Human Crystal Diagnostics with hybrid Raman spectrograph and polarized light microscope
The current golden standard of polarization microscopy offers too little accuracy in characterizing observed crystals in synovial fluids. With Raman spectroscopy, it was observed in preliminary work that many more unidentified by PLM crystals can be recognized. No systematic study presently exists that investigates the frequency of such occurrences. Dr. T. Jansen and Dr. M. Janssen, key opinion leaders regarding crystal diseases founded the company Human Crystal Research and initiated collaboration with the University of Twente in order to develop an innovative hybrid scope which combines Raman spectrograph and PLM technology.
The inter-operator variability in the diagnosis of crystal diseases is relatively high. Trained investigators do miss diagnosis of crystal diseases (81% for gout crystals and 68% for non-urate crystals (Clinical Rheumatology: Berendsen et al 2016)). This leads to delayed diagnosis or false diagnosis and thus the patient may not receive the correct medication or therapy. An improved diagnosis would increase the cost-effectiveness and quality of life surrounding crystal diseases. It also would lead to fewer unnecessary side effects of medication, a possible better patient compliance through a stronger diagnosis, and earlier diagnoses so further damage to the joints can be prevented through timely intervention.
The innovation of Human Crystal Therapy encompasses a combination of polarization microscopy and Raman spectroscopy resulting in a speedy and accurate crystal recognition. It may also lead to the acceptance of Raman technology in the scientific medical community because of the possibility to compare both techniques on accuracy.
The goals in this study are:
- -the development of an integrated polarization-Raman microscope, that results in an efficient use of the method to detect and characterize all crystals in synovial fluids. This goal has been achieved.
- the development of a database of crystal Raman spectra from synovial fluids. This goal has been achieved.
- the development of an easy accessibility to the database in order to computerize crystal diagnosis. This goal has been achieved.
- a proposition of criteria for medical valorization of the new technique and method. This goal has been achieved.
- the valorization of the technique and method on a relevant number of medical samples for the distinction of crystal diseases. This goal has been achieved.
- the acquisition of relevant numbers of patient samples with other signaling crystals. This goal has been achieved.
- the assessment of the new method as a suitable technique to investigate effects of therapy on the synovial fluids. This goal has been achieved.
- to understand the origin and consequences of the measurement of multiple types of crystals in the synovial fluids. This goal has been achieved for gout, CPPD and new findings concerning OA and the presence of calcite crystals and their inflammatory properties have been made.
- to make crystal diagnosis independent of hospital specialists and therefore reduction of costs involved.The method has the potential to achieve this. The instrument is user-friendly and students (MBO, HBO) have been successfully trained in the use of the technology on patient samples.
