LIFE SCIENCES/MEDICAL SPECTROSCOPY


Portable spectrometers fight America’s opioid crisis


F


ourier transform infrared (FTIR) spectroscopy is being used in the United


States to tackle the worsening overdose epidemic. New York City, for example, announced in Summer 2022 it was expanding access to FTIR devices for testing pre-obtained drugs for fentanyl and other potentially lethal substances at special testing sites.


“The opioid epidemic has


already taken the lives of thousands of New Yorkers and the pandemic only exacerbated this crisis. Today, one of our city’s residents loses their life to an overdose every three hours, so it is essential we use every tool in our arsenal to tackle the overdose crisis,” said NYC Mayor Eric Adams. The testing is being carried out at centres


such as OnPoint NYC, which operates the USA’s first publicly- recognised overdose prevention service. Bruker Alpha FTIR


spectrometers are being used by trained operators to identify the presence and approximate amounts of a range of substances, including fentanyl, in drug samples brought in by programme participants. New York City is among the first health departments to implement these services in the United States, while such programmes are more widespread in Canada. Most FTIR spectrometers used in drug testing reflect IR light through a small IR- transparent prism against which the sample is pressed, in a method known as attenuated


FRONTIERS PHOTONICS


One New York resident dies every three hours from an opiate overdose


total internal reflection (ATR). Substances must make up at least around 5% of the sample to be detected, and so immunoassay test strips are commonly used in combination with FTIR to detect trace quantities. There have been several


studies analysing the effectiveness of point-of-care drug testing techniques such as FTIR. The cost of equipment ($40-60,000) and the level of training required (particularly to analyse the results) were mentioned as barriers to adoption of the technology. l


INTRAVASCULAR IMAGING


OCT-NIRS imaging to optimise stent surgeries


A


n imaging device that aids coronary stenting has received


pre-market approval from the FDA. The system, which uses a combination of optical coherence tomography (OCT) and near infrared spectroscopy (NIRS), allows doctors to see inside arteries to optimise stent placement. Spectrawave, which received


FDA 510(k) pre-market clearance in May, say their HyperVue device will improve the treatment and outcomes for patients with coronary artery disease. The system has already been


used by multiple physicians as part of a first-in-human study. “Clinical evidence strongly


suggests that patients benefit from intravascular imaging-guided stent optimisation,” said Dr Ziad Ali, Director of the DeMatteis Cardiovascular Institute at St


Francis Hospital and Heart Center and Director of the Angiographic Core Laboratory at the Cardiovascular Research Foundation in New York. “The DeepOCT technology provides exceptional visualisation of critical structures – such as the external elastic membrane and calcium – while NIRS removes the guesswork in classifying lipidic plaques. I believe the HyperVue system will… act as a trailblazing tool for future applications in high-risk vulnerable plaque detection and treatment.” Coronary artery disease


(CAD), the buildup of plaque in the wall of the coronary arteries that supply blood to the heart, causes nine million deaths worldwide each year. In CAD, patients can undergo stent placement to relieve symptoms, but one in five patients can experience a major adverse


Coronary artery disease causes nine million deaths each year


event. Half of those adverse events were caused by high-risk plaques that were previously left untreated. Advances in OCT image


resolution, along with catheter designs, has created interest for intravascular imaging using OCT. However, the technique struggles to distinguish between molecules within vessels, limiting its use in CAD monitoring.


To overcome this challenge, NIRS is integrated into the catheter alongside OCT to identify molecules within vessels, resulting in doctors receiving information on both composition and structure. Interventional cardiologists


are then able to use the data to optimise stent surgery – for example, in determining stent sizing or optimising where the stent is placed. l


Photonics Frontiers 2023 17


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Evdokimov Maxim/Shutterstock.com


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