NONINVASIVE MEDICAL
SPECTROPHOTOMETRY:
MEDICAL ASPECTS AND SOME OUR RESULTS BY 2012
Key points: In accordance with the used general physical principles of optical noninvasive medical diagnostics (ONMD) in noninvasive medical spectrophotometry (NMS, see also Noninvasive optical and laser medical diagnostics) the object of the medical investigation consists in evaluation of biochemical composition of human tissues including tissues' peripheral blood and lymph supply. The most easily "in vivo" detected by the optical technique biochemical components in tissues are: water, melanin, different fractions of hemoglobin (oxyhemoglobin, deoxyhemoglobin, etc.), lipids, porphyrins as well as flavins and some other organic molecules. A lot of dynamic fluctuations in peripheral blood microcirculation processes at a short scale of time allow a doctor to observe analogous fluctuations in registered concentration of one or another biochemical components that makes it possible to diagnosis a functional specialties of tissues' and vessels' clinical state (status, conditions). The changes in registered parameters at a long scale of time allow a doctor to quantitatively study the efficacy of applied treatment procedures and tendencies in a patient's health.
Basing on that it is possible today to determine a number of medical & biological parameters of the peripheral tissues’ blood microcirculation - blood flow and perfusion, low-frequency rhythms of the microcirculatory processes regulation, some parameters of oxygen utilization in the tissue, etc. This technology allows a doctor to have a powerful, simple and convenient tool for monitoring and identifying some different destructive-inflammatory, tumorous, erosive-ulcerative impairments and processes in tissues and organs, for estimating some functional parameters of vessels and, even, of a vegetative nervous system in a total. For example, the noninvasive spectrophotometric technique allows a doctor to identify quickly a type of blood microcirculation in a tissue with the use of conventional functional tests (the tests with functional loading on the microcirculatory bedside), for instance - tests with occlusion. With the use of our reflectance oximeter "Spectrotest" it was shown in 2003 [6] that there are various physiological rhythms in the StO2 parameter like ones exist in blood perfusion which are measured by Laser Doppler Flowmetry technique. So, the noninvasive spectrophotometry can be used in different areas of the modern medicine: surgery, oncology, urology, dermatology, radiology, gynecology, etc. for a purpose of better understanding of the basic pathophysiological aspects of diseases. It gives for a doctor a lot of additional information about the patient without the use of any invasive, expensive and long-time laboratory tests.
One of the most perspective area of applications of this diagnostic technique is the oncology. For oncology the overwhelming majority of the research and publications is concentrated now on a problem of the differential diagnosis of the normal and malignant tissues for different localizations and clinical forms of the young cancers. In our research we didn't obtain such promising results, but, meanwhile, in our opinion the noninvasive optical spectrophotometry can have high possibilities in monitoring the efficiency of different methods of tumors treatment, the radiotherapy and the chemo-radiotherapy, for instance. It is well known that different processes of blood microcirculation and tissues oxygenation in malignant tumors have a strong influence on a radiotherapy efficacy. But there are in the modern radiology only few methods to prognosticate a positive radiotherapy outcome. Noninvasive spectrophotometry can assist a doctor to produce a more objective and grounded prognosis by means of indicating a parameter of specific oxygen utilization in the malignant tissue, a parameter of blood perfusion in it as well as different parameters of activity of cells' respiratory ferments in a tumorous area.
For more and detailed information see our publications:
1. Rogatkin D.A., Prisnyakova O.A., Moiseeva L.G., and Cherkasov A.S. "Analysis of the accuracy of clinical laser fluorescence diagnosis", Measurement techniques, vol. 41, No. 7, 1998. - pp. 670-674.
Have a look at the paper in PDF (341Kb)
3. Rogatkin
D.A., Tereshenko S.G., Lapaeva L.G., Gorenkov R.V., "Complex
Therapeutic-Diagnostic Endoscopy with Laser Irradiation and in-Situ
Spectrophotometry of Erosive-Ulcerative Impairments of Upper Part of the
Gastrointestinal Tract", Proc. SPIE, v. 4613, 2002. – pp.286-294.
4. Rogatkin D.A., Lapaeva L.G., "Prospects for development of noninvasive spectrophotometric medical diagnosis", Biomedical Engineering, vol. 37, No. 4, 2003. – p. 217-222.
Have
a look at the paper in PDF (116KB)
5. Klebanov
G.I., Rogatkin D.A., Tereshenko S.G., "Fluorescence
of Endogenous Porphirins Recorded In Situ from Surfaces of Gastric and Duodenal
Ulcers During Laser Therapy" // Biophysics [Russian J.], v. 49, No. 5, 2004. –
p.857-862.
6. Rogatkin D.A., Karpov V.N., Gorenkov R.V. et. al., "New horizons of noninvasive reflectance oximetry", non-published paper, prepared for SFM'04 Conference, 2004.
Have
a look at the paper in PDF (186Kb)
7. Tchernyi V.V., Rogatkin D.A., Bychenkov O.A., Polyakov P.Yu., "Some results of multiwave in situ autofluorescence diagnostics", Proc. SPIE, vol. 5693, 2005. – pp. 336-343.
Have a look at the paper in PDF (610Kb)
8.
Tchernyi V.V., Rogatkin D.A.,
Gorenkov R.V., Karpov V.N., Shumskiy V.I., Lubchenko P.N.,
"Complex noninvasive spectrophotometry in examination of
patients with vibration disease
Have a look at the paper in PDF (265Kb)
9. Krupatkin A.I., Rogatkin D.A., Sidorov V.V. Clinical-diagnostic parameters for complex investigation of microhaemodynamics and oxygen transport in the system of microcirculation / Abstr. book of the VI-th. International Conference "Hemorheology and microcirculation" - RF, Yaroslavl, 2007. - p.106.
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a look at the abstract in PDF (66Kb)
10. Rogatkin D.A., Bychenkov O.A., and Lapaeva L.G., "The accuracy, reliability and interpretation of the results of in vivo laser fluorescence diagnosis in the spectral range of the fluorescence of endogenous porphyrins", J. Opt. Technol., vol. 76, No.11, 2009. - p.708-713.
Have a look at the paper in PDF (139Kb)
11. Rogatkin D.A., Lapaeva L.G., Petritskaya E.N. Diagnostic volume phenomenon in noninvasive medical spectrophotometry and a simple theoretical definition of that, Proc.of PIERS’2009 Symposium, August 18-21, Moscow, Russia, 2009. - ð.1762-1765.
Have a look at the paper in PDF (309Kb)
12.
Litvinova K.S., Rogatkin D.A., Bychenkov O.A., Shumskiy V.I. Chronic hypoxia as
a factor of enhanced autofluorescence of endogenous porphyrins in soft
biological tissues, Proc. SPIE, Vol.
7547, 2010. – 7547-0D.
Have a look at the paper in PDF (144Kb)
13. Rogatkin D.A., Makarov D.S., Dmitruk L.I. Informativeness and sources of errors of in vivo laser spectrophotometry methods in diagnostics of blood microcirculation disorders. // Abstract book of International symposium on laser medical applications – Moscow, A.M.Prokhorov General Physics Institute, 2010. – p.35-36.
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14. Smirnova O.D., Rogatkin D.A. and Litvinova K.S. Collagen as in vivo quantitative fluorescent biomarkers of abnormal tissue changes. // Journal of Innovative Optical Health Science, vol. 5, No.2, 2012. - 1250010 (9 pages).
Have a look at the paper in PDF (778Kb)
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