-fixed and paraffin-embedded duodenal gastrinoma slides with a second-harmonic generation (SHG) channel and four 2PEF channels. The excitation and emission profiles of each 2PEF channel were tuned to capture signal dominated by distinct fluorophores with well-characterized fluorescent spectra and known connections to the physiologic changes that arise in cancerous tissue. RESULTS: We found that there was a significant difference in the relative abundance of signal generated in the 2PEF channels for regions of DGASTs in comparison to the neighboring tissues of the duodenum. Data generated from texture feature extraction of the MPM images were used in linear discriminant analysis models to create classifiers for tumor versus all other tissue types before and after principal component analysis (PCA). PCA improved the classifier accuracy and reduced the number of features required to achieve maximum accuracy. The linear discriminant classifier after PCA distinguished between tumor and other tissue types with an accuracy of 90.6%-93.8%. CONCLUSIONS: These results suggest that multiphoton microscopy 2PEF and SHG imaging is a promising label-free method for discriminating between DGASTs and normal duodenal tissue which has implications for future applications of in vivo assessment of resection margins with endoscopic MPM.

Endoscopic diagnosis of H. pylori infection. / Diagnóstico endoscópico de la infección por H. pylori.

Helicobacter pylori (H. pylori) infection is highly prevalent in our environment and is associated with highly relevant gastric disease, both benign and malignant. The gold standard for diagnosis is histological confirmation by biopsy. However, there is increasing evidence that optical endoscopic diagnosis could have a fundamental role in avoiding unnecessary biopsies in certain cases. Specifically, the regular distribution of the collecting venules (RAC pattern) seems to have a high negative predictive value (NPV) to rule out infection. This review describes the most outstanding endoscopic findings with the best diagnostic potential for H. pylori infection after an exhaustive search comparing the most relevant studies that have been carried out in Europe and the East.

The complementary value of intraoperative fluorescence imaging and Raman spectroscopy for cancer surgery: combining the incompatibles.

A clear margin is an important prognostic factor for most solid tumours treated by surgery. Intraoperative fluorescence imaging using exogenous tumour-specific fluorescent agents has shown particular benefit in improving complete resection of tumour tissue. However, signal processing for fluorescence imaging is complex, and fluorescence signal intensity does not always perfectly correlate with tumour location. Raman spectroscopy has the capacity to accurately differentiate between malignant and healthy tissue based on their molecular composition. In Raman spectroscopy, specificity is uniquely high, but signal intensity is weak and Raman measurements are mainly performed in a point-wise manner on microscopic tissue volumes, making whole-field assessment temporally unfeasible. In this review, we describe the state-of-the-art of both optical techniques, paying special attention to the combined intraoperative application of fluorescence imaging and Raman spectroscopy in current clinical research. We demonstrate how these techniques are complementary and address the technical challenges that have traditionally led them to be considered mutually exclusive for clinical implementation. Finally, we present a novel strategy that exploits the optimal characteristics of both modalities to facilitate resection with clear surgical margins.

Micro-Raman spectroscopy study of blood samples from myocardial infarction patients.

Acute myocardial infarction (MI) is found to be a major causative factor for global mortality and morbidity. This situation demands necessity of developing efficient and rapid diagnostic tools to detect acute MI. Raman spectroscopy is a non-destructive optical diagnostic technique, which has high potential in probing biochemical changes in clinical samples during initiation and progress of diseases. In this work, blood was taken as the sample to examine inflammation in acute MI patients using Raman spectroscopy. Ratio of Raman peak intensities that corresponds to phenylalanine (1000 cm-1) and tyrosine (825 cm-1) can facilitate indirect information about tetrahydrobiopterin (BH4) availability, which can indicate inflammatory status in patients. This ratio obtained was higher for MI patients in comparison with control subjects. The decrease in phenylalanine and tyrosine ratio (Phe-Tyr ratio) is attributed to the prognosis of standard of care (medications like antiplatelets including aspirin, statin and revascularisation) leading to inflammation reduction. Phe-Tyr ratio estimated from the Raman spectra of blood can be exploited as a reliable method to probe inflammation due to MI. The method is highly objective, require only microliters of sample and minimal sample preparation, signifying its clinical utility.

Evaluation of an image enhancement system for the assessment of nasal and paranasal sinus diseases.

PURPOSE: Dysplasia and cancer of the upper aerodigestive tract are characterized by significant neoangiogenesis. This can be recognized by optical methods like the Storz Professional Image Enhancement System (SPIES). Up to now, there are no reports of using this novel technique for examining nasal diseases. The objective of this study was to evaluate the use of SPIES during sinus surgery to help differentiate various nasal pathologies and determine their extension. METHODS: Patients (n = 27) with different pathologies in the region of the paranasal sinuses were operated via functional endoscopic surgery using a 2D-HD-camera with white light and SPIES. In addition, 10 healthy individuals were examined. The system was evaluated using two different questionnaires. RESULTS: The handling and operation of SPIES was intuitive and easy. Use of SPIES did not prolong the procedure. There was no disturbing image distortion. SPIES seemed to improve the visualization, differentiation and evaluation of vascularization of paranasal pathologies and allowed for precise and accurate surgery. Compared to examination with the 2D-HD-camera and white light alone, SPIES appeared to facilitate the identification of mucosal pathologies. CONCLUSION: SPIES could be a promising adjunct tool to evaluate nasal pathologies intraoperatively. Especially in the case of vascularized tumors the enhanced image endoscopy seemed to be clearly superior to standard white light alone. In our study, the system facilitated the assessment of tumor extension and vascularization as well as the differentiation of healthy mucosa. Future randomized studies will be necessary to prove the potential of integrating this novel technique into the clinical routine for the differentiation of nasal pathologies and the improvement of resection margins during nasal tumor surgery.

Investigation of the Possibility of Using Microspectrometers Based on CMOS Photodiode Arrays in Small-Sized Devices for Optical Diagnostics.

The article considers the potential applicability of C12880MA and C11708MA Hamamatsu microspectrometers, which are characterized by an extremely compact design, occupying a small volume of several cubic centimeters, in portable spectrometric equipment with spatial resolution for monitoring the optical properties of condensed scattering media. The development of methods for determining the reduced scattering and absorption spectral coefficients of radiation from various scattering materials and products allows us to speak about the possibility of real-time control of the volume concentration of optically active components included in them, for example, fat and water in dairy products. For this, it is necessary to provide sufficiently accurate spectra of diffusely reflected broadband light radiation at different distances between the points of radiation entrance and registration. The aim of the manuscript is to assess the possibility of using the considered microspectrometers in compact devices for optical diagnostics and control of the optical properties of condensed scattering media. The features of the connection diagram of these microspectrometers and the necessary methods for correcting the initially obtained spectral dependencies of diffusive reflection, which will be of interest to developers of spectral diagnostic equipment, are considered in detail. The need to eliminate the influence of the inhomogeneity of dark counts of a CMOS photodiode array is shown. The hardware functions of the C12880MA and C11708MA Hamammatsu microspectrometers, as well as the AvaSpec 2048L fiber-optic spectrometer, were experimentally measured and compared. Methods for correcting the nonlinearity of their reading scales and light characteristics, as well as improving their equivalent spectral resolution using digital Wiener filtering, are described. It is shown that the equivalent spectral resolution of C12880MA and C11708MA microspectrometers can be improved by about 40% when recording smooth spectra, subject to the condition that the resulting side oscillations are small. It is pointed out that in order to reduce the level of side oscillations in the corrected spectra with improved resolution, it is necessary to ensure the smoothness of the original spectra and a good signal-to-noise ratio. A conclusion is made about the possibility of using the considered microspectrometers in portable spectrometric equipment with careful consideration of their characteristics, the features of their switching circuit, and the necessary software.

Gas Monitoring in Human Frontal Sinuses-Stability Considerations and Gas Exchange Studies.

Acute rhinosinusitis is a common infectious disease, which, in more than 90% of cases, is caused by viruses rather than by bacteria. Even so, antibiotics are often unnecessarily prescribed, and in the long run this contributes to the alarming level of antibiotics resistance. The reason is that there are no good guiding tools for defining the background reason of the infection. One main factor for the clearance of the infection is if there is non-obstructed ventilation from the sinus to the nasal cavity. Gas in Scattering Media Absorption Spectroscopy (GASMAS) has potential for diagnosing this. We have performed a study of frontal sinuses of volunteers with a focus on signal stability and reproducibility over time, accurate oxygen concentration determination, and assessment of gas transport through passages, naturally and after decongestant spray administration. Different from earlier studies on frontal sinuses, water vapor, serving the purpose of oxygen signal normalization, was measured at 818 nm rather than earlier at 937 nm, now closer to the 760 nm oxygen absorption band and thus resulting in more reliable results. In addition, the action of decongestants was objectively demonstrated for the first time. Evaluated oxygen concentration values for left- and right-hand side sinus cavities were found to agree within 0.3%, and a left-right geometrical asymmetry parameter related to anatomical differences was stable within 10%.

Random Lasing Detection of Mutant Huntingtin Expression in Cells.

Huntington's disease (HD) is an autosomal dominant, incurable neurodegenerative disease caused by mutation in the huntingtin gene (HTT). HTT mutation leads to protein misfolding and aggregation, which affect cells' functions and structural features. Because these changes might modify the scattering strength of affected cells, we propose that random lasing (RL) is an appropriate technique for detecting cells that express mutated HTT. To explore this hypothesis, we used a cell model of HD based on the expression of two different forms-pathogenic and non-pathogenic-of HTT. The RL signals from both cell profiles were compared. A multivariate statistical analysis of the RL signals based on the principal component analysis (PCA) and linear discriminant analysis (LDA) techniques revealed substantial differences between cells that expressed the pathogenic and the non-pathogenic forms of HTT.

[Raman spectroscopy and its application in different areas of medicine]. / Ramanovskaya spektroskopiya i ee primenenie v stomatologii.

The aim of the review is to learn about the areas of application of the Raman spectroscopy in medicine, particularly in dentistry. The method is widely used in biology, medicine, pharmacy, forensic science, gemology, food industry and other industries. The main advantages of Raman spectroscopy are no need for sample preparation and small amounts of the object of study, as well as the ability to contactlessly obtain unique information about the conformation and microenvironment of living cell molecules. The disadvantages are high costs of the equipment that are compensated with the long-term use by having no costs for additional reagents. The combinatorial scattering is used in dermatology, as it is a high-accuracy automated method of visualization and diagnostics of both benign growths as pigmented nevus, seborrheic keratosis, and malignant neoplasms as melanoma and basal cell carcinoma. This method is an analytical tool for diagnosing various diseases, making the direct measurements in hard and liquid media easier, does not require special treatment of samples and is not sensitive to absorption bands. The Raman spectroscopy use in dentistry allows diagnosing and comparative analysis of the changes of hard tissues of teeth and mucous membrane of the mouth, which improves security and rationalization of treatment and further prevention of complications before and after making different operations.

Structural validation of facial skin using optical coherence tomography: A descriptive study.

BACKGROUND: In this immediate ex vivo study, we aimed to identify the structures of normal and pathological facial skin using optical coherence tomography (OCT) and compared them to the gold standard histopathology. MATERIAL AND METHODS: A total of 53 patients, with 57 suspicious facial lesions, participated in this study. A set of variables have been highlighted by the pathologist to represent the minimum unique features that could be used to diagnose a skin pathology have been included in a checklist. One pathologist used this checklist while examining the histopathology slides and one clinician while examining the OCT images. The data from both checklists have been reviewed and compared. RESULTS: Optical coherence tomography's overall accuracy in diagnosing AK was 83%. Best accuracy was achieved in diagnosing BCC and was 97%, while it was 85% for cutaneous SCC. OCT failed to diagnose LM with an accuracy of 33.3% based on the two parameters of the pathology checklist, while it was 81% for malignant melanoma. CONCLUSION: This study proved the success of OCT in identifying structural changes in normal and pathological facial skin. Further studies to prove its usefulness in vivo are recommended.

Phenol-Formaldehyde Resin for Optical-Chemical Temperature Sensing.

The application of phenol-formaldehyde (PF) resin as an optical temperature sensor is investigated. Recent developments in optical luminescent sensors allow for global measurements to be made over the surface of a test article, extending beyond conventional point measurements. Global temperature distributions are particularly helpful when validating computational models or when mapping temperature over complex geometries, and can be used to calculate surface heat flux values. Temperature-sensitive paint (TSP) is a novel chemical approach to obtaining these global temperature measurements, but there are still challenges to overcome to make it a reliable tool. A sensor with a wide range of temperature sensitivity is desired to provide the maximum amount of utility, especially for tests spanning large temperature gradients. Naturally luminescent materials such as PF resin provide an attractive alternative to chemical sensor coatings, and PF resin is studied for this reason. Static tests of different PF resin samples are conducted using two binder materials to strengthen the material: cloth and paper. The material shows temperature sensitivities up to -0.8%/K, demonstrating the usefulness of PF resin as a temperature sensor.

Intraoperative assessment of laryngeal pathologies with optical coherence tomography integrated into a surgical microscope.

OBJECTIVE: Endoscopic examination followed by tissue biopsy is the gold standard in the evaluation of lesions of the upper aerodigestive tract. However, it can be difficult to distinguish between healthy mucosa, dysplasia, and invasive carcinoma. Optical coherence tomography (OCT) is a non-invasive technique which acquires high-resolution, cross-sectional images of tissue in vivo. Integrated into a surgical microscope, it allows the intraoperative evaluation of lesions simultaneously with microscopic visualization. STUDY DESIGN: In a prospective case series, we evaluated the use of OCT integrated into a surgical microscope during microlaryngoscopy to help differentiating various laryngeal pathologies. METHODS: 33 patients with laryngeal pathologies were examined with an OCT- microscope (OPMedT iOCT-camera, HS Hi-R 1000G-microscope, Haag-Streit Surgical GmbH, Wedel, Germany) during microlaryngoscopy. The suspected intraoperative diagnoses were compared to the histopathological reports of subsequent tissue biopsies. RESULTS: Hands-free non-contact OCT revealed high-resolution images of the larynx with a varying penetration depth of up to 1.2 mm and an average of 0.6 mm. Picture quality was variable. OCT showed disorders of horizontal tissue layering in dysplasias with a disruption of the basement membrane in carcinomas. When comparing the suspected diagnosis during OCT-supported microlaryngoscopy with histology, 79% of the laryngeal lesions could be correctly identified. Premalignant lesions were difficult to diagnose and falsely classified as carcinoma. CONCLUSION: OCT integrated into a surgical microscope seems to be a promising adjunct tool to discriminate pathologies of the upper aerodigestive tract intraoperatively. However, picture quality and penetration depth were variable. Although premalignant lesions were difficult to diagnose, the system proved overall helpful for the intraoperative discrimination of benign and malignant tumors. Further studies will be necessary to define its value in the future. Lasers Surg. Med. 49:490-497, 2017. © 2017 Wiley Periodicals, Inc.

Evaluation of the combined use of narrow band imaging and high-speed imaging to discriminate laryngeal lesions.

BACKGROUND AND OBJECTIVE: Laryngeal lesions are usually investigated by microlaryngoscopy, biopsy, and histopathology. This study aimed to evaluate the combined use of Narrow Band Imaging (NBI) and High-Speed Imaging (HSI) in the differentiation of glottic lesions in awake patients. STUDY DESIGN: Prospective diagnostic study. MATERIALS AND METHODS: Thirty-six awake patients with 41 glottic lesions were investigated with both NBI and HSI, and the suspected diagnoses were compared to the histopathological results of tissue biopsies taken during subsequent microlaryngoscopies. Of the 41 lesions, 28 were primary lesions and 13 recurrent lesions after previous laryngeal pathologies. RESULTS: Sensitivity, specificity, positive predictive value, and negative predictive value in the differentiation between benign/premalignant and malignant lesions with both NBI and HSI accounted to 100.0%, 79.4%, 50.0%, and 100.0%. Sensitivities and specificities were 100.0% and 85.7% for HSI alone, and 100.0% and 79.4% for NBI alone. Regarding only primary lesions the results were generally better with sensitivities and specificities of 100% and 81% for NBI, 100% and 84.2% for HSI and 100% and 85.7% for the combination of both methods, respectively. CONCLUSION: NBI and HSI both seem to be promising adjunct tools in the differentiation of various laryngeal lesions in awake patients with high sensitivities. Specificities, however, were moderate but could be increased when using NBI and HSI in combination in a subgroup of patients with only primary lesions. Although both methods still have limitations they might ameliorate the evaluation of suspicious laryngeal lesions in the future and could possibly spare patients from repeated invasive tissue biopsies. Lasers Surg. Med. 49:609-618, 2017. © 2017 Wiley Periodicals, Inc.

Optical diagnostic systems for assessing head and neck lesions.

Novel optical-based diagnostic systems are promising technologies that can be used in the clinic providing the clinician with an adjunct to histopathological assessment and facilitating rapid diagnosis for patients. Aided by the use of differing wavelengths of light, these systems are capable of detecting changes within tissues and provide immediate results. We reviewed the most common optical biopsy systems to detect oral and head and neck lesions and discussed their clinical applications.

Influence of nanosecond repetitively pulsed discharges on the stability of a swirled propane/air burner representative of an aeronautical combustor.

This paper reports on an experimental study of the influence of a nanosecond repetitively pulsed spark discharge on the stability domain of a propane/air flame. This flame is produced in a lean premixed swirled combustor representative of an aeronautical combustion chamber. The lean extinction limits of the flame produced without and with plasma are determined and compared. It appears that only a low mean discharge power is necessary to increase the flame stability domain. Lastly, the effects of several parameters (pulse repetition frequency, global flowrate, electrode location) are studied.

The combined use of serum Raman spectroscopy and D dimer testing for the early diagnosis of acute aortic dissection.

Objectives: Acute aortic dissection (AAD) is an extremely life-threatening medical emergency, often misdiagnosed in its early stages, resulting in prolonged wait times for rescue. This study aims to identify potential serum biomarkers that can assist in the accurate diagnosis of AAD and effectively differentiate it from other conditions causing severe chest pain. Methods: A total of 122 patients with AAD and 129 patients with other severe chest pain disorders were included in the study. Serum samples were analyzed by measuring the peak intensities of Raman spectra. For each measurement, the Raman spectrum was accumulated by two accumulations (3 s per acquisition). Logistic regression and nomogram models were developed using these peak intensities as well as D-dimer levels to predict the occurrence of AAD. The clinical utilities of these models were assessed through receiver operating characteristics (ROC) curve analysis, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA) in both training and internal test cohorts. Results: The D-dimer levels of AAD patients were significantly increased, as well as higher intensities at specific Raman peaks, including 505 cm-1, 842 cm-1, 947 cm-1, 1254 cm-1, 1448 cm-1, and 1655 cm-1 when compared to non-AAD patients. Conversely, decreased intensities were observed at Raman peaks such as 750 cm-1, 1004 cm-1, 1153 cm-1, 1208 cm-1, and 1514 cm-1 in AAD patients. Least absolute shrinkage and selection operator regression analysis on the training cohort identified eight potential predictors: D-dimer along with intensity measurements at peaks such as 505 cm-1, 750 cm-1, 1153 cm-1, 1208 cm-1, 1254 cm-1, 1448 cm-1, and 1655 cm-1. The combination of these eight potential predictors demonstrated a good discriminatory performance, with an area under the curve (AUC) value of 0.928 in the training cohort and an AUC of 0.936 in the internal test cohort, outperforming the use of D-dimer alone. Furthermore, DCA curve analysis revealed that leveraging this combination of eight potential predictors would provide substantial net benefits for clinical application. Moreover, this combination significantly augmented discrimination power, as evidenced by a continuous NRI of 39.8 % and IDI of 9.95 % in the training cohort, as well as a continuous NRI of 27.1 % and IDI of 9.95 % in the internal test cohort. Conclusions: The employment of this combination of eight potential predictors effectively rules out AAD to a greater extent. This study presents a promising diagnostic strategy for early detection using optical diagnostic techniques such as Raman spectroscopy.

Polarimetric imaging for cervical pre-cancer screening aided by machine learning: ex vivo studies.

Significance: Wide-field imaging Mueller polarimetry is an optical imaging technique that has great potential to become a reliable, fast, non-contact in vivo imaging modality for the early detection of, e.g., deceases and tissue structural malformations, such as cervical intraepithelial neoplasia, in both clinical and low-resource settings. On the other hand, machine learning methods have established themselves as a superior solution in image classification and regression tasks. We combine Mueller polarimetry and machine learning, critically assess the data/classification pipeline, investigate the bias arising from training strategies, and demonstrate how higher levels of detection accuracy can be achieved. Aim: We aim to automate/assist with diagnostic segmentation of polarimetric images of uterine cervix specimens. Approach: A comprehensive capture-to-classification pipeline is developed in house. Specimens are acquired and measured with imaging Mueller polarimeter and undergo histopathological classification. Subsequently, a labeled dataset is created within tagged regions of either healthy or neoplastic cervical tissues. Several machine learning methods are trained utilizing different training-test-set-split strategies, and their corresponding accuracies are compared. Results: Our results include robust measurements of model performance with two approaches: a 90:10 training-test-set-split and leave-one-out cross-validation. By comparing the classifier's accuracy directly with the ground truth obtained during histology analysis, we demonstrate how conventionally used shuffled split leads to an over-estimate of true classifier performance (0.964±0.00). The leave-one-out cross-validation, however, leads to more accurate performance (0.812±0.21) with respect to newly obtained samples that were not used to train the models. Conclusions: Combination of Mueller polarimetry and machine learning is a powerful tool for the task of screening for pre-cancerous conditions in cervical tissue sections. Nevertheless, there is a inherent bias with conventional processes that can be addressed using more conservative classifier training approaches. This results in overall improvements of the sensitivity and specificity of the developed techniques for "unseen" images.

Digital diaphanoscopy of maxillary sinus pathologies supported by machine learning.

Maxillary sinus pathologies remain among the most common ENT diseases requiring timely diagnosis for successful treatment. Standard ENT inspection approaches indicate low sensitivity in detecting maxillary sinus pathologies. In this paper, we report on capabilities of digital diaphanoscopy combined with machine learning tools in the detection of such pathologies. We provide a comparative analysis of two machine learning approaches applied to digital diapahnoscopy data, namely, convolutional neural networks and linear discriminant analysis. The sensitivity and specificity values obtained for both employed approaches exceed the reported accuracy indicators for traditional screening diagnosis methods (such as nasal endoscopy or ultrasound), suggesting the prospects of their usage for screening maxillary sinuses alterations. The analysis of the obtained values showed that the linear discriminant analysis, being a simpler approach as compared to neural networks, allows one to detect the maxillary sinus pathologies with the sensitivity and specificity of 0.88 and 0.98, respectively.

Simulated assessment of light transport through ischaemic skin flaps.

Currently, free flaps and pedicled flaps are assessed for reperfusion in postoperative care using colour, capillary refill, temperature, texture, and Doppler signal (if available). While these techniques are effective, they are prone to error due to their qualitative nature. In this research, different wavelengths of light were used to quantify the response of ischaemic tissue. The assessment provides indicators that are key to developing a point-of-care diagnostic device that is capable of observing reduced perfusion quantitatively. Detailed optical models of the layers of the skin were set up and appropriate optical properties assigned, with due consideration of melanin and haemoglobin concentration. A total of 24 models of healthy, perfused and perfusion-deprived tissue were used to assess the responses when illuminated with visible and near-infrared wavelengths of light. In addition to detailed fluence maps of photon propagation, a simple mathematical model is proposed to assess the differential propagation of photons in tissue; the optical reperfusion factor (ORF). The results show clear advantages of using light at longer wavelengths (red, near-infrared) and the inferences drawn from the simulations hold significant clinical relevance. The simulated scenarios and results consolidate the belief in a multi-wavelength, point-of-care diagnostic device, and inform its design to quantify blood flow in transplanted tissue. The modelling approach is applicable beyond the current research and can be used to investigate other medical conditions in the skin that can be mathematically represented. Through these, additional inferences and approaches to other point-of-care devices can be realised.

Insights into Biochemical Sources and Diffuse Reflectance Spectral Features for Colorectal Cancer Detection and Localization.

Colorectal cancer (CRC) is the third most common and second most deadly type of cancer worldwide. Early detection not only reduces mortality but also improves patient prognosis by allowing the use of minimally invasive techniques to remove cancer while avoiding major surgery. Expanding the use of microsurgical techniques requires accurate diagnosis and delineation of the tumor margins in order to allow complete excision of cancer. We have used diffuse reflectance spectroscopy (DRS) to identify the main optical CRC biomarkers and to optimize parameters for the integration of such technologies into medical devices. A total number of 2889 diffuse reflectance spectra were collected in ex vivo specimens from 47 patients. Short source-detector distance (SDD) and long-SDD fiber-optic probes were employed to measure tissue layers from 0.5 to 1 mm and from 0.5 to 1.9 mm deep, respectively. The most important biomolecules contributing to differentiating DRS between tissue types were oxy- and deoxy-hemoglobin (Hb and HbO2), followed by water and lipid. Accurate tissue classification and potential DRS device miniaturization using Hb, HbO2, lipid and water data were achieved particularly well within the wavelength ranges 350-590 nm and 600-1230 nm for the short-SDD probe, and 380-400 nm, 420-610 nm, and 650-950 nm for the long-SDD probe.