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Hamidi A, Bayhaqi YA, Drusová S, Navarini AA, Cattin PC, Canbaz F, Zam A. Multimodal feedback systems for smart laser osteotomy: Depth control and tissue differentiation. Lasers Surg Med 2023; 55:900-911. [PMID: 37870158 DOI: 10.1002/lsm.23732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/28/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVES The study aimed to improve the safety and accuracy of laser osteotomy (bone surgery) by integrating optical feedback systems with an Er:YAG laser. Optical feedback consists of a real-time visual feedback system that monitors and controls the depth of laser-induced cuts and a tissue sensor differentiating tissue types based on their chemical composition. The developed multimodal feedback systems demonstrated the potential to enhance the safety and accuracy of laser surgery. MATERIALS AND METHODS The proposed method utilizes a laser-induced breakdown spectroscopy (LIBS) system and long-range Bessel-like beam optical coherence tomography (OCT) for tissue-specific laser surgery. The LIBS system detects tissue types by analyzing the plasma generated on the tissue by a nanosecond Nd:YAG laser, while OCT provides real-time monitoring and control of the laser-induced cut depth. The OCT system operates at a wavelength of 1288 ± 30 nm and has an A-scan rate of 104.17 kHz, enabling accurate depth control. Optical shutters are used to facilitate the integration of these multimodal feedback systems. RESULTS The proposed system was tested on five specimens of pig femur bone to evaluate its functionality. Tissue differentiation and visual depth feedback were used to achieve high precision both on the surface and in-depth. The results showed successful real-time tissue differentiation and visualization without any visible thermal damage or carbonization. The accuracy of the tissue differentiation was evaluated, with a mean absolute error of 330.4 μm and a standard deviation of ±248.9 μm, indicating that bone ablation was typically stopped before reaching the bone marrow. The depth control of the laser cut had a mean accuracy of 65.9 μm with a standard deviation of ±45 μm, demonstrating the system's ability to achieve the pre-planned cutting depth. CONCLUSION The integrated approach of combining an ablative laser, visual feedback (OCT), and tissue sensor (LIBS) has significant potential for enhancing minimally invasive surgery and warrants further investigation and development.
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Affiliation(s)
- Arsham Hamidi
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Yakub A Bayhaqi
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Sandra Drusová
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Alexander A Navarini
- Digital Dermatology, Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Philippe C Cattin
- Department of Biomedical Engineering, Center for medical Image Analysis and Navigation (CIAN), University of Basel, Allschwil, Switzerland
| | - Ferda Canbaz
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Azhar Zam
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Division of Engineering, New York University Abu Dhabi, Abu Dhabi, UAE
- Department of Biomedical Engineering, Department of Electrical and Computer Engineering, Tandon School of Engineering, New York University, Brooklyn, New York, USA
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Rohde M, Mehari F, Klämpfl F, Adler W, Neukam FW, Schmidt M, Stelzle F. The differentiation of oral soft- and hard tissues using laser induced breakdown spectroscopy - a prospect for tissue specific laser surgery. JOURNAL OF BIOPHOTONICS 2017; 10:1250-1261. [PMID: 27875030 DOI: 10.1002/jbio.201600153] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/12/2016] [Accepted: 10/26/2016] [Indexed: 06/06/2023]
Abstract
Compared to conventional techniques, Laser surgery procedures provide a number of advantages, but may be associated with an increased risk of iatrogenic damage to important anatomical structures. The type of tissue ablated in the focus spot is unknown. Laser-Induced Breakdown-Spectroscopy (LIBS) has the potential to gain information about the type of material that is being ablated by the laser beam. This may form the basis for tissue selective laser surgery. In the present study, 7 different porcine tissues (cortical and cancellous bone, nerve, mucosa, enamel, dentine and pulp) from 6 animals were analyzed for their qualitative and semiquantitative molecular composition using LIBS. The so gathered data was used to first differentiate between the soft- and hard-tissues using a Calcium-Carbon emission based classifier. The tissues were then further classified using emission-ratio based analysis, principal component analysis (PCA) and linear discriminant analysis (LDA). The relatively higher concentration of Calcium in the hard tissues allows for an accurate first differentiation of soft- and hard tissues (100% sensitivity and specificity). The ratio based statistical differentiation approach yields results in the range from 65% (enamel-dentine pair) to 100% (nerve-pulp, cancellous bone-dentine, cancellous bone-enamel pairs) sensitivity and specificity. Experimental LIBS measuring setup.
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Affiliation(s)
- Maximilian Rohde
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Straße 6, 91052, Erlangen, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstraße 11, 91054, Erlangen, Germany
| | - Fanuel Mehari
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Straße 6, 91052, Erlangen, Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052, Erlangen, Germany
| | - Florian Klämpfl
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Straße 6, 91052, Erlangen, Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052, Erlangen, Germany
| | - Werner Adler
- Institute of Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 6, 91054, Erlangen, Germany
| | - Friedrich-Wilhelm Neukam
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstraße 11, 91054, Erlangen, Germany
| | - Michael Schmidt
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Straße 6, 91052, Erlangen, Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052, Erlangen, Germany
| | - Florian Stelzle
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Straße 6, 91052, Erlangen, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstraße 11, 91054, Erlangen, Germany
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Hughes C, Voros S, Moreau-Gaudry A. Unintended Consequences of Sensor, Signal, and Imaging Informatics: New Problems and New Solutions. Yearb Med Inform 2016:159-162. [PMID: 27830245 DOI: 10.15265/iy-2016-053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This synopsis presents a selection for the IMIA (International Medical Informatics Association) Yearbook 2016 of excellent research in the broad field of Sensor, Signal and Imaging Informatics published in the year 2015, with a focus on Unintended consequences: new problems and new solutions. METHODS We performed a systematic initial selection and a double blind peer review process to find the best papers in this domain published in 2015, from the PubMed and Web of Science databases. The set of MesH keywords used was provided by experts. RESULTS The constant advances in medical technology allow ever more relevant diagnostic and therapeutic approaches to be designed. Nevertheless, there is a need to acquire expert knowledge of these innovations in order to identify precociously new associated problems for which new solutions need to be designed and developed.
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Gorpas D, Ma D, Bec J, Yankelevich DR, Marcu L. Real-Time Visualization of Tissue Surface Biochemical Features Derived From Fluorescence Lifetime Measurements. IEEE TRANSACTIONS ON MEDICAL IMAGING 2016; 35:1802-11. [PMID: 26890641 PMCID: PMC5131727 DOI: 10.1109/tmi.2016.2530621] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Fiber based fluorescence lifetime imaging has shown great potential for intraoperative diagnosis and guidance of surgical procedures. Here we describe a novel method addressing a significant challenge for the practical implementation of this technique, i.e., the real-time display of the quantified biochemical or functional tissue properties superimposed on the interrogated area. Specifically, an aiming beam (450 nm) generated by a continuous-wave laser beam was merged with the pulsed fluorescence excitation light in a single delivery/collection fiber and then imaged and segmented using a color-based algorithm. We demonstrate that this approach enables continuous delineation of the interrogated location and dynamic augmentation of the acquired frames with the corresponding fluorescence decay parameters. The method was evaluated on a fluorescence phantom and fresh tissue samples. Current results demonstrate that 34 frames per second can be achieved for augmenting videos of 640 × 512 pixels resolution. Also we show that the spatial resolution of the fluorescence lifetime map depends on the tissue optical properties, the scanning speed, and the frame rate. The dice similarity coefficient between the fluorescence phantom and the reconstructed maps was estimated to be as high as 93%. The reported method could become a valuable tool for augmenting the surgeon's field of view with diagnostic information derived from the analysis of fluorescence lifetime data in real-time using handheld, automated, or endoscopic scanning systems. Current method provides also a means for maintaining the tissue light exposure within safety limits. This study provides a framework for using an aiming beam with other point spectroscopy applications.
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Affiliation(s)
- Dimitris Gorpas
- Department of Biomedical Engineering, University of California Davis, CA 95616 USA
| | - Dinglong Ma
- Department of Biomedical Engineering, University of California Davis, CA 95616 USA
| | - Julien Bec
- Department of Biomedical Engineering, University of California Davis, CA 95616 USA
| | - Diego R. Yankelevich
- Department of Biomedical Engineering and with the Department of Electrical and Computer Engineering, University of California Davis, CA 95616 USA
| | - Laura Marcu
- Department of Biomedical Engineering, University of California Davis, CA 95616 USA
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Han JH, Moon Y, Lee JJ, Choi S, Kim YC, Jeong S. Differentiation of cutaneous melanoma from surrounding skin using laser-induced breakdown spectroscopy. BIOMEDICAL OPTICS EXPRESS 2016; 7:57-66. [PMID: 26819817 PMCID: PMC4722910 DOI: 10.1364/boe.7.000057] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 11/30/2015] [Accepted: 12/01/2015] [Indexed: 05/23/2023]
Abstract
Laser-induced breakdown spectroscopy (LIBS) has the potential to be used as a surgical tool for simultaneous tissue ablation and elemental analysis of the ablated tissue. LIBS may be used to distinguish melanoma lesions from the surrounding dermis based on the quantitative difference of elements within melanoma lesions. Here, we measured the elements in homogenized pellets and real tissues from excised skin samples of melanoma-implanted mice. In addition, statistical analysis of LIBS spectra using principal component analysis and linear discriminant analysis was performed. Our results showed that this method had high detection sensitivity, highlighting the potential of this tool in clinical applications.
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Affiliation(s)
- Jung Hyun Han
- Department of Medical System Engineering, Gwangju Institute of Science and Technology, 1 Oryong-dong Buk-gu, Gwangju 500-712, South Korea
- Co-first authors with equal contribution
| | - Youngmin Moon
- Department of Medical System Engineering, Gwangju Institute of Science and Technology, 1 Oryong-dong Buk-gu, Gwangju 500-712, South Korea
- Co-first authors with equal contribution
| | - Jong Jin Lee
- Department of Medical System Engineering, Gwangju Institute of Science and Technology, 1 Oryong-dong Buk-gu, Gwangju 500-712, South Korea
| | - Sujeong Choi
- School of Life Sciences, Gwangju Institute of Science and Technology, 1 Oryong-dong Buk-gu, Gwangju 500-712, South Korea
| | - Yong-Chul Kim
- Department of Medical System Engineering, Gwangju Institute of Science and Technology, 1 Oryong-dong Buk-gu, Gwangju 500-712, South Korea
- School of Life Sciences, Gwangju Institute of Science and Technology, 1 Oryong-dong Buk-gu, Gwangju 500-712, South Korea
- Co-corresponding authors:
| | - Sungho Jeong
- School of Mechatronics, Gwangju Institute of Science and Technology, 1 Oryong-dong Buk-gu, Gwangju 500-712, South Korea
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