Spectroscopic diagnosis and imaging of invisible pre-cancer
Spectroscopic diagnosis and imaging of invisible pre-cancer
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DOI：
10.1039/b305410a
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发表时间：
2004-01-01
影响因子：
3.4
通讯作者：
Feld, MS
中科院分区：
文献类型：
--
作者：
Badizadegan, K;Backman, V;Feld, MS
本文的主题是使用光谱学来诊断接受内窥镜检查和类似医疗程序的患者中不可见的癌前病变。我们描述了三种技术，提供诊断信息和两种仪器来实现它们，FastEEM研究小区域的组织和LSS（光散射光谱）成像系统的广域监视。FastEEM是一种光纤临床设备，可在几分之一秒内收集来自组织的多个激发波长的反射光和荧光光谱。在真实的时间内获得定量信息，而不需要去除组织，也不需要染色和固定。三种类型的光谱信息提取-固有荧光，漫反射和弹性光散射。三种分析中的每一种都基于生物物理模型，并且每一种都提供关于细胞/组织结构的补充定量物理和化学信息。这些信息用于进行组合光谱诊断，我们称之为三模态光谱（TMS）的方法。正在对接受口腔、子宫颈和胃肠道癌前常规监测的患者进行有希望的临床研究。LSS成像系统提供上皮的广域光谱图像，通常每个维度为2 cm，描绘细胞核的大小分布和染色质含量，这是诊断癌前病变的关键参数。该仪器处于临床前开发阶段，尽管实验室原型已用于在切除的结肠息肉样本中创建诊断图像。TMS/FastEEM和LSS成像仪器的组合将构成一种强大的新诊断工具，LSS成像提供广域监视，TMS探头提供可疑组织部位的详细信息。
The theme of this paper is the use of optical spectroscopy to diagnose invisible pre-cancer in patients undergoing endoscopy and similar medical procedures. We describe three techniques that provide diagnostic information and two instruments to implement them, the FastEEM for studying small regions of tissue and the LSS ( light scattering spectroscopy) imaging system for wide-area surveillance. The FastEEM is an optical fiber clinical device that collects spectra of reflected light and fluorescence at multiple excitation wavelengths from the tissue, all in a fraction of a second. Quantitative information is obtained in real time, without removing the tissue and without the need for staining and fixation. Three types of spectral information are extracted - intrinsic fluorescence, diffuse reflectance and elastic light scattering. Each of the three analyses is based on a biophysical model, and each provides complementary quantitative physical and chemical information about cellular/tissue structures. This information is used to make a combined spectral diagnosis, a method we call tri-modal spectroscopy (TMS). Promising clinical studies are being carried out on patients undergoing routine pre-cancer surveillance in the oral cavity, the uterine cervix and the gastrointestinal tract. The LSS imaging system provides wide-area spectroscopic images of the epithelium, typically 2 cm in each dimension, depicting the size distribution and chromatin content of the cell nuclei, which are key parameters in diagnosing pre-cancer. This instrument is in preclinical stages of development, although a laboratory prototype has been used to create diagnostic images in resected colon polyp samples. The combination of the TMS/FastEEM and LSS imaging instrument will constitute a powerful new diagnostic tool, with LSS imaging to provide wide area surveillance and the TMS probe to provide detailed information on suspect tissue sites.