Routine histology, the current gold standard, involves staining for specific biomolecules. However, untapped biochemical information in tissue can be gathered using biochemical imaging. Infrared spectroscopy is an emerging modality that allows label-free chemical imaging to derive biochemical information (such as protein, lipids, DNA, collagen) from tissues. Here we employed this technology in order to better predict the development of diabetic nephropathy. Using human primary kidney biopsies or nephrectomies, we obtained tissue from four histologically normal kidneys, four histologically normal kidneys from diabetic subjects and five kidneys with evidence of diabetic nephropathy. A biochemical signature of diabetic nephropathy was derived that enabled prediction of nephropathy based on the ratio of only two spectral frequencies. Nonetheless, using the entire spectrum of biochemical information, we were able to detect renal disease with near perfect accuracy. Additionally, study of sequential protocol biopsies from three transplanted kidneys showed biochemical changes even prior to clinical manifestation of diabetic nephropathy. Thus, infrared imaging can identify critical biochemical alterations that precede morphological changes, potentially allowing for earlier intervention.
Abstract:The importance of stroma as a rich diagnostic region in tissue biopsies is growing as there is an increasing understanding that disease processes in multiple organs can affect the composition of adjacent connective tissue regions. This may be especially true in the liver, since this organ's central metabolic role exposes it to multiple disease processes. We use quantum cascade laser infrared spectroscopic imaging to study changes in the chemical status of hepatocytes and fibrotic regions of liver tissue that result from the progression of liver cirrhosis to hepatocellular carcinoma and the potentially confounding effects of diabetes mellitus.
High-definition Fourier Transform Infrared (FT-IR) spectroscopic imaging is an emerging approach to obtain detailed images that have associated biochemical information. FT-IR imaging of tissue is based on the principle that different regions of the mid-infrared are absorbed by different chemical bonds (e.g., C=O, C-H, N-H) within cells or tissue that can then be related to the presence and composition of biomolecules (e.g., lipids, DNA, glycogen, protein, collagen). In an FT-IR image, every pixel within the image comprises an entire Infrared (IR) spectrum that can give information on the biochemical status of the cells that can then be exploited for cell-type or disease-type classification. In this paper, we show: how to obtain IR images from human tissues using an FT-IR system, how to modify existing instrumentation to allow for high-definition imaging capabilities, and how to visualize FT-IR images. We then present some applications of FT-IR for pathology using the liver and kidney as examples. FT-IR imaging holds exciting applications in providing a novel route to obtain biochemical information from cells and tissue in an entirely label-free non-perturbing route towards giving new insight into biomolecular changes as part of disease processes. Additionally, this biochemical information can potentially allow for objective and automated analysis of certain aspects of disease diagnosis.
Hyperspectral imaging (HSI) of tissue samples in the mid-infrared (mid-IR) range provides spectro-chemical and tissue structure information at sub-cellular spatial resolution. Disease-states can be directly assessed by analyzing the mid-IR spectra of different cell-types (e.g. epithelial cells) and subcellular components (e.g. nuclei), provided we can accurately classify the pixels belonging to these components. The challenge is to extract information from hundreds of noisy mid-IR bands at each pixel, where each band is not very informative in itself, making annotations of unstained tissue HSI images particularly tricky. Because the tissue structure is not necessarily identical between the two sections, only a few regions in unstained HSI image can be annotated with high confidence, even when serial (or adjacent) H&E stained section is used as a visual guide. In order to completely use both labeled and unlabeled pixels in training images, we have developed an HSI pixel classification method that uses semi-supervised learning for both spectral dimension reduction and hierarchical pixel clustering. Compared to supervised classifiers, the proposed method was able to account for the vast differences in spectra of sub-cellular components of the same cell-type and achieve an F1-score of 71.18% on twofold cross-validation across 20 tissue images. To generate further interest in this promising modality we have released our source code and also showed that disease classification is straightforward after HSI image segmentation.
Renal transplants have not seen a significant improvement in their 10-year graft life. Chronic damage accumulation often leads to interstitial fibrosis and tubular atrophy (IF/TA) and thus graft function loss over time. For this reason, IF/TA has been the chief suspect for a potential prognostic marker for long term outcomes. In this study, we have used infrared spectroscopic (IR) imaging to interrogate the biochemistry of regions of fibrosis from renal transplant biopsies to identify a biochemical signature that can predict rapid progression of fibrosis. IR imaging represents an approach that permits label-free biochemical imaging of human tissues towards identifying novel biomarkers for disease diagnosis or prognosis. Two cohorts were identified as progressors (n = 5, > 50% fibrosis increase between time points) and non-progressors (n = 5, < 5% increase between time points). Each patient had an early time point and late time point biopsy. Collagen associated carbohydrate moieties (ν(C–O), 1035 cm−1 and ν(C–O–C),1079 cm−1) spectral ratios demonstrated good separation between the two cohorts (p = 0.001). This was true for late and early time point biopsies suggesting the regions of fibrosis are biochemically altered in cases undergoing progressive fibrosis. Thus, IR imaging can potentially predict rapid progression of fibrosis using histologically normal early time point biopsies.
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