Subsurface probing of calcifications with spatially offset Raman spectroscopy (SORS): future possibilities for the diagnosis of breast cancer

Breast calcifications are often the only mammographic features indicating the presence of a cancerous lesion. Calcium oxalate (type I) may be found in and around benign lesions, however calcium hydroxyapatite (type II) is usually found within proliferative lesions, which can include both benign and malignant pathologies. However, the composition of type II calcifications has been demonstrated to vary between benign and malignant proliferative lesions, and could be an indicator for the possible disease state. Raman spectroscopy has previously been demonstrated as a powerful tool for non-destructive analysis of tissues, utilising laser light to probe chemical composition. Raman spectroscopy is traditionally a surface technique. However, we have recently developed methods that permit its application for obtaining sample composition to clinically relevant depths of many mm. We report the first demonstration of spatially offset Raman spectroscopy (SORS) for potential in vivo breast analysis. This study evaluates the possibility of utilising SORS for measuring calcification composition through varying thicknesses of tissues (2 to 10 mm), which is about one to two orders of magnitude deeper than has been possible with conventional Raman approaches. SORS can be used to distinguish non-invasively between calcification types I and II (and carbonate substitution of phosphate in calcium hydroxyapatite) within tissue of up to 10 mm deep. This result secures the first step in taking this technique forward for clinical applications seeking to use Raman spectroscopy as an adjunct to mammography for early diagnosis of breast cancer, by utilising both soft tissue and calcification signals. Non-invasive elucidation of calcification composition, and hence type, associated with benign or malignant lesions, could eliminate the requirement for biopsy in many patients.     

Towards a safe non-invasive method for evaluating the carbonate substitution levels of hydroxyapatite (HAP) in micro-calcifications found in breast tissue

A new diagnostic concept based on deep Raman spectroscopy is proposed permitting the non-invasive determination of the level of carbonate substitution in type II calcifications (HAP). The carbonate substitution has shown to be directly associated with the pathology of the surrounding breast tissue and different pathology groups can therefore be separated using specific features in the Raman spectra of the calcifications. This study explores the principle of distinguishing between type II calcifications, found in proliferating lesions, by using the strongest Raman peak from calcium hydroxyapatites (the phosphate peak at 960 cm(-1)) to act as a surrogate marker for carbonate substitution levels. It is believed that carbonate ion substitution leads to a perturbation of the hydroxyapatite lattice which in turn affects the phosphate vibrational modes. By studying calcifications, with known carbonate content, buried in porcine tissue it has been possible to evaluate the feasibility of using the proposed approach to probe the composition of the calcifications in vivo and hence provide pathology specific information non-invasively, in real time. Using the proposed concept we were able to determine the level of carbonate substitutions through soft tissue phantom samples (total thickness of 5.6 mm). As the level of carbonate substitution has been previously correlated with mid-FTIR to the lesion type, i.e. whether benign or invasive or in situ carcinoma, the new findings provide a major step forward towards establishing a new capability for diagnosing benign and malignant lesions in breast tissue in a safe and non-invasive manner in vivo.     

Raman, fluorescence, and time-resolved light scattering as optical diagnostic techniques to separate diseased and normal biomedical media.

Studies of Raman scattering, fluorescence and time-resolved light scattering were conducted on cancer and normal biomedical media. Fourier transform Raman spectroscopic measurements were performed on human normal, benign and cancerous tissues from gynecological (GYN) tracts. A comparison of the intensity differences between various Raman modes as well as the number of Raman lines, enables one to distinguish normal GYN tissues from diseased tissues. Fluorescence spectroscopic measurements on human breast tissues show that the ratio of fluorescence intensity at 340 nm to that at 440 nm can be used to distinguish between cancerous and non-cancerous tissues. Separate studies on normal and cancerous breast cell lines show spectral differences. The measurements of back-scattered ultrafast laser pulses from human breast tissues show differences in the scattered pulse profiles for different tissues. These studies show that various optical techniques have the potential to be used in medical diagnostic applications.     

Raman endoscopy for in vivo differentiation between benign and malignant ulcers in the stomach

The aim of this study was to evaluate the clinical utility of an image-guided Raman endoscopy technique for in vivo differential diagnosis of benign and malignant ulcerous lesions in the stomach. A rapid-acquisition image-guided Raman endoscopy system with 785 nm laser excitation has been developed to acquire in vivo gastric tissue Raman spectra within 0.5 s during clinical gastroscopic examinations. A total of 1102 in vivo Raman spectra were acquired from 71 gastric patients, in which 924 Raman spectra were from normal tissue, 111 Raman spectra were from benign ulcers whereas 67 Raman spectra were from ulcerated adenocarcinoma. There were distinctive spectral differences in Raman spectra among normal mucosa, benign ulcers and malignant ulcers, particularly in the spectral ranges of 800-900, 1000-1100, 1245-1335, 1440-1450 and 1500-1800 cm(-1), which primarily contain signals related to proteins, DNA, lipids and blood. The malignant ulcerous lesions showed Raman signals to be mainly associated with abnormal nuclear activity and decrease in lipids as compared to benign ulcers. Partial least squares-discriminant analysis (PLS-DA) was employed to generate multi-class diagnostic algorithms for classification of Raman spectra of different gastric tissue types. The PLS-DA algorithms together with leave-one tissue site-out, cross validation technique yielded diagnostic sensitivities of 90.8%, 84.7%, 82.1%, and specificities of 93.8%, 94.5%, 95.3%, respectively, for classification of normal mucosa, benign and malignant ulcerous lesions in the stomach. This work demonstrates that image-guided Raman endoscopy technique associated with PLS-DA diagnostic algorithms has for the first time promising clinical potential for rapid, in vivo diagnosis and detection of malignant ulcerous gastric lesions at the molecular level.     

Raman spectroscopic studies of CO2 laser-irradiated human dental enamel.

While the effects of carbon dioxide (CO2) laser radiation on the physical properties of human dental enamel are well characterized, little is known regarding laser-induced chemical changes. In this study, enamel was exposed to CO2 laser radiation to induce fusion and recrystallization, and the Raman spectra recorded using both dispersive and Fourier-transformed (FT) Raman spectroscopy. Spectra were compared to a heart-treated specimen of hydroxyapatite (HAP) and enamel. Laser irradiation induced chemical changes which differed from those induced by heat treatment. Comparing the Raman spectra of lased enamel to HAP and tricalcium phosphate (TCP), it is evident that CO2 laser irradiation of enamel causes the partial conversion of HAP to TCP. The effect of laser irradiation is not merely a simple local heating effect as previously thought, since simple heating of enamel leads to the formation of both TCP and Ca(OH)2, while laser treatment of enamel results in the formation of TCP but not Ca(OH)2.     

Evaluation of Raman probe for oesophageal cancer diagnostics

Early detection of (pre-)cancerous changes improves prognosis, therefore in the UK patients at high risk of developing gastrointestinal cancers are enrolled on endoscopic surveillance programmes or the Bowel Cancer Screening Programme. The current gold standard technique for the detection of pre-cancerous changes in the gastrointestinal tract is histopathological analysis of biopsy tissue collected at endoscopy. This relies upon subjective assessment of morphological changes within the excised tissue samples and poor targeting of pre-malignant lesions. Raman spectroscopy offers a number of potential advantages for in vivo assessment of tissue at endoscopy. The performance of a custom built Raman probe as a biopsy targeting tool has been evaluated using excised biopsy material. Multivariate classification models have been used to demonstrate the likely ability of a miniature, confocal, fibre optic Raman probe to be used as an optical biopsy tool at endoscopy to provide spectral information in clinically practicable timescales. This technique could facilitate improved targeting of excisional biopsy with associated clinical benefits.     

基于稳健统计的新鲜乳腺组织拉曼光谱分析

采用便携式拉曼光谱仪对新鲜乳腺正常组织、良性组织和恶性组织进行检测,通过稳健统计方法对拉曼光谱数据进行分析处理,建立乳腺组织拉曼光谱标准图谱,根据标准图谱特征峰归纳3类组织的主要区别和特征.在3类乳腺组织中,正常组织有明显的脂类特征峰(1078,1297,1437,1653,1746 cm-1),而在良性和恶性组织中则出现了较明显的蛋白特征峰(1259,1530,1650 cm-1),正常、良性和恶性组织的主要区别集中在1340和1534 cm-1处,应归属为蛋白和类胡萝卜素,这一结果并不能由经典统计方法得出.基于稳健统计建立的新鲜乳腺组织拉曼光谱标准图谱为构建数学模型来鉴别乳腺病灶的性质奠定了基础.     

傅里叶变换红外光谱法用于体表无创性检测乳腺肿瘤的研究

乳腺肿瘤是女性常见的疾病之一,其中乳腺癌的发病率在女性恶性肿瘤中占首位,并且发病率呈不断增加的趋势,严重危害妇女的身体健康．乳腺癌的早期诊断和治疗是提高乳腺癌患者整体生存率的关键．目前大多采用传统的X线、超声、CT和核磁共振等技术进行影像诊断,这些诊断方法需要等到肿块形成具有占位效应时才能检测出来．而振动光谱法是分子结构变化的灵敏探针,它在癌症形成的初级阶段即可观察到分子结构的改变,因此傅里叶变换中红外光谱技术有可能发展成为一种无损伤、快速和方便的肿瘤早期诊断方法．     

对比增强能谱乳腺X线摄影在致密型乳腺疾病中的诊断价值

为了对比分析对比增强能谱乳腺X线摄影(contrast enhanced specral mammography,CESM)与全视野数字化乳腺X线摄影(full-field digital mammography,FFDM)在致密型乳腺疾病中的诊断价值,回顾性分析了2017年3月~2018年12月在我院乳腺外科就诊并经病理证实的137例患者。所有患者乳腺纤维腺体均为致密型,且在一周内行FFDM和CESM两种检查,以病理结果为金标准,计算了两种检查方法诊断致密型乳腺疾病的敏感度、特异度、阳性预测值、阴性预测值和准确率,采用卡方检验比较了FFDM与CESM在致密型乳腺疾病中的诊断效能。结果显示,137例患者经病理证实共检出140个病灶,其中良性病灶105个、恶性病灶35个。CESM诊断致密型乳腺疾病的特异度、阳性预测率和准确率均高于FFDM(P<0.05)。总之,与FFDM比较,CESM对致密型乳腺疾病的诊断效能较高。     

3.0T MRI检查结合X线钼靶诊断乳腺恶性肿瘤的研究

本研究探讨3.0T磁共振成像(MRI)结合X线钼靶诊断乳腺恶性肿瘤的价值。采用回顾性研究方法,选取乳腺肿块患者110例162个病灶,给予3.0T MRI及X线钼靶检查。经病理确诊为恶性病变101个;恶性病灶形态不规则、边缘毛刺、时间-信号强度曲线(TIC)类型Ⅲ型和早期增强率≥60%比例明显高于良性病灶(P<0.05),而分叶状比例和表观扩散系数(ADC)值明显低于良性病变(P<0.05);恶性病变X线钼靶表现:形态不规则、钙化、结构不对称和大导管征比例明显高于良性病变(P<0.05);MRI联合X线钼靶诊断乳腺恶性病变的灵敏性、准确性和阴性预测值明显高于MRI诊断(P<0.05)。3.0T MRI检查结合X线钼靶诊断乳腺恶性肿瘤有较好的价值。     

High-wavenumber FT-Raman spectroscopy for in vivo and ex vivo measurements of breast cancer

The identification of normal and cancer breast tissue of rats was investigated using high-frequency (HF) FT-Raman spectroscopy with a near-infrared excitation source on in vivo and ex vivo measurements. Significant differences in the Raman intensities of prominent Raman bands of lipids and proteins structures (2,800?C3,100?cm^?1) as well as in the broad band of water (3,100?C3,550?cm^?1) were observed in mean normal and cancer tissue spectra. The multivariate statistical analysis methods of principal components analysis (PCA) and linear discriminant analysis (LDA) were performed on all high-frequency Raman spectra of normal and cancer tissues. LDA results with the leave-one-out cross-validation option yielded a discrimination accuracy of 77.2, 83.3, and 100% for in vivo transcutaneous, in vivo skin-removed, and ex vivo biopsy HF Raman spectra. Despite the lower discrimination value for the in vivo transcutaneous measurements, which could be explained by the breathing movement and skin influences, our results showed good accuracy in discriminating between normal and cancer breast tissue samples. To support this, the calculated integration areas from the receiver-operating characteristic (ROC) curve yielded 0.86, 0.94, and 1.0 for in vivo transcutaneous, in vivo skin-removed, and ex vivo biopsy measurements, respectively. The feasibility of using HF Raman spectroscopy as a clinical diagnostic tool for breast cancer detection and monitoring is due to no interfering contribution from the optical fiber in the HF Raman region, the shorter acquisition time due to a more intense signal in the HF Raman region, and the ability to distinguish between normal and cancerous tissues.     

A biospectroscopic interrogation of fine needle aspirates points towards segregation between graded categories: an initial study towards diagnostic screening

Fine needle aspirates (FNAs) of suspicious breast lesions are often used to aid the diagnosis of female breast cancer. Biospectroscopy tools facilitate the acquisition of a biochemical cell fingerprint representative of chemical bonds present in a biological sample. The mid-infrared (IR; 4,000–400 cm⁻¹) is absorbed by the chemical bonds present, allowing one to derive an absorbance spectrum. Complementary to IR spectroscopy, Raman spectroscopy measures the scattering by chemical bonds following excitation by a laser to generate an intensity spectrum. Our objective was to apply these methods to determine whether a biospectroscopy approach could objectively segregate different categories of FNAs. FNAs of breast tissue were collected (n = 48) in a preservative solution and graded into categories by a cytologist as C1 (non-diagnostic), C2 (benign), C3 (suspicious, probably benign) or C5 (malignant) [or C4 (suspicious, probably malignant); no samples falling within this category were identified during the collection period of the study]. Following washing, the cellular material was transferred onto BaF₂ (IR-transparent) slides for interrogation by Raman or Fourier-transform IR (FTIR) microspectroscopy. In some cases where sufficient material was obtained, this was transferred to low-E (IR-reflective) glass slides for attenuated total reflection–FTIR spectroscopy. The spectral datasets produced from these techniques required multivariate analysis for data handling. Principal component analysis followed by linear discriminant analysis was performed independently on each of the spectral datasets for only C2, C3 and C5. The resulting scores plots revealed a marked overlap of C2 with C3 and C5, although the latter pair were both significantly segregated (P < 0.001) in the Raman spectra. Good separation was observed between C3 and C5 in all three spectral datasets. Analysis performed on the average spectra showed the presence of three distinct cytological groups. Our findings suggest that biospectroscopy tools coupled with multivariate analysis may support the current FNA tests whilst increasing the sensitivity and associated reliability for improved diagnostics.     

Raman spectroscopy and imaging: applications in human breast cancer diagnosis

The applications of spectroscopic methods in cancer detection open new possibilities in early stage diagnostics. Raman spectroscopy and Raman imaging represent novel and rapidly developing tools in cancer diagnosis. In the study described in this paper Raman spectroscopy has been employed to examine noncancerous and cancerous human breast tissues of the same patient. The most significant differences between noncancerous and cancerous tissues were found in regions characteristic for the vibrations of carotenoids, lipids and proteins. Particular attention was paid to the role played by unsaturated fatty acids in the differentiation between the noncancerous and the cancerous tissues. Comparison of Raman spectra of the noncancerous and the cancerous tissues with the spectra of oleic, linoleic, α-linolenic, γ-linolenic, docosahexaenoic and eicosapentaenoic acids has been presented. The role of sample preparation in the determination of cancer markers is also discussed in this study.     

Polymer-capped fiber-optic Raman probe for non-invasive Raman spectroscopy

Advances in fiber optic probe design are moving Raman spectroscopy into the clinic, although there remain important practical problems. While much effort has been devoted to minimizing Raman and fluorescence background from fibers, less attention has been given to the need to generate reference Raman signals that can correct for variations in tissue albedo, which is important in quantifying changes in tissue composition. To address this shortcoming, we have developed a fiber optic probe that incorporates a fluorinated ethylene-propylene copolymer (FEP) cap at the end of each excitation fiber. Transmission of laser light through the transparent cap generates a 732 cm(-1) Raman band whose intensity scales linearly with the laser power delivered to the tissue of interest. In our first design, the FEP cap functions as a waveguide with only a small insertion loss (~5%). Laser transmission through 1 mm of the polymer is sufficient to generate a usable reference Raman signal. We show the application of the probe to quantitative non-invasive Raman spectroscopy of animal tissues using rat leg phantoms as models. Ex-vivo Raman spectroscopy of excised rat tibia supports the use of the probe for spectroscopy of various tissues. These results provide proof of principle that the Raman probe can be used in multiple spectroscopic applications.     

Intra-operative optical diagnostics with vibrational spectroscopy

Established methods for characterization of tissue and diagnostics, for example histochemistry, magnetic resonance imaging (MRI), X-ray tomography, or positron emission tomography (PET), are mostly not suitable for intra-operative use. However, there is a clear need for an intra-operative diagnostics especially to identify the borderline between normal and tumor tissue. Currently, vibrational spectroscopy techniques (both Raman and infrared) complement the standard methods for tissue diagnostics. Vibrational spectroscopy has the potential for intra-operative use, because it can provide a biochemically based profile of tissue in real time and without requiring additional contrast agents, which may perturb the tissue under investigation. In addition, no electric potential needs to be applied, and the measurements are not affected by electromagnetic fields. Currently, promising approaches include Raman fiber techniques and nonlinear Raman spectroscopy. Infrared spectroscopy is also being used to examine freshly resected tissue ex vivo in the operating theater. The immense volume of information contained in Raman and infrared spectra requires multivariate analysis to extract relevant information to distinguish different types of tissue. The promise and limitations of vibrational spectroscopy methods as intra-operative tools are surveyed in this review.     

Raman Spectroscopy and Fluorescence Photon Migration for Breast Cancer Diagnosis and Imaging

We are developing optical methods based on near infra-red Raman spectroscopy and fluorescence photon migration for diagnosis and localization of breast cancer. We demonstrate the ability of Raman spectroscopy to classify accurately normal, benign and malignant breast tissues, an important step in developing Raman spectroscopic needle probes as a tool for improving the accuracy of needle biopsy. We also show that photon migration imaging can be used to localize accurately small fluorescent objects imbedded in a thick turbid medium with realistic optical properties, thus demonstrating the potential of this technique for optical imaging.     

Near-Infrared Raman Spectroscopy for In Vitro Detection of Cervical Precancers

Abstract— In this study, we investigate the potential of near-infrared Raman spectroscopy to differentiate cervical precancers from normal tissues, inflammation and metaplasia and to differentially diagnose low-grade and high-grade precancers. Near infrared Raman spectra were measured from 36 biopsies from 18 patients in vitro. Detection algorithms were developed and evaluated relative to histopathologic examination. Algorithms based on empirically selected peak intensities, ratios of peak intensities and a combination of principal component analysis for data reduction and Fisher discriminant analysis for classification were investigated. Spectral peaks were tentatively identified from measured spectra of potential chromophores. Empirically selected normalized intensities can differentiate precancers from other tissues with an average sensitivity and specificity of 88 ± 4% and 92 ± 4%. Ratios of un-normalized intensities can differentiate precancers from other tissues with a sensitivity and specificity of 82% and 88% and high-grade from low-grade lesions with a sensitivity and specificity of 100%. Using multivariate methods, intensities at eight frequencies can be used to differentiate precancers from all other tissues with a sensitivity and specificity of 82% and 92% in an unbiased test. Raman algorithms can potentially separate benign abnormalities such as inflammation and metaplasia from precancers. Comparison of tissue spectra to published and measured chromophore spectra indicate that the most likely primary contributors to the tissue spectra are collagen, nucleic acids, phospholipids and glucose 1-phos-phate. These results suggest that near-infrared Raman spectroscopy can be used for cervical precancer diagnosis and may be able to accurately separate samples with inflammation and metaplasia from precancer.     

Distinctive Molecular Abnormalities in Benign and Malignant Skin Lesions: Studies by Raman Spectroscopy

Abstract— Near-infrared Fourier transform Raman spectroscopy is an analytical, nondestructive technique that provides information about the molecular structure of the investigated sample. The molecular structure of proteins and lipids differs between neoplastic and normal tissues and therefore Raman spectroscopy has been considered promising for the diagnosis of cancer. We aimed to compare the molecular structure of normal skin, benign and malignant skin lesions by the near-infrared Fourier transform Raman spectroscopy. Biopsies were obtained from the following skin lesions: skin tag, dermatofibroma, seborrhoeic keratosis, actinic keratosis, keratoacan-thoma, basal cell carcinoma, squamous cell carcinoma, nevus intradermal, nevus compositus, dysplastic nevus and lentigo maligna. Control skin was harvested from the vicinity of these lesions. In the Raman spectra, the secondary structure of the proteins was reflected by the amide vibrations of peptide bonds. The principal lipid vibrations were twisting and wagging (CH₂) and CH stretching vibrations. Histologically distinguishable lesions showed specific combinations of band changes indicating alterations in the protein conformation and in the molecular structure of the lipids. Histogenetically related lesions (actinic keratosis and sqamous cell carcinoma) produced similar but not identical patterns of spectral changes. Because the examined skin lesions produced reproducible and unique spectra, we suggest that Raman spectroscopy will be useful for diagnosis of skin lesions.     

Investigation of skin and skin lesions by NIR-FT-Raman spectroscopy

There is a vast demand for in vivo methods for the detection of skin cancer, one of the most dangerous skin lesions. Use of near infrared Fourier transform (NIR-FT)-Raman spectroscopy virtually eliminates the fluorescence of the normal cell constituents and provides a signal to noise ratio, r _SN, large enough to successfully evaluate the spectra using chemometric methods. A novel fiber optic probe for NIR-FT-Raman spectroscopy was used, which allows sterilization and the prevention of hazards due to laser radiation and makes in vivo measurements possible. The Raman spectra of normal skin are dominated by the connective tissue, mainly collagen type I. The Raman spectra of skin with inflammatory diseases show an increased lipid and water content. Kaposi sarcomas show typical features of tumors mainly in the amide III and the protein backbone range. A clear separation of Raman spectra of normal skin from those of benign and malignant neoplasms can be achieved by cluster analysis. However, the unequivocal diagnosis of skin cancer needs investigation of a larger number of more defined skin samples, taking into consideration the concurrent appearance of different skin symptoms like coloring and inflammation. Received: 25 July 1997 / Revised: 16 September 1997 / Accepted: 20 September 1997     

Raman Imaging: An Impending Approach Towards Cancer Diagnosis

In accordance with the recent studies, Raman spectroscopy is well experimented as a highly sensitive analytical and imaging technique in biomedical research, mainly for various disease diagnosis including cancer. In comparison with other imaging modalities, Raman spectroscopy facilitate numerous assistances owing to its low background signal, immense spatial resolution, high chemical specificity, multiplexing capability, excellent photo stability and non-invasive detection capability. In cancer diagnosis Raman imaging intervened as a promising investigative tool to provide molecular level information to differentiate the cancerous vs non-cancerous cells, tissues and even in body fluids. Anciently, spontaneous Raman scattering is very feeble due to its low signal intensity and long acquisition time but new advanced techniques like coherent Raman scattering (CRS) and surface enhanced Raman scattering (SERS) gradually superseded these issues. So, the present review focuses on the recent developments and applications of Raman spectroscopy-based imaging techniques for cancer diagnosis.