Clinical instrumentation and applications of Raman spectroscopy.
Clinical instrumentation and applications of Raman spectroscopy.
复制标题
DOI：
10.1039/c5cs00581g
复制
发表时间：
2016-04-07
影响因子：
46.2
通讯作者：
Mahadevan-Jansen A
中科院分区：
文献类型：
--
作者：
Pence I;Mahadevan-Jansen A
临床诊断设备提供了新的信息来源，这些信息提供了有关健康状况的见解，然后可以用于管理患者护理。这些工具可以像耳镜一样简单，以更好地观察耳道，也可以像无线胶囊内窥镜一样复杂，以监测胃肠道。有了这些工具，医生就可以确定病人何时健康，并在病人不健康时作出适当的诊断。诊断医学的目标是有效地确定疾病的存在和原因，以便提供最适当的干预措施。最早的医学诊断形式依赖于眼睛直接观察光与样品的相互作用。希波克拉底在他公元前世纪的著作《传染病》中支持这种技术，在这部著作中，病人皮肤的苍白和体液的颜色可能是健康的标志。在过去的一百年里，医学诊断已经从依赖于视觉检查转向依赖于许多技术工具，这些技术工具基于样品与不同类型的能量-光，超声波，无线电波，X射线等的各种类型的相互作用。光学方法一直专注于提供微米到毫米尺度的信息，而超声波，X射线和无线电波一直是帮助毫米到厘米尺度的关键。虽然一些光学技术已经达到了医疗仪器的地位，但尽管许多研究人员在将这些方法转化为临床护理方面做出了不懈的努力，但许多技术仍处于研究和开发阶段。其中，拉曼光谱学被描述为一种灵敏的方法，其可以提供关于组织状态的生化信息，同时保持以实时、非侵入性和自动化方式递送该信息的能力。本综述介绍了与拉曼光谱的临床应用相关的各种仪器考虑，并回顾了一组有趣的应用，这些应用已成功证明了该技术在大型（n ≥ 50）体内人体研究中用于临床诊断和监测的有效性。
Clinical diagnostic devices provide new sources of information that give insight about the state of health which can then be used to manage patient care. These tools can be as simple as an otoscope to better visualize the ear canal or as complex as a wireless capsule endoscope to monitor the gastrointestinal tract. It is with tools such as these that medical practitioners can determine when a patient is healthy and to make an appropriate diagnosis when he/she is not. The goal of diagnostic medicine then is to efficiently determine the presence and cause of disease in order to provide the most appropriate intervention. The earliest form of medical diagnostics relied on the eye – direct visual observation of the interaction of light with the sample. This technique was espoused by Hippocrates in his 5th century BCE work Epidemics, in which the pallor of a patient’s skin and the coloring of the bodily fluids could be indicative of health. In the last hundred years, medical diagnosis has moved from relying on visual inspection to relying on numerous technological tools that are based on various types of interaction of the sample with different types of energy – light, ultrasound, radio waves, X-rays etc. Modern advances in science and technology have depended on enhancing technologies for the detection of these interactions for improved visualization of human health. Optical methods have been focused on providing this information in the micron to millimeter scale while ultrasound, X-ray, and radio waves have been key in aiding in the millimeter to centimeter scale. While a few optical technologies have achieved the status of medical instruments, many remain in the research and development phase despite persistent efforts by many researchers in the translation of these methods for clinical care. Of these, Raman spectroscopy has been described as a sensitive method that can provide biochemical information about tissue state while maintaining the capability of delivering this information in real-time, non-invasively, and in an automated manner. This review presents the various instrumentation considerations relevant to the clinical implementation of Raman spectroscopy and reviews a subset of interesting applications that have successfully demonstrated the efficacy of this technique for clinical diagnostics and monitoring in large (n ≥ 50) in vivo human studies.