Optical Diagnosis In OBGYN

Biomedical light scattering spectroscopy has become a major field in medical optics, as it enables non-invasive detection of disease; such as pre-cancer and early cancer in various human organs without the need for exogenous contrast agents.  The technology has recently been applied to non-invasive detection of early precancerous changes in epithelial tissues and tissue characterization on the sub-cellular scale.  A BIDMC OB/GYN research team originally described biomedical light scattering spectroscopy in 1998 and in 2000 and 2001 described the application of the technique to various organs.  Current research involves the application of optics and spectroscopy for early detection of disease such as gastrointestinal and gynecological cancers, cell biology, prenatal diagnosis and Alzheimer's disease.

Dr. L. T. Perelman, who conceived of and developed biomedical light scattering spectroscopy, is Director of the Biomedical Imaging and Spectroscopy Laboratory in the Department of Obstetrics and Gynecology at BIDMC.

An Endoscopic Polarized Scanning Biopsy Guidance Technique

Using principles of polarized light scattering spectroscopy, Perelman's group developed an endoscopic polarized scanning biopsy guidance technique that underwent a pilot clinical test at the BIDMC Interventional Endoscopy Center.  The technology was used to successfully guide esophageal biopsies in patients, detecting and mapping sites of invisible dysplasia missed by the current standard-of-care.  This NIH-funded breakthrough accomplishment was described in Nature Medicine in 2010.

Confocal Light Scattering Spectroscopic (CLASS) Microscope

The confocal light scattering spectroscopic (CLASS) microscope, first described in 2007, represents a significant new step in the ability to observe the functions of sub cellular organelles because it does not damage the living cells.  It also approaches the spatial resolution of electron microscopy and it functions without the need for exogenous contrast agents that could interfere with inherent cell functioning.  This project has been supported by several NIH and NSF grants including an NSF Major Research Instrumentation grant.

Early Detection of Ovarian Cancer with Polarized Light Scattering Spectroscopy

Polarized light scattering spectroscopy is a potentially powerful diagnostic screening tool that aims to enable physicians to survey ovaries in patients with high levels of CA-125 and/or a family history of ovarian cancer in a minimally invasive fashion and determine with high probability the presence of dysplasia or early cancer.  The microscope will perform measurements on most of the surface of the ovary in about one minute and present the information in real time.  Suspicious areas can then be biopsied and the diagnosis verified.  This approach should be vastly superior to the present strategies of performing a CA-125 test and ultrasound examination.  It may also significantly improve the probability of locating early cancer during the significantly more invasive random biopsies.

Optical Spectroscopic Technique for Noninvasive Prenatal Diagnosis
Present techniques for prenatal diagnosis are invasive and present significant risks of fetal loss.  Noninvasive prenatal diagnosis utilizing fetal nucleated red blood cells (fNRBC) circulating in maternal peripheral blood has received attention, since it poses no risk to the fetus, but differentiating fetal from adult NRBC remains a challenge.  Recently we demonstrated that light scattering spectroscopy is capable of reliably distinguishing fetal NRBC from adult NRBC without tagging, fixation, or risk of cell damage. This project, supported by a new NIH R01 grant, may facilitate development of a clinically useful method for fNRBC enrichment and recovery from peripheral maternal blood and lead to minimally invasive prenatal genetic testing.

Development of an Optical Spectroscopic Technique for Detection of Alzheimer's Disease
The goal of this collaboration with Bedford VA Medical Center is to develop a clinical optical spectroscopic technique for real-time non-invasive detection of Alzheimer's disease in vivo.