Infrared (IR) and Raman spectroscopy are emerging biophotonic tools to recognize various diseases. The current review gives an overview of the experimental techniques, data-classification algorithms and applications to assess soft tissues, hard tissues and body fluids. The methodology section presents the principles to combine vibrational spectroscopy with microscopy, lateral information and fiber-optic probes. A crucial step is the classification of spectral data by a variety of algorithms. We discuss unsupervised algorithms such as cluster analysis or principal component analysis and supervised algorithms such as linear discriminant analysis, soft independent modeling of class analogies, artificial neural networks support vector machines, Bayesian classification, partial least-squares regression and ensemble methods. The selected topics include tumors of epithelial tissue, brain tumors, prion diseases, bone diseases, atherosclerosis, kidney stones and gallstones, skin tumors, diabetes and osteoarthritis.

Disease recognition by infrared and Raman spectroscopy.

There is growing interest in the possibility that identification and treatment of vulnerable plaques and vulnerable patients can enhance the progress made against coronary artery disease. Innovations in medical therapy—statins and other agents—and novel interventional cardiology techniques—eg, drug-eluting stents—have significantly decreased the morbidity and mortality caused by coronary atherosclerosis. However, coronary events continue to be the leading cause of death in the United States, accounting for >479 000 deaths (1 in 5) in 2003.1

Improved preventive measures are needed because, for many individuals, sudden coronary death is the first sign of the disorder. And even those who survive an acute coronary syndrome remain at high risk. After successful treatment of the initial culprit lesion by a percutaneous coronary intervention (PCI), the risk of a coronary event from a new lesion is ≈10% in the following year and 5% in each of the subsequent 4 years2,3 (Figure 1). 



Figure 1. Occurrence of coronary events (revascularization, death, MI, acute coronary syndromes, or congestive heart failure) after PCI in 4 studies of bare-metal stents. In addition to events resulting from stented lesions (solid line), many events are caused by nontarget (vulnerable) plaques (dashed line). Modified from Cutlip et al2 with permission from the American Heart Association. Copyright 2004.



These substantial levels of ongoing morbidity and mortality have led to heightened interest in new methods to prevent coronary events. For primary prevention, the effort has focused on plasma markers and noninvasive testing to identify vulnerable individuals. For secondary prevention, interest has focused on vulnerable patients and the vulnerable plaques they may possess that might be identified and treated during the catheterization for their initial event.

### Definitions of the Vulnerable Plaque and the Vulnerable Patient

The terminology to describe vulnerability has become relatively standardized.4–10 The term “vulnerable plaque” is used to designate a plaque at high risk of disruption leading …

Detection and Treatment of Vulnerable Plaques and Vulnerable Patients Novel Approaches to Prevention of Coronary Events

A tutorial article is presented for the use of linear and nonlinear Raman microspectroscopies in biomedical diagnostics. Coherent anti-Stokes Raman scattering (CARS) is the most frequently applied nonlinear variant of Raman spectroscopy. The basic concepts of Raman and CARS are introduced first, and subsequent biomedical applications of Raman and CARS are described. Raman microspectroscopy is applied to both in-vivo and in-vitro tissue diagnostics, and the characterization and identification of individual mammalian cells. These applications benefit from the fact that Raman spectra provide specific information on the chemical composition and molecular structure in a label-free and nondestructive manner. Combining the chemical specificity of Raman spectroscopy with the spatial resolution of an optical microscope allows recording hyperspectral images with molecular contrast. We also elaborate on interfacing Raman spectroscopic tools with other technologies such as optical tweezing, microfluidics and fiber optic probes. Thereby, we aim at presenting a guide into one exciting branch of modern biophotonics research.

https://www.spiedigitallibrary.org/journals/journal-of-biomedical-optics/volume-17/issue-4/040801/Raman-and-coherent-anti-Stokes-Raman-scattering-microspectroscopy-for-biomedical/10.1117/1.JBO.17.4.040801.pdf

Raman and coherent anti-Stokes Raman scattering microspectroscopy for biomedical applications

Vulnerable Plaque: Definition, Diagnosis, and Treatment

New Drugs and Technologies

Background: Raman spectroscopy has the unique potential to detect and quantify cholesterol and calcification in an atherosclerotic plaque in vivo. Objective: To evaluate the sensitivity and specificity of this technique for detecting cholesterol or calcification in human coronary artery and aorta specimens ex vivo, using a compact clinical fibreoptic based Raman system developed for in vivo applications. Design: From nine coronary arteries and four aorta specimens, 114 sites were evaluated for the presence of cholesterol and calcification by Raman spectroscopy and standard histology. Raman spectra were acquired and evaluated on-line in around five seconds. Results: The correlation between Raman spectroscopy and histology was r = 0.68 for cholesterol and r = 0.71 calcification in the plaque (p 0.92 (p 80% and negative predictive values of > 90% were obtained. Conclusions: On-line real time catheter based Raman spectroscopy detects accumulation of cholesterol and calcification in atherosclerotic plaque with high sensitivity and specificity.

https://heart.bmj.com/content/heartjnl/89/9/1078.full.pdf

On-line detection of cholesterol and calcification by catheter based Raman spectroscopy in human atherosclerotic plaque ex vivo

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On-line detection of cholesterol and calcification by catheter based Raman spectroscopy in human atherosclerotic plaque ex vivo