Accurate in situ diagnosis and optimal surgical removal of a malignancy constitute key elements in reducing cancer-related morbidity and mortality. In surgical oncology, the accurate discrimination between healthy and cancerous tissues is critical for the postoperative care of the patient. Conventional imaging techniques have attempted to serve as adjuvant tools for in situ biopsy and surgery guidance. However, no single imaging modality has been proven sufficient in terms of specificity, sensitivity, multiplexing capacity, spatial and temporal resolution. Moreover, most techniques are unable to provide information regarding the molecular tissue composition. In this review, we highlight the potential of Raman spectroscopy as a spectroscopic technique with high detection sensitivity and spatial resolution for distinguishing healthy from malignant margins in microscopic scale and in real time. A Raman spectrum constitutes an intrinsic “molecular finger-print” of the tissue and any biochemical alteration related to inflammatory or cancerous tissue state is reflected on its Raman spectral fingerprint. Nowadays, advanced Raman systems coupled with modern instrumentation devices and machine learning methods are entering the clinical arena as adjunct tools towards personalized and optimized efficacy in surgical oncology.
Over the past few years, tremendous research concerning the possibilities of gold nanoparticles in medicine has been conducted. Gold nanoparticles (AuNPs) are considered to be unique nanostructures due to their extraordinary chemical and physical properties. This review article aims to bring into light the potential applications of gold nanoparticles for diagnostic purposes in ophthalmology. More specifically, attention will be drawn to the utilization of AuNPs as contrast agents (CAs) in optical coherence tomography (OCT) and photoacoustic imaging (PAI), which are two novel imaging modalities for the visualization of the eye. None of these techniques requires the use of an imaging adjuvant to function; however, the addition of a contrast agent has been proposed for image improvement, and AuNPs are attractive candidates for this purpose. The in vitro, ex vivo, and in vivo studies investigating and supporting this concept will be presented thoroughly to elucidate whether AuNPs are eligible for imaging enhancement owing to their optical characteristics.
Advanced Raman spectroscopy (RS) systems have gained new interest in the field of medicine as an emerging tool for in vivo tissue discrimination. The coupling of RS with artificial intelligence (AI) algorithms has given a boost to RS to analyze spectral data in real time with high specificity and sensitivity. However, limitations are still encountered due to the large amount of clinical data which are required for the pre-training process of AI algorithms. In this study, human healthy and cancerous colon specimens were surgically resected from different sites of the ascending colon and analyzed by RS. Two transfer learning models, the one-dimensional convolutional neural network (1D-CNN) and the 1D–ResNet transfer learning (1D-ResNet) network, were developed and evaluated using a Raman open database for the pre-training process which consisted of spectra of pathogen bacteria. According to the results, both models achieved high accuracy of 88% for healthy/cancerous tissue discrimination by overcoming the limitation of the collection of a large number of spectra for the pre-training process. This gives a boost to RS as an adjuvant tool for real-time biopsy and surgery guidance.
The multifactorial nature of cancer still classifies the disease as one of the leading causes of death worldwide. Modern medical sciences are following an interdisciplinary approach that has been fueled by the nanoscale revolution of the past years. The exploitation of high-Z materials, in combination with ionizing or non-ionizing radiation, promises to overcome restrictions in medical imaging and to augment the efficacy of current therapeutic modalities. Gold nanoparticles (AuNPs) have proven their value among the scientific community in various therapeutic and diagnostic techniques. However, the high level of multiparametric demands of AuNP experiments in combination with their biocompatibility and cytotoxicity levels remain crucial issues. Gadolinium NPs (GdNPs), have presented high biocompatibility, low cytotoxicity, and excellent hemocompatibility, and have been utilized in MRI-guided radiotherapy, photodynamic and photothermal therapy, etc. Τhe utilization of gadolinium bound to AuNPs may be a promising alternative that would reduce phenomena, such as toxicity, aggregation, etc., and could create a multimodal in vivo contrast and therapeutic agent. This review highlights multi-functionalization strategies against cancer where gold and gadolinium NPs are implicated. Their experimental applications and limitations of the past 5 years will be analyzed in the hope of enlightening the benefits and drawbacks of their proper combination.
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