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Novikov A, Perevoschikov S, Usenov I, Sakharova T, Artyushenko V, Bogomolov A. Multimodal fiber probe for simultaneous mid-infrared and Raman spectroscopy. Sci Rep 2024; 14:7430. [PMID: 38548800 PMCID: PMC10978856 DOI: 10.1038/s41598-024-57539-4] [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: 08/03/2023] [Accepted: 03/19/2024] [Indexed: 04/01/2024] Open
Abstract
A fiber probe has been developed that enables simultaneous acquisition of mid-infrared (MIR) and Raman spectra in the region of 3100-2600 cm-1. Multimodal measurement is based on a proposed ZrO2 crystal design at the tip of an attenuated total reflection (ATR) probe. Mid-infrared ATR spectra are obtained through a pair of chalcogenide infrared (CIR) fibers mounted at the base of the crystal. The probe enables both excitation and acquisition of a weak Raman signal from a portion of the sample in front of the crystal using an additional pair of silica fibers located in a plane perpendicular to the CIR fibers. The advantages of combining MIR and Raman spectra in a single probe have been discussed.
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Affiliation(s)
- Alexander Novikov
- Art Photonics GmbH, Rudower Chaussee 46, 12489, Berlin, Germany.
- Technische Universität Berlin, Straße Des 17. Juni 135, 10623, Berlin, Germany.
| | - Stanislav Perevoschikov
- Art Photonics GmbH, Rudower Chaussee 46, 12489, Berlin, Germany
- Skolkovo Institute of Science and Technology, Bolshoy Boulevard 30, Bld. 1, 121205, Moscow, Russia
| | - Iskander Usenov
- Art Photonics GmbH, Rudower Chaussee 46, 12489, Berlin, Germany
- Technische Universität Berlin, Straße Des 17. Juni 135, 10623, Berlin, Germany
| | | | | | - Andrey Bogomolov
- Art Photonics GmbH, Rudower Chaussee 46, 12489, Berlin, Germany
- Samara State Technical University, Molodogvardeyskaya Str. 244, 443100, Samara, Russia
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Wårdell K, Klint E, Milos P, Richter J. One-Insertion Stereotactic Brain Biopsy Using In Vivo Optical Guidance-A Case Study. Oper Neurosurg (Hagerstown) 2023; 25:176-182. [PMID: 37083519 PMCID: PMC10313274 DOI: 10.1227/ons.0000000000000722] [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: 11/23/2022] [Accepted: 02/21/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Stereotactic neurosurgical brain biopsies are afflicted with risks of inconclusive results and hemorrhage. Such complications can necessitate repeated trajectories and prolong surgical time. OBJECTIVE To develop and introduce a 1-insertion stereotactic biopsy kit with direct intraoperative optical feedback and to evaluate its applicability in 3 clinical cases. METHODS An in-house forward-looking probe with optical fibers was designed to fit the outer cannula of a side-cutting biopsy kit. A small aperture was made at the tip of the outer cannula and the edges aligned with the optical probe inside. Stereotactic biopsies were performed using the Leksell Stereotactic System. Optical signals were measured in millimeter steps along the preplanned trajectory during the insertion. At the region with the highest 5-aminolevulinic acid (5-ALA)-induced fluorescence, the probe was replaced by the inner cannula, and tissue samples were taken. The waiting time for pathology diagnosis was noted. RESULTS Measurements took 5 to 10 minutes, and the surgeon received direct visual feedback of intraoperative 5-ALA fluorescence, microcirculation, and tissue gray-whiteness. The 5-ALA fluorescence corroborated with the pathological findings which had waiting times of 45, 50, and 75 minutes. Because only 1 trajectory was required and the patient could be prepared for the end of surgery immediately after sampling, this shortened the total surgical time. CONCLUSION A 1-insertion stereotactic biopsy procedure with real-time optical guidance has been presented and successfully evaluated in 3 clinical cases. The method can be modified for frameless navigation and thus has great potential to improve safety and diagnostic yield for both frameless and frame-based neurosurgical biopsy procedures.
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Affiliation(s)
- Karin Wårdell
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Elisabeth Klint
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Peter Milos
- Department of Neurosurgery and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Johan Richter
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
- Department of Neurosurgery and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Klint E, Richter J, Wårdell K. Combined Use of Frameless Neuronavigation and In Situ Optical Guidance in Brain Tumor Needle Biopsies. Brain Sci 2023; 13:brainsci13050809. [PMID: 37239281 DOI: 10.3390/brainsci13050809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/10/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
Brain tumor needle biopsies are performed to retrieve tissue samples for neuropathological analysis. Although preoperative images guide the procedure, there are risks of hemorrhage and sampling of non-tumor tissue. This study aimed to develop and evaluate a method for frameless one-insertion needle biopsies with in situ optical guidance and present a processing pipeline for combined postoperative analysis of optical, MRI, and neuropathological data. An optical system for quantified feedback on tissue microcirculation, gray-whiteness, and the presence of a tumor (protoporphyrin IX (PpIX) accumulation) with a one-insertion optical probe was integrated into a needle biopsy kit that was used for frameless neuronavigation. In Python, a pipeline for signal processing, image registration, and coordinate transformation was set up. The Euclidian distances between the pre- and postoperative coordinates were calculated. The proposed workflow was evaluated on static references, a phantom, and three patients with suspected high-grade gliomas. In total, six biopsy samples that overlapped with the region of the highest PpIX peak without increased microcirculation were taken. The samples were confirmed as being tumorous and postoperative imaging was used to define the biopsy locations. A 2.5 ± 1.2 mm difference between the pre- and postoperative coordinates was found. Optical guidance in frameless brain tumor biopsies could offer benefits such as quantified in situ indication of high-grade tumor tissue and indications of increased blood flow along the needle trajectory before the tissue is removed. Additionally, postoperative visualization enables the combined analysis of MRI, optical, and neuropathological data.
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Affiliation(s)
- Elisabeth Klint
- Department of Biomedical Engineering, Linköping University, 581 85 Linköping, Sweden
| | - Johan Richter
- Department of Biomedical Engineering, Linköping University, 581 85 Linköping, Sweden
- Department of Neurosurgery, Linköping University Hospital, 581 85 Linköping, Sweden
| | - Karin Wårdell
- Department of Biomedical Engineering, Linköping University, 581 85 Linköping, Sweden
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Milos P, Haj-Hosseini N, Hillman J, Wårdell K. 5-ALA fluorescence in randomly selected pediatric brain tumors assessed by spectroscopy and surgical microscope. Acta Neurochir (Wien) 2023; 165:71-81. [PMID: 36242636 PMCID: PMC9840574 DOI: 10.1007/s00701-022-05360-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/25/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE Fluorescence-guided surgery applying 5-aminolevulinic acid (5-ALA) in high-grade gliomas is an established method in adults. In children, results have so far been ambiguous. The aim of this study was to investigate 5-ALA-induced fluorescence in pediatric brain tumors by using the surgical microscope and a spectroscopic hand-held probe. METHODS Fourteen randomly selected children (age 4-17) with newly MRI-verified brain tumors were included. No selection was based on the suspected diagnosis prior to surgery. All patients received 5-ALA (20 mg /kg) either orally or via a gastric tube prior to surgery. Intratumoral fluorescence was detected with the microscope and the probe. Moreover, fluorescence in the skin of the forearm was measured. Histopathology samples revealed seven low-grade gliomas, four medulloblastomas, one diffuse intrinsic pontine glioma, one glioblastoma and one atypical meningioma. Blood samples were analyzed, and potential clinical side effects were monitored. RESULTS Microscopically, vague fluorescence was visible in two patients. Intratumoral fluorescence could be detected in five patients with the probe, including the two patients with vague microscopic fluorescence. Three of the oldest children had PpIX fluorescence in the skin. Nine children did not show any fluorescence in the tumor or in the skin. No clinical side effects or laboratory adverse events were observed. CONCLUSION Fluorescence could not be used to guide surgery in this study, neither with the surgical microscope nor with the hand-held probe. In nine children, no fluorescence was discerned and children with noticeable fluorescence were all older than nine years. 5-ALA was considered safe to apply in children.
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Affiliation(s)
- Peter Milos
- Department of Neurosurgery and Department of Biomedical and Clinical Sciences, Linköping University, Linköping University Hospital, 581 85, Linköping, Sweden.
| | - Neda Haj-Hosseini
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Jan Hillman
- Department of Neurosurgery and Department of Biomedical and Clinical Sciences, Linköping University, Linköping University Hospital, 581 85, Linköping, Sweden
| | - Karin Wårdell
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
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Bex A, Mathon B. Advances, technological innovations, and future prospects in stereotactic brain biopsies. Neurosurg Rev 2022; 46:5. [PMID: 36471144 PMCID: PMC9734929 DOI: 10.1007/s10143-022-01918-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Stereotactic brain biopsy is one of the most frequently performed brain surgeries. This review aimed to expose the latest cutting-edge and updated technologies and innovations available to neurosurgeons to safely perform stereotactic brain biopsy by minimizing the risks of complications and ensuring that the procedure is successful, leading to a histological diagnosis. We also examined methods for improving preoperative, intraoperative, and postoperative workflows. We performed a comprehensive state-of-the-art literature review. Intraoperative histology, fluorescence, and imaging techniques appear as smart tools to improve the diagnostic yield of biopsy. Constant innovations such as optical methods and augmented reality are also being made to increase patient safety. Robotics and integrated imaging techniques provide an enhanced intraoperative workflow. Patients' management algorithms based on early discharge after biopsy optimize the patient's personal experience and make the most efficient possible use of the available hospital resources. Many new trends are emerging, constantly improving patient care and safety, as well as surgical workflow. A parameter that must be considered is the cost-effectiveness of these devices and the possibility of using them on a daily basis. The decision to implement a new instrument in the surgical workflow should also be dependent on the number of procedures per year, the existing stereotactic equipment, and the experience of each center. Research on patients' postbiopsy management is another mandatory approach to enhance the safety profile of stereotactic brain biopsy and patient satisfaction, as well as to reduce healthcare costs.
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Affiliation(s)
- Alix Bex
- Department of Neurosurgery, CHR Citadelle, Liege, Belgium
| | - Bertrand Mathon
- Department of Neurosurgery, Sorbonne University, APHP, La Pitié-Salpêtrière Hospital, 47-83, Boulevard de L'Hôpital, 75651 Cedex 13, Paris, France.
- ICM, INSERM U 1127, CNRS UMR 7225, UMRS, Paris Brain Institute, Sorbonne University, 1127, Paris, France.
- GRC 23, Brain Machine Interface, APHP, Sorbonne University, Paris, France.
- GRC 33, Robotics and Surgical Innovation, APHP, Sorbonne University, Paris, France.
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Skyrman S, Burström G, Lai M, Manni F, Hendriks B, Frostell A, Edström E, Persson O, Elmi-Terander A. Diffuse reflectance spectroscopy sensor to differentiate between glial tumor and healthy brain tissue: a proof-of-concept study. BIOMEDICAL OPTICS EXPRESS 2022; 13:6470-6483. [PMID: 36589562 PMCID: PMC9774850 DOI: 10.1364/boe.474344] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 06/17/2023]
Abstract
Glial tumors grow diffusely in the brain. Survival is correlated to the extent of tumor removal, but tumor borders are often invisible. Resection beyond the borders as defined by conventional methods may further improve prognosis. In this proof-of-concept study, we evaluate diffuse reflectance spectroscopy (DRS) for discrimination between glial tumors and normal brain ex vivo. DRS spectra and histology were acquired from 22 tumor samples and nine brain tissue samples retrieved from 30 patients. The content of biological chromophores and scattering features were estimated by fitting a model derived from diffusion theory to the DRS spectra. DRS parameters differed significantly between tumor and normal brain tissue. Classification using random forest yielded a sensitivity and specificity for the detection of low-grade gliomas of 82.0% and 82.7%, respectively, and the area under curve (AUC) was 0.91. Applied in a hand-held probe or biopsy needle, DRS has the potential to provide intra-operative tissue analysis.
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Affiliation(s)
- Simon Skyrman
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Gustav Burström
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Marco Lai
- Philips Research, 5656 AE, Eindhoven, The Netherlands
- Eindhoven University of Technology (TU/e), Eindhoven, The Netherlands
| | - Francesca Manni
- Eindhoven University of Technology (TU/e), Eindhoven, The Netherlands
| | - Benno Hendriks
- Philips Research, 5656 AE, Eindhoven, The Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, 2628 CD, Delft, The Netherlands
| | - Arvid Frostell
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Erik Edström
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
| | - Oscar Persson
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Adrian Elmi-Terander
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
- Stockholm Spine Center, 194 45 Upplands-Väsby, Sweden
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7
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Wilson BC, Eu D. Optical Spectroscopy and Imaging in Surgical Management of Cancer Patients. TRANSLATIONAL BIOPHOTONICS 2022. [DOI: 10.1002/tbio.202100009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Brian C. Wilson
- Princess Margaret Cancer Centre/University Health Network 101 College Street Toronto Ontario Canada
- Department of Medical Biophysics, Faculty of Medicine University of Toronto Canada
| | - Donovan Eu
- Department of Otolaryngology‐Head and Neck Surgery‐Surgical Oncology, Princess Margaret Cancer Centre/University Health Network University of Toronto Canada
- Department of Otolaryngology‐Head and Neck Surgery National University Hospital System Singapore
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8
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Tahhan N, Balanca B, Fierstra J, Waelchli T, Picart T, Dumot C, Eker O, Marinesco S, Radovanovic I, Cotton F, Berhouma M. Intraoperative cerebral blood flow monitoring in neurosurgery: A review of contemporary technologies and emerging perspectives. Neurochirurgie 2021; 68:414-425. [PMID: 34895896 DOI: 10.1016/j.neuchi.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/30/2021] [Accepted: 10/12/2021] [Indexed: 10/19/2022]
Abstract
Intraoperative monitoring of cerebral blood flow (CBF) has become an invaluable adjunct to vascular and oncological neurosurgery, reducing the risk of postoperative morbidity and mortality. Several technologies have been developed during the last two decades, including laser-based techniques, videomicroscopy, intraoperative MRI, indocyanine green angiography, and thermography. Although these technologies have been thoroughly studied and clinically applied outside the operative room, current practice lacks an optimal technology that perfectly fits the workflow within the neurosurgical operative room. The different available technologies have specific strengths but suffer several drawbacks, mainly including limited spatial and/or temporal resolution. An optimal CBF monitoring technology should meet particular criteria for intraoperative use: excellent spatial and temporal resolution, integration in the operative workflow, real-time quantitative monitoring, ease of use, and non-contact technique. We here review the main contemporary technologies for intraoperative CBF monitoring and their current and potential future applications in neurosurgery.
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Affiliation(s)
- N Tahhan
- Department of Neurosurgical Oncology and Vascular Neurosurgery, Pierre Wertheimer Neurological and Neurosurgical Hospital, University of Lyon - Hospices Civils de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - B Balanca
- Department of Neuro-Anesthesia and Neuro-Critical Care, Pierre Wertheimer Neurological and Neurosurgical Hospital, Hospices Civils de Lyon, Lyon, France; Lyon Neuroscience Research Center, TIGER team and AniRA-Beliv technological platform, Inserm U2018, CNRS UMR 5292, Lyon 1 University, Lyon, France
| | - J Fierstra
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - T Waelchli
- Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - T Picart
- Department of Neurosurgical Oncology and Vascular Neurosurgery, Pierre Wertheimer Neurological and Neurosurgical Hospital, University of Lyon - Hospices Civils de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - C Dumot
- Department of Neurosurgical Oncology and Vascular Neurosurgery, Pierre Wertheimer Neurological and Neurosurgical Hospital, University of Lyon - Hospices Civils de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - O Eker
- Department of Interventional Neuroradiology, Pierre Wertheimer Neurological and Neurosurgical Hospital, Hospices Civils de Lyon, Lyon, France
| | - S Marinesco
- Lyon Neuroscience Research Center, TIGER team and AniRA-Beliv technological platform, Inserm U2018, CNRS UMR 5292, Lyon 1 University, Lyon, France
| | - I Radovanovic
- Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - F Cotton
- Department of Imaging, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; Creatis Lab - CNRS UMR 5220 - INSERM U1206, Lyon 1 University, INSA Lyon, Lyon, France
| | - M Berhouma
- Department of Neurosurgical Oncology and Vascular Neurosurgery, Pierre Wertheimer Neurological and Neurosurgical Hospital, University of Lyon - Hospices Civils de Lyon, 59, boulevard Pinel, 69003 Lyon, France; Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Canada; Creatis Lab - CNRS UMR 5220 - INSERM U1206, Lyon 1 University, INSA Lyon, Lyon, France.
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Klint E, Mauritzon S, Ragnemalm B, Richter J, Wardell K. FluoRa - a System for Combined Fluorescence and Microcirculation Measurements in Brain Tumor Surgery. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:1512-1515. [PMID: 34891572 DOI: 10.1109/embc46164.2021.9629801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In brain tumor surgery it is difficult to distinguish the marginal zone with the naked eye. Fluorescence techniques can help identifying tumor tissue in the zone during resection and biopsy procedures. In this paper a novel system for combined real-time measurements of PpIX-fluorescence, microcirculation and tissue grey-whiteness is presented and experimentally evaluated. The system consists of a fluorescence hardware with a sensitive CCD spectrometer for PpIX peak detection, a laser Doppler system, optical probes, and a LabView software. System evaluation was done on static fluorescing material, human skin, and brain tumor tissue. The static material indicates reproducibility, the skin measurements exemplify simultaneous fluorescence and microcirculation measurement in real-time, and the tumor tissue showed PpIX peaks. These decreased over time, as expected, due to photo bleaching. In addition, the system was prepared for clinical use and thus laser- and electrical safety issues were considered. In summary, a system for multiparameter measurements during neurosurgery was successfully evaluated in an experimental environment. As a next step the system will be applied in clinical brain tumor biopsies and resections.
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10
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Richter J, Haj-Hosseini N, Milos P, Hallbeck M, Wårdell K. Optical Brain Biopsy with a Fluorescence and Vessel Tracing Probe. Oper Neurosurg (Hagerstown) 2021; 21:217-224. [PMID: 34192763 PMCID: PMC8440062 DOI: 10.1093/ons/opab216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Accurate stereotactic biopsies of brain tumors are imperative for diagnosis and tailoring of the therapy. Repetitive needle insertions enhance risks of brain lesioning, hemorrhage, and complications due to prolonged procedure. OBJECTIVE To investigate clinical benefits of a combined 5-aminolaevulinic acid (5-ALA) fluorescence and laser Doppler flowmetry system for the detection of malignant brain tumor and blood vessels in stereotactic biopsies. METHODS Planning of targets and trajectories was followed by optical measurements in 20 patients, using the Leksell Stereotactic System and a manual insertion device. Fluorescence spectra, microvascular blood flow, and tissue grayness were recorded each millimeter along the paths. Biopsies were taken at preplanned positions. The diagnoses were compared with the fluorescence signals. The recordings were plotted against measurement positions and compared. Sites indicating a risk of hemorrhage were counted as well as the time for the procedures. RESULTS Signals were recorded along 28 trajectories, and 78 biopsies were collected. The final diagnosis showed 17 glioblastomas, 2 lymphomas, and 1 astrocytoma grade III. Fluorescence was seen along 23 of the paths with 4 having the peak of 5-ALA fluorescence 3 mm or more from the precalculated target. There was increased microcirculation in 40 of 905 measured positions. The measurement time for each trajectory was 5 to 10 min. CONCLUSION The probe provided direct feedback of increased blood flow along the trajectory and of malignant tissue in the vicinity of the target. The method can increase the precision and the safety of the biopsy procedure and reduce time.
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Affiliation(s)
- Johan Richter
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden.,Department of Neurosurgery, Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Neda Haj-Hosseini
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Peter Milos
- Department of Neurosurgery, Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Martin Hallbeck
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Pathology, Linköping University, Linköping, Sweden
| | - Karin Wårdell
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
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Rasmussen ET, Shiao EC, Zourelias L, Halbreiner MS, Passineau MJ, Murali S, Riviere CN. Coronary vessel detection methods for organ-mounted robots. Int J Med Robot 2021; 17:e2297. [PMID: 34081821 DOI: 10.1002/rcs.2297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND HeartLander is a tethered robot walker that utilizes suction to adhere to the beating heart. HeartLander can be used for minimally invasive administration of cardiac medications or ablation of tissue. In order to administer injections safely, HeartLander must avoid coronary vasculature. METHODS Doppler ultrasound signals were recorded using a custom-made cardiac phantom and used to classify different coronary vessel properties. The classification was performed by two machine learning algorithms, the support vector machines and a deep convolutional neural network. These algorithms were then validated in animal trials. RESULTS Accuracy of identifying vessels above turbulent flow reached greater than 92% in phantom trials and greater than 98% in animal trials. CONCLUSIONS Through the use of two machine learning algorithms, HeartLander has shown the ability to identify different sized vasculature proximally above turbulent flow. These results indicate that it is feasible to use Doppler ultrasound to identify and avoid coronary vasculature during cardiac interventions using HeartLander.
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Affiliation(s)
- Eric T Rasmussen
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Eric C Shiao
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Lee Zourelias
- Cardiovascular Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Michael S Halbreiner
- Cardiovascular Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Michael J Passineau
- Cardiovascular Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Srinivas Murali
- Cardiovascular Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Cameron N Riviere
- The Robotics Institute, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
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12
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Lu H, Grygoryev K, Bermingham N, Jansen M, O’Sullivan M, Nunan G, Buckley K, Manley K, Burke R, Andersson-Engels S. Combined autofluorescence and diffuse reflectance for brain tumour surgical guidance: initial ex vivo study results. BIOMEDICAL OPTICS EXPRESS 2021; 12:2432-2446. [PMID: 33996239 PMCID: PMC8086447 DOI: 10.1364/boe.420292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/09/2021] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Abstract
This ex vivo study was conducted to assess the potential of using a fibre optic probe system based on autofluorescence and diffuse reflectance for tissue differentiation in the brain. A total of 180 optical measurements were acquired from 28 brain specimens (five patients) with eight excitation and emission wavelengths spanning from 300 to 700 nm. Partial least square-linear discriminant analysis (PLS-LDA) was used for tissue discrimination. Leave-one-out cross validation (LOOCV) was then used to evaluate the performance of the classification model. Grey matter was differentiated from tumour tissue with sensitivity of 89.3% and specificity of 92.5%. The variable importance in projection (VIP) derived from the PLS regression was applied to wavelengths selection, and identified the biochemical sources of the detected signals. The initial results of the study were promising and point the way towards a cost-effective, miniaturized hand-held probe for real time and label-free surgical guidance.
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Affiliation(s)
- Huihui Lu
- Biophotonics @ Tyndall, IPIC, Tyndall National Institute, University College Cork, Cork, Ireland
| | - Konstantin Grygoryev
- Biophotonics @ Tyndall, IPIC, Tyndall National Institute, University College Cork, Cork, Ireland
| | - Niamh Bermingham
- Department of Neuropathology, Cork University Hospital, Cork, Ireland
| | - Michael Jansen
- Department of Neuropathology, Cork University Hospital, Cork, Ireland
| | | | - Gerard Nunan
- Stryker, Instruments Innovation Centre, IDA Business and Technology Park, Cork, Ireland
| | - Kevin Buckley
- Stryker, Instruments Innovation Centre, IDA Business and Technology Park, Cork, Ireland
| | - Kevin Manley
- Stryker, Instruments Innovation Centre, IDA Business and Technology Park, Cork, Ireland
| | - Ray Burke
- Biophotonics @ Tyndall, IPIC, Tyndall National Institute, University College Cork, Cork, Ireland
| | - Stefan Andersson-Engels
- Biophotonics @ Tyndall, IPIC, Tyndall National Institute, University College Cork, Cork, Ireland
- Department of Physics, University College Cork, Cork, Ireland
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13
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Ottobrini L, Martelli C, Lucignani G. Optical Imaging Agents. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00035-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Laurence A, Bouthillier A, Robert M, Nguyen DK, Leblond F. Multispectral diffuse reflectance can discriminate blood vessels and bleeding during neurosurgery based on low-frequency hemodynamics. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200094R. [PMID: 33179457 PMCID: PMC7657412 DOI: 10.1117/1.jbo.25.11.116003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 10/21/2020] [Indexed: 06/11/2023]
Abstract
SIGNIFICANCE The practicality of optical methods detecting tissue optical contrast (absorption, elastic and inelastic scattering, fluorescence) for surgical guidance is limited by interferences from blood pooling and the resulting partial or complete inability to interrogate cortex and blood vessels. AIM A multispectral diffuse reflectance technique was developed for intraoperative brain imaging of hemodynamic activity to automatically discriminate blood vessels, cortex, and bleeding at the brain surface. APPROACH A manual segmentation of blood pooling, cortex, and vessels allowed the identification of a frequency range in hemoglobin concentration variations associated with high optical signal in blood vessels and cortex but not in bleeding. Reflectance spectra were then used to automatically segment areas with and without hemodynamic activity as well as to discriminate blood from cortical areas. RESULTS The frequency range associated with low-frequency hemodynamics and respiratory rate (0.03 to 0.3 Hz) exhibits the largest differences in signal amplitudes for bleeding, blood vessels, and cortex. A segmentation technique based on simulated reflectance spectra initially allowed discrimination of blood (bleeding and vessels) from cortical tissue. Then, a threshold applied to the low-frequency components from deoxyhemoglobin allowed the segmentation of bleeding from vessels. A study on the minimum acquisition time needed to discriminate all three components determined that ∼25 s was necessary to detect changes in the low-frequency range. Other frequency ranges such as heartbeat (1 to 1.7 Hz) can be used to reduce the acquisition time to few seconds but would necessitate optimizing instrumentation to ensure larger signal-to-noise ratios are achieved. CONCLUSIONS A method based on multispectral reflectance signals and low-frequency hemoglobin concentration changes can be used to distinguish bleeding, blood vessels, and cortex. This could be integrated into fiber optic probes to enhance signal specificity by providing users an indication of whether measurements are corrupted by blood pooling, an important confounding factor in biomedical optics applied to surgery.
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Affiliation(s)
- Audrey Laurence
- Polytechnique Montréal, Department of Engineering Physics, Montréal, Québec, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Alain Bouthillier
- Centre Hospitalier de l’Université de Montréal, Division of Neurosurgery, Montréal, Québec, Canada
| | - Manon Robert
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Dang K. Nguyen
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Centre Hospitalier de l’Université de Montréal, Division of Neurology, Montréal, Québec, Canada
| | - Frédéric Leblond
- Polytechnique Montréal, Department of Engineering Physics, Montréal, Québec, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
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DePaoli D, Lemoine É, Ember K, Parent M, Prud’homme M, Cantin L, Petrecca K, Leblond F, Côté DC. Rise of Raman spectroscopy in neurosurgery: a review. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-36. [PMID: 32358930 PMCID: PMC7195442 DOI: 10.1117/1.jbo.25.5.050901] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/10/2020] [Indexed: 05/21/2023]
Abstract
SIGNIFICANCE Although the clinical potential for Raman spectroscopy (RS) has been anticipated for decades, it has only recently been used in neurosurgery. Still, few devices have succeeded in making their way into the operating room. With recent technological advancements, however, vibrational sensing is poised to be a revolutionary tool for neurosurgeons. AIM We give a summary of neurosurgical workflows and key translational milestones of RS in clinical use and provide the optics and data science background required to implement such devices. APPROACH We performed an extensive review of the literature, with a specific emphasis on research that aims to build Raman systems suited for a neurosurgical setting. RESULTS The main translatable interest in Raman sensing rests in its capacity to yield label-free molecular information from tissue intraoperatively. Systems that have proven usable in the clinical setting are ergonomic, have a short integration time, and can acquire high-quality signal even in suboptimal conditions. Moreover, because of the complex microenvironment of brain tissue, data analysis is now recognized as a critical step in achieving high performance Raman-based sensing. CONCLUSIONS The next generation of Raman-based devices are making their way into operating rooms and their clinical translation requires close collaboration between physicians, engineers, and data scientists.
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Affiliation(s)
- Damon DePaoli
- Université Laval, CERVO Brain Research Center, Québec, Canada
- Université Laval, Centre d’optique, Photonique et Lasers, Québec, Canada
| | - Émile Lemoine
- Polytechnique Montréal, Department of Engineering Physics, Montréal, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Katherine Ember
- Polytechnique Montréal, Department of Engineering Physics, Montréal, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Martin Parent
- Université Laval, CERVO Brain Research Center, Québec, Canada
| | - Michel Prud’homme
- Hôpital de l’Enfant-Jésus, Department of Neurosurgery, Québec, Canada
| | - Léo Cantin
- Hôpital de l’Enfant-Jésus, Department of Neurosurgery, Québec, Canada
| | - Kevin Petrecca
- McGill University, Montreal Neurological Institute-Hospital, Department of Neurology and Neurosurgery, Montreal, Canada
| | - Frédéric Leblond
- Polytechnique Montréal, Department of Engineering Physics, Montréal, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Daniel C. Côté
- Université Laval, CERVO Brain Research Center, Québec, Canada
- Université Laval, Centre d’optique, Photonique et Lasers, Québec, Canada
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Maintz M, Black D, Haj-Hosseini N. Auditory and Visual User Interface for Optical Guidance During Stereotactic Brain Tumor Biopsies. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:1981-1984. [PMID: 31946288 DOI: 10.1109/embc.2019.8857310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
During stereotactic brain tumor biopsies, the detection of protoporphyrin IX (PpIX) fluorescence and microvascular perfusion using laser Doppler flowmetry (LDF) with a handheld fiber optic probe allows the identification of tumor tissue while decreasing the risk of intracranial hemorrhage. Neurosurgeons performing this procedure usually view the measurement values on a screen. When their visual focus is directed at the surgical site, they require an assistant to verbally relay the values. An auditory and visual user interface (UI), which displays measurement values accurately and allows fast and intuitive signal recognition, can improve this procedure. This paper experimentally evaluates an auditory and visual UI for providing real-time measurement feedback during stereotactic brain tumor biopsies. In a user study (n = 15), the accuracy of auditory and visual response was determined using function response tests, and user acceptance was evaluated. The auditory signals proved to be intuitive and easy to recognize and remember. The visual display of measurement values was easy to understand and facilitated the user's decision-making process. Moreover, the UI exhibited high user acceptance.
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Akshulakov SK, Kerimbayev TT, Biryuchkov MY, Urunbayev YA, Farhadi DS, Byvaltsev VA. Current Trends for Improving Safety of Stereotactic Brain Biopsies: Advanced Optical Methods for Vessel Avoidance and Tumor Detection. Front Oncol 2019; 9:947. [PMID: 31632903 PMCID: PMC6783564 DOI: 10.3389/fonc.2019.00947] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 09/09/2019] [Indexed: 01/06/2023] Open
Abstract
Stereotactic brain needle biopsies are indicated for deep-seated or multiple brain lesions and for patients with poor prognosis in whom the risks of resection outweigh the potential outcome benefits. The main goal of such procedures is not to improve the resection extent but to safely acquire viable tissue representative of the lesion for further comprehensive histological, immunohistochemical, and molecular analyses. Herein, we review advanced optical techniques for improvement of safety and efficacy of stereotactic needle biopsy procedures. These technologies are aimed at three main areas of improvement: (1) avoidance of vessel injury, (2) guidance for biopsy acquisition of the viable diagnostic tissue, and (3) methods for rapid intraoperative assessment of stereotactic biopsy specimens. The recent technological developments in stereotactic biopsy probe design include the incorporation of fluorescence imaging, spectroscopy, and label-free imaging techniques. The future advancements of stereotactic biopsy procedures in neuro-oncology include the incorporation of optical probes for real-time vessel detection along and around the biopsy needle trajectory and in vivo confirmation of the diagnostic tumor tissue prior to sample acquisition.
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Affiliation(s)
- Serik K Akshulakov
- Department of Neurosurgery, JSC "National Center for Neurosurgery", Nur-Sultan, Kazakhstan
| | - Talgat T Kerimbayev
- Department of Neurosurgery, JSC "National Center for Neurosurgery", Nur-Sultan, Kazakhstan
| | - Michael Y Biryuchkov
- Department of Neurosurgery and Traumatology, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan
| | - Yermek A Urunbayev
- Department of Neurosurgery, JSC "National Center for Neurosurgery", Nur-Sultan, Kazakhstan
| | - Dara S Farhadi
- University of Arizona College of Medicine, Phoenix, AZ, United States
| | - Vadim A Byvaltsev
- Department of Neurosurgery, JSC "National Center for Neurosurgery", Nur-Sultan, Kazakhstan.,Department of Neurosurgery and Innovative Medicine, Irkutsk State Medical University, Irkutsk, Russia
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Alston L, Mahieu-Williame L, Hebert M, Kantapareddy P, Meyronet D, Rousseau D, Guyotat J, Montcel B. Spectral complexity of 5-ALA induced PpIX fluorescence in guided surgery: a clinical study towards the discrimination of healthy tissue and margin boundaries in high and low grade gliomas. BIOMEDICAL OPTICS EXPRESS 2019; 10:2478-2492. [PMID: 31149380 PMCID: PMC6524587 DOI: 10.1364/boe.10.002478] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/09/2019] [Accepted: 03/21/2019] [Indexed: 05/06/2023]
Abstract
Gliomas are diffuse and hard to cure brain tumors. A major reason for their aggressive behavior is their property to infiltrate the brain. The gross appearance of the infiltrative component is comparable to normal brain, constituting an obstacle to extended surgical resection. 5-ALA induced PpIX fluorescence measurements enable gains in sensitivity to detect infiltrated cells, but still lack sensitivity to get accurate discrimination between the tumor margin and healthy tissue. In this fluorescence spectroscopic study, we assume that two states of PpIX contribute to total fluorescence to get better discrimination of healthy tissues against tumor margins. We reveal that fluorescence in low-density margins of high-grade gliomas or in low-grade gliomas is mainly influenced by the second state of PpIX centered at 620 nm. We thus conclude that consideration of the contributions of both states to total fluorescence can help to improve fluorescence-guided resection of gliomas by discriminating healthy tissues from tumor margins.
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Affiliation(s)
- L. Alston
- Univ Lyon, INSA‐Lyon, Université Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR5220, U1206, F-69616, Lyon, France
| | - L. Mahieu-Williame
- Univ Lyon, INSA‐Lyon, Université Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR5220, U1206, F-69616, Lyon, France
| | - M. Hebert
- Univ Lyon, UJM-Saint-Etienne, CNRS, Institut d Optique Graduate School, Lab. Hubert Curien UMR5516, F-42023, St Etienne, France
| | - P. Kantapareddy
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service d’anatomopathologie, 59 Bvd Pinel, 69394, Lyon, Cedex, France
| | - D. Meyronet
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service d’anatomopathologie, 59 Bvd Pinel, 69394, Lyon, Cedex, France
- Department of Cancer Cell Plasticity, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR5286, Lyon, France, Université Claude Bernard Lyon 1, Lyon, France
| | - D. Rousseau
- Univ Lyon, INSA‐Lyon, Université Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR5220, U1206, F-69616, Lyon, France
| | - J. Guyotat
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service d’anatomopathologie, 59 Bvd Pinel, 69394, Lyon, Cedex, France
| | - B. Montcel
- Univ Lyon, INSA‐Lyon, Université Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR5220, U1206, F-69616, Lyon, France
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19
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Zhu M, Chang W, Jing L, Fan Y, Liang P, Zhang X, Wang G, Liao H. Dual-modality optical diagnosis for precise in vivo identification of tumors in neurosurgery. Am J Cancer Res 2019; 9:2827-2842. [PMID: 31244926 PMCID: PMC6568186 DOI: 10.7150/thno.33823] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 03/09/2019] [Indexed: 12/13/2022] Open
Abstract
In neurosurgery, the precise diagnosis and treatment of tumor diseases are challenging to realize. Current clinical diagnoses lack fast and accurate intraoperative information. Therefore, the development of new methods and techniques to assist neurosurgeons intraoperatively is necessary. Optical diagnosis is a promising method to provide accurate information about biological tissues in a short time. Therefore, in this study, we proposed a dual-modality optical diagnostic method through point-to-face registration fusion in the optical system. We incorporated quantitative autofluorescence spectroscopy and optical coherence tomography (OCT) and evaluated our methods in an animal model. Methods: A mouse model consisting of 16 nude mice was built by injecting the mouse brains with human glioma cells. Preoperative bioluminescence imaging was used to evaluate the growth states of tumors and locate the tumor sites. Quantitative autofluorescence spectroscopy, which provided local biochemical information with single-point detection, and OCT, which provided relatively global structural information with en face mapping scanning, were combined using the point-to-face registration fusion method to provide precise diagnostic information for identifying the brain tumors. Postoperative pathology was performed to evaluate the sensitivity and specificity of optical diagnosis. Results: Ex vivo quantitative autofluorescence spectroscopy and OCT imaging were first performed in eight mice to acquire the optimal measuring parameters for tumor staging and identification. We then performed in vivo quantitative autofluorescence spectroscopy and OCT imaging. The results showed that tumor staging could be realized through quantitative autofluorescence spectroscopy, and fusion images could be used to precisely identify tumors. The autofluorescence spectral map, OCT en face map, and fused diagnostic map had average sensitivities of 91.7%, 86.1%, and 95.9% and specificities of 93.2%, 96.0%, and 88.7%, respectively, for tumor identification. Conclusion: The dual-modality optical point-to-face registration fusion method and system we proposed could provide both biochemical information and structural information. The in vivo experimental results validated that the sensitivity (95.9%) of the fused map was higher than that of either single diagnostic modality (86.1% or 91.7%). Tumor staging was realized through quantitative autofluorescence spectroscopy. The proposed method will be applicable to future intelligent theranostic systems and improve many clinical neurosurgeries.
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20
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Ramakonar H, Quirk BC, Kirk RW, Li J, Jacques A, Lind CRP, McLaughlin RA. Intraoperative detection of blood vessels with an imaging needle during neurosurgery in humans. SCIENCE ADVANCES 2018; 4:eaav4992. [PMID: 30585293 PMCID: PMC6300404 DOI: 10.1126/sciadv.aav4992] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 11/20/2018] [Indexed: 05/05/2023]
Abstract
Intracranial hemorrhage can be a devastating complication associated with needle biopsies of the brain. Hemorrhage can occur to vessels located adjacent to the biopsy needle as tissue is aspirated into the needle and removed. No intraoperative technology exists to reliably identify blood vessels that are at risk of damage. To address this problem, we developed an "imaging needle" that can visualize nearby blood vessels in real time. The imaging needle contains a miniaturized optical coherence tomography probe that allows differentiation of blood flow and tissue. In 11 patients, we were able to intraoperatively detect blood vessels (diameter, >500 μm) with a sensitivity of 91.2% and a specificity of 97.7%. This is the first reported use of an optical coherence tomography needle probe in human brain in vivo. These results suggest that imaging needles may serve as a valuable tool in a range of neurosurgical needle interventions.
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Affiliation(s)
- Hari Ramakonar
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Surgery, University of Western Australia, Crawley, Western Australia, Australia
| | - Bryden C. Quirk
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Rodney W. Kirk
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Jiawen Li
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Angela Jacques
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Christopher R. P. Lind
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Surgery, University of Western Australia, Crawley, Western Australia, Australia
| | - Robert A. McLaughlin
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
- Corresponding author.
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