Abstract:
Various studies have shown promising results in using Raman spectroscopy (RS) for the detection of skin cancers. In-vivo evaluations showed similar results to those found by trained dermatologists using dermoscopy, the current clinical practice for skin cancer diagnosis. However, dermoscopy is highly subjective which would make an objective, non-invasive diagnostic method useful. Although successful results were achieved, RS is barely applied in clinical routine yet. This review summarizes studies of Raman spectroscopy for skin cancer diagnosis ex vivo and in vivo. The latter has special demands that often lead to a tradeoff between applicability and classification performance. The necessary steps are explained for instrumentation design, handling, data analysis and clinical testing on groups with a sufficient amount of subjects in order to promote the application of RS in a routine clinical setting. A number of methods are summarized which attempt to overcome the ongoing challenge of reducing large background signals. Modifications of RS by combination with other diagnostic methods are summarized that can give a new perspective to future developments in RS.
Zusammenfassung:
In verschiedenen Studien wurden vielversprechende Ergebnisse bei der Erkennung von Hautkrebs mittels Raman-Spektroskopie (RS) erreicht. In-vivo-Erprobungen haben vergleichbare Ergebnisse zur Dermatoskopie durch erfahrene Dermatologen gezeigt, dem derzeitigen klinischen Standard zur Hautkrebserkennung. Die Dermatoskopie ist jedoch in hohem Maße subjektiv, weshalb die Etablierung einer objektiven, nicht-invasiven Diagnosemethode sinnvoll ist. Trotz erfolgreicher Ergebnisse, wird die RS bislang dennoch nur vereinzelt im klinischen Routinebetrieb eingesetzt. Der vorliegende Reviewartikel fasst Raman-spektroskopische Ex-vivo- und In-vivo-Studien zusammen. Für In-vivo-Studien ergeben sich besondere Anforderungen, die oft zum Abwägen zwischen Anwendbarkeit und Klassifikationseffizienz führen. Die notwendigen Schritte für das Design der Instrumentierung sowie die Handhabung, Datenanalyse und klinische Evaluierung an ausreichend großen Studienpopulationen werden erklärt, um die Anwendung der RS im klinischen Umfeld zu ermöglichen. Es werden zudem Methoden zur Reduzierung von großen Untergrundsignalen zusammenfassend beschrieben. Weiterhin werden Modifikationen der RS, die sich aus der Kombination mit anderen diagnostischen Methoden ergeben und dadurch neue Perspektiven für zukünftige Entwicklungen eröffnen, zusammengestellt.
Funding: Senate of Berlin and EU (EFRE) (Grant/Award Number: ‘FKZ 10147189’).
Conflict of interest statement: The authors report no conflict of interest.
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