CARS Microscopy Technique May Help Identify Heart Involvement

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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A tissue analysis technique called CARS microscopy could be useful for identifying heart involvement in Fabry disease, according to a new study.

Fully known as Coherent anti-Stokes Raman microscopy, the technique “allows early, reliable and efficient detection of [Fabry]-triggered alterations in affected organs,” such as the heart, the researchers wrote.

The study, “CARS Imaging Advances Early Diagnosis of Cardiac Manifestation of Fabry Disease,” was published in the International Journal of Molecular Sciences.

Fabry disease is characterized by the buildup of certain fat molecules, called lipids, that can affect many bodily tissues, including the heart. Heart involvement is a leading cause of mortality in Fabry, and it often takes a long time to identify.

Thus, finding ways to more quickly identify heart disease in people with Fabry could allow for better-tailored treatment strategies.

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CARS microscopy is an imaging technique that, very simplistically, involves analyzing how molecules in tissue vibrate when two laser beams are shined on a sample. Lipids — including the molecules whose buildup characterizes Fabry — characteristically have long hydrocarbon “tail” structures, which usually produce strong vibrational signals when analyzed via CARS microscopy.

Now, researchers in Germany used the technique to analyze heart tissue from mice with or without Fabry disease.

The team used a battery of machine learning techniques to make sense of the raw data generated by CARS. That allowed a computer to “learn” how to differentiate Fabry from non-Fabry cases based on differences in patterns on the imaging.

Results showed that CARS microscopy could effectively identify hearts from Fabry mice, with an average sensitivity as high as 96%.

Notably, Fabry-specific differences could be detected by CARS microscopy that were not evident with standard tissue analysis of the heart, known as histological staining.

“The study suggests CARS microscopy as a reliable method for estimating abnormal [lipid] accumulations in certain organs of [Fabry disease] even if they are not yet detectable by standard histological staining,” the researchers wrote.

The team concluded that their study supports CARS microscopy as a “novel, fast, and effective imaging tool.” With further testing, this technique may be useful in clinics for identifying heart involvement as quickly as possible in people with Fabry, the team suggested.

“In the effort to initiate [Fabry]-specific therapy at the earliest necessary time point while at the same time allowing to avoid unnecessary high therapy costs if the pathological substrate remains low, CARS microscopy might be particularly helpful not only in diagnosing but also in staging the disease and foreseeing clinical course,” the team wrote.

“Ultimately, this method has the potential to help physicians initiate the needed therapy timely, to follow the patient’s response to the treatment, and to optimize cost-benefit considerations,” they concluded.