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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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Massalimova A, Timmermans M, Esfandiari H, Carrillo F, Laux CJ, Farshad M, Denis K, Fürnstahl P. Intraoperative tissue classification methods in orthopedic and neurological surgeries: A systematic review. Front Surg 2022; 9:952539. [PMID: 35990097 PMCID: PMC9381957 DOI: 10.3389/fsurg.2022.952539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Accurate tissue differentiation during orthopedic and neurological surgeries is critical, given that such surgeries involve operations on or in the vicinity of vital neurovascular structures and erroneous surgical maneuvers can lead to surgical complications. By now, the number of emerging technologies tackling the problem of intraoperative tissue classification methods is increasing. Therefore, this systematic review paper intends to give a general overview of existing technologies. The review was done based on the PRISMA principle and two databases: PubMed and IEEE Xplore. The screening process resulted in 60 full-text papers. The general characteristics of the methodology from extracted papers included data processing pipeline, machine learning methods if applicable, types of tissues that can be identified with them, phantom used to conduct the experiment, and evaluation results. This paper can be useful in identifying the problems in the current status of the state-of-the-art intraoperative tissue classification methods and designing new enhanced techniques.
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Affiliation(s)
- Aidana Massalimova
- Research in Orthopedic Computer Science (ROCS), Balgrist Campus, University of Zurich, Zurich, Switzerland
- Correspondence: Aidana Massalimova
| | - Maikel Timmermans
- KU Leuven, Campus Group T, BioMechanics (BMe), Smart Instrumentation Group, Leuven, Belgium
| | - Hooman Esfandiari
- Research in Orthopedic Computer Science (ROCS), Balgrist Campus, University of Zurich, Zurich, Switzerland
| | - Fabio Carrillo
- Research in Orthopedic Computer Science (ROCS), Balgrist Campus, University of Zurich, Zurich, Switzerland
| | - Christoph J. Laux
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Mazda Farshad
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Kathleen Denis
- KU Leuven, Campus Group T, BioMechanics (BMe), Smart Instrumentation Group, Leuven, Belgium
| | - Philipp Fürnstahl
- Research in Orthopedic Computer Science (ROCS), Balgrist Campus, University of Zurich, Zurich, Switzerland
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