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Anichini G, Leiloglou M, Hu Z, O'Neill K, Daniel Elson. Hyperspectral and multispectral imaging in neurosurgery: a systematic literature review and meta-analysis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024:108293. [PMID: 38658267 DOI: 10.1016/j.ejso.2024.108293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/21/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION The neuro-surgical community is witnessing a rising interest for surgical application of multispectral/hyperspectral imaging. Several potential technical applications of this optical imaging are reported, but the set-up is variable and so are the processing methods. We present a systematic review of the relevant literature on the topic. MATERIALS AND METHODS A literature search based on the PRISMA principles was performed on PubMed, SCOPUS, and Web of Science, using MESH terms and Boolean operators. Papers regarding intra-operative in-vivo application of multispectral and/or hyperspectral imaging in humans during neurosurgical procedures were included. Papers reporting technologies related to radiological applications were excluded. A meta-analysis on the performance metrics was also conducted. RESULTS Our search string retrieved 20 papers. The main applications of optical imaging during neurosurgery concern tumour detection and improvement of the extent of resection (15 papers) or visualization of perfusion changes during neuro-oncology or neuro-vascular surgery (5 papers). All the retrieved articles were pilot studies, proof of concepts, or case reports, with limited number of patients recruited. Sensitivity, specificity, and accuracy were promising in most of the reports, but the metanalysis showed heterogeneous approaches and results among studies. CONCLUSIONS The present review shows that several approaches are currently being tested to integrate hyperspectral imaging in neurosurgery, but most of the studies reported a limited pool of patients, with different approaches to data collection and analysis. Further studies on larger cohorts of patients are therefore desirable to fully explore the potential of this imaging technique.
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Affiliation(s)
- Giulio Anichini
- Department of Brain Sciences, Imperial College of London, United Kingdom; Department of Neurosurgery, Neuroscience, Imperial College Healthcare NHS Trust, United Kingdom.
| | - Maria Leiloglou
- Department of Surgery and Cancer, Imperial College of London, United Kingdom; The Hamlyn Centre, Imperial College of London, United Kingdom
| | - Zepeng Hu
- Department of Surgery and Cancer, Imperial College of London, United Kingdom; The Hamlyn Centre, Imperial College of London, United Kingdom
| | - Kevin O'Neill
- Department of Brain Sciences, Imperial College of London, United Kingdom; Department of Neurosurgery, Neuroscience, Imperial College Healthcare NHS Trust, United Kingdom
| | - Daniel Elson
- Department of Surgery and Cancer, Imperial College of London, United Kingdom; The Hamlyn Centre, Imperial College of London, United Kingdom
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Chen X, Qin X, Wang J, Wang R, Guo X, Yao L. Effect of cerebral oxygen saturation monitoring in patients undergoing superficial temporal anterior-middle cerebral artery anastomosis for ischemic Moyamoya disease: a prospective cohort study. Front Neurol 2023; 14:1226455. [PMID: 37808481 PMCID: PMC10552867 DOI: 10.3389/fneur.2023.1226455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023] Open
Abstract
Objective Regional cerebral oxygen saturation (rSO2) is linked with blood pressure. This study evaluated the influence of perioperative rSO2 monitoring on the prognosis of ischemic Moyamoya disease (MMD) patients undergoing anastomosis surgery. Methods In this prospective cohort, patients with unilateral ischemic MMD of Suzuki stage ≥3 were included. The decision of rSO2 was made by the clinician and the patient. The rSO2 group maintained intraoperative rSO2 levels through the modulation of blood pressure, inhaled oxygen concentration, carbon dioxide in arterial blood, and red blood cell transfusion. The non-rSO2 group used conventional anesthesia practices. Perioperative mean arterial pressure (MAP), rSO2 values, neurological complications, and postoperative results were assessed. Results A total of 75 eligible patients were categorized into a rSO2 monitoring group (n = 30) and a non-rSO2 monitoring group (n = 45). For the rSO2 group, the preoperative rSO2 was significantly lower on the affected side (P < 0.05). After anastomosis, this value notably increased (P = 0.01). A moderate relationship was observed between perioperative rSO2 and MAP before, during, and after surgery, with correlation coefficients (r) of 0.536, 0.502, and 0.592 (P < 0.05). Post-surgery MAP levels differed between the groups, with the rSO2 group showing decreased levels compared to pre-surgery and the non-rOS2 group displaying elevated levels. Notably, the rSO2 group reported shorter hospitalizations and decreased neurological complications. Patients with a hypertension history found postoperative MAP influencing hospital stay duration. Conclusion Perioperative rSO2 surveillance enhanced cerebral perfusion and minimized postoperative complications in ischemic MMD patients. Thus, rSO2 monitoring is advocated for MMD patients undergoing vascular anastomosis.
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Affiliation(s)
- Xuanling Chen
- Department of Anesthesiology, Peking University International Hospital, Beijing, China
| | - Xuewei Qin
- Department of Anesthesiology, Peking University International Hospital, Beijing, China
| | - Jing Wang
- Department of Neurosurgery, Peking University International Hospital, Beijing, China
| | - Rong Wang
- Department of Neurosurgery, Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiangyang Guo
- Department of Anesthesiology, Peking University Third Hosptial, Beijing, China
| | - Lan Yao
- Department of Anesthesiology, Peking University International Hospital, Beijing, China
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Puustinen S, Vrzáková H, Hyttinen J, Rauramaa T, Fält P, Hauta-Kasari M, Bednarik R, Koivisto T, Rantala S, von Und Zu Fraunberg M, Jääskeläinen JE, Elomaa AP. Hyperspectral Imaging in Brain Tumor Surgery-Evidence of Machine Learning-Based Performance. World Neurosurg 2023; 175:e614-e635. [PMID: 37030483 DOI: 10.1016/j.wneu.2023.03.149] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/10/2023]
Abstract
BACKGROUND Hyperspectral imaging (HSI) has the potential to enhance surgical tissue detection and diagnostics. Definite utilization of intraoperative HSI guidance demands validated machine learning and public datasets that currently do not exist. Moreover, current imaging conventions are dispersed, and evidence-based paradigms for neurosurgical HSI have not been declared. METHODS We presented the rationale and a detailed clinical paradigm for establishing microneurosurgical HSI guidance. In addition, a systematic literature review was conducted to summarize the current indications and performance of neurosurgical HSI systems, with an emphasis on machine learning-based methods. RESULTS The published data comprised a few case series or case reports aiming to classify tissues during glioma operations. For a multitissue classification problem, the highest overall accuracy of 80% was obtained using deep learning. Our HSI system was capable of intraoperative data acquisition and visualization with minimal disturbance to glioma surgery. CONCLUSIONS In a limited number of publications, neurosurgical HSI has demonstrated unique capabilities in contrast to the established imaging techniques. Multidisciplinary work is required to establish communicable HSI standards and clinical impact. Our HSI paradigm endorses systematic intraoperative HSI data collection, which aims to facilitate the related standards, medical device regulations, and value-based medical imaging systems.
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Affiliation(s)
- Sami Puustinen
- University of Eastern Finland, Faculty of Health Sciences, School of Medicine, Kuopio, Finland; Kuopio University Hospital, Eastern Finland Microsurgery Center, Kuopio, Finland.
| | - Hana Vrzáková
- Kuopio University Hospital, Eastern Finland Microsurgery Center, Kuopio, Finland; University of Eastern Finland, Faculty of Science and Forestry, School of Computing, Joensuu, Finland
| | - Joni Hyttinen
- University of Eastern Finland, Faculty of Science and Forestry, School of Computing, Joensuu, Finland
| | - Tuomas Rauramaa
- Kuopio University Hospital, Department of Clinical Pathology, Kuopio, Finland
| | - Pauli Fält
- University of Eastern Finland, Faculty of Science and Forestry, School of Computing, Joensuu, Finland
| | - Markku Hauta-Kasari
- University of Eastern Finland, Faculty of Science and Forestry, School of Computing, Joensuu, Finland
| | - Roman Bednarik
- University of Eastern Finland, Faculty of Science and Forestry, School of Computing, Joensuu, Finland
| | - Timo Koivisto
- Kuopio University Hospital, Department of Neurosurgery, Kuopio, Finland
| | - Susanna Rantala
- Kuopio University Hospital, Department of Neurosurgery, Kuopio, Finland
| | - Mikael von Und Zu Fraunberg
- Oulu University Hospital, Department of Neurosurgery, Oulu, Finland; University of Oulu, Faculty of Medicine, Research Unit of Clinical Medicine, Oulu, Finland
| | | | - Antti-Pekka Elomaa
- University of Eastern Finland, Faculty of Health Sciences, School of Medicine, Kuopio, Finland; Kuopio University Hospital, Eastern Finland Microsurgery Center, Kuopio, Finland; Kuopio University Hospital, Department of Neurosurgery, Kuopio, Finland
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Wu Y, Xu Z, Yang W, Ning Z, Dong H. Review on the Application of Hyperspectral Imaging Technology of the Exposed Cortex in Cerebral Surgery. Front Bioeng Biotechnol 2022; 10:906728. [PMID: 35711634 PMCID: PMC9196632 DOI: 10.3389/fbioe.2022.906728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
The study of brain science is vital to human health. The application of hyperspectral imaging in biomedical fields has grown dramatically in recent years due to their unique optical imaging method and multidimensional information acquisition. Hyperspectral imaging technology can acquire two-dimensional spatial information and one-dimensional spectral information of biological samples simultaneously, covering the ultraviolet, visible and infrared spectral ranges with high spectral resolution, which can provide diagnostic information about the physiological, morphological and biochemical components of tissues and organs. This technology also presents finer spectral features for brain imaging studies, and further provides more auxiliary information for cerebral disease research. This paper reviews the recent advance of hyperspectral imaging in cerebral diagnosis. Firstly, the experimental setup, image acquisition and pre-processing, and analysis methods of hyperspectral technology were introduced. Secondly, the latest research progress and applications of hyperspectral imaging in brain tissue metabolism, hemodynamics, and brain cancer diagnosis in recent years were summarized briefly. Finally, the limitations of the application of hyperspectral imaging in cerebral disease diagnosis field were analyzed, and the future development direction was proposed.
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Affiliation(s)
- Yue Wu
- Research Center for Intelligent Sensing Systems, Zhejiang Lab, Hangzhou, China
| | - Zhongyuan Xu
- Research Center for Intelligent Sensing Systems, Zhejiang Lab, Hangzhou, China
| | - Wenjian Yang
- Research Center for Intelligent Sensing Systems, Zhejiang Lab, Hangzhou, China
| | - Zhiqiang Ning
- Anhui Institute of Optics and Fine Mechanics, Chinese Academy of Sciences (CAS), Hefei, China.,Science Island Branch, Graduate School of USTC, Hefei, China
| | - Hao Dong
- Research Center for Sensing Materials and Devices, Zhejiang Lab, Hangzhou, China
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Waterhouse DJ, Bano S, Januszewicz W, Stoyanov D, Fitzgerald RC, di Pietro M, Bohndiek SE. First-in-human pilot study of snapshot multispectral endoscopy for early detection of Barrett's-related neoplasia. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210159R. [PMID: 34628734 PMCID: PMC8501416 DOI: 10.1117/1.jbo.26.10.106002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/02/2021] [Indexed: 05/04/2023]
Abstract
SIGNIFICANCE The early detection of dysplasia in patients with Barrett's esophagus could improve outcomes by enabling curative intervention; however, dysplasia is often inconspicuous using conventional white-light endoscopy. AIM We sought to determine whether multispectral imaging (MSI) could be applied in endoscopy to improve detection of dysplasia in the upper gastrointestinal (GI) tract. APPROACH We used a commercial fiberscope to relay imaging data from within the upper GI tract to a snapshot MSI camera capable of collecting data from nine spectral bands. The system was deployed in a pilot clinical study of 20 patients (ClinicalTrials.gov NCT03388047) to capture 727 in vivo image cubes matched with gold-standard diagnosis from histopathology. We compared the performance of seven learning-based methods for data classification, including linear discriminant analysis, k-nearest neighbor classification, and a neural network. RESULTS Validation of our approach using a Macbeth color chart achieved an image-based classification accuracy of 96.5%. Although our patient cohort showed significant intra- and interpatient variance, we were able to resolve disease-specific contributions to the recorded MSI data. In classification, a combined principal component analysis and k-nearest-neighbor approach performed best, achieving accuracies of 95.8%, 90.7%, and 76.1%, respectively, for squamous, non-dysplastic Barrett's esophagus and neoplasia based on majority decisions per-image. CONCLUSIONS MSI shows promise for disease classification in Barrett's esophagus and merits further investigation as a tool in high-definition "chip-on-tip" endoscopes.
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Affiliation(s)
- Dale J. Waterhouse
- University of Cambridge, Department of Physics and CRUK Cambridge Institute, Cambridge, United Kingdom
- University College London, Wellcome/EPSRC Centre for Interventional and Surgical Sciences, London, United Kingdom
| | - Sophia Bano
- University College London, Wellcome/EPSRC Centre for Interventional and Surgical Sciences, London, United Kingdom
| | - Wladyslaw Januszewicz
- Medical Centre for Postgraduate Education, Department of Gastroenterology, Hepatology and Clinical Oncology, Warsaw, Poland
| | - Dan Stoyanov
- University College London, Wellcome/EPSRC Centre for Interventional and Surgical Sciences, London, United Kingdom
| | - Rebecca C. Fitzgerald
- University of Cambridge, MRC Cancer Unit, Hutchison/MRC Research Centre, Cambridge, United Kingdom
| | - Massimiliano di Pietro
- University of Cambridge, MRC Cancer Unit, Hutchison/MRC Research Centre, Cambridge, United Kingdom
| | - Sarah E. Bohndiek
- University of Cambridge, Department of Physics and CRUK Cambridge Institute, Cambridge, United Kingdom
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