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Hartmann K, Stein KP, Neyazi B, Sandalcioglu IE. Theranostic applications of optical coherence tomography in neurosurgery? Neurosurg Rev 2021; 45:421-427. [PMID: 34398385 PMCID: PMC8827310 DOI: 10.1007/s10143-021-01599-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/11/2021] [Accepted: 06/27/2021] [Indexed: 12/14/2022]
Abstract
In light of our own experiences, we value the existing literature to critically point out possible “near” future applications of optical coherence tomography (OCT) as an intraoperative neurosurgical guidance tool. “Pub Med”, “Cochrane Library”, “Crossref Metadata Search”, and “IEEE Xplore” databases as well as the search engine “Google Scholar” were screened for “optical coherence tomography + neurosurgery”, “optical coherence tomography + intraoperative imaging + neurosurgery”, and “microscope integrated optical coherence tomography + neurosurgery”. n = 51 articles related to the use of OCT as an imaging technique in the field of neurosurgery or neurosurgical research. n = 7 articles documented the intraoperative use of OCT in patients. n = 4 articles documented the use of microscope-integrated optical coherence tomography as a neurosurgical guidance tool. The Results demonstrate that OCT is the first imaging technique to study microanatomy in vivo. Postoperative analysis of intraoperative scans holds promise to enrich our physiological and pathophysiological understanding of the human brain. No data exists to prove that OCT-guided surgery minimizes perioperative morbidity or extends tumor resection. But results suggest that regular use of microscope-integrated OCT could increase security during certain critical microsurgical steps like, e.g., dural dissection at cavernous sinus, transtentorial approaches, or aneurysm clip placement. Endoscopy integration could aid surgery in regions which are not yet accessible to real-time imaging modalities like the ventricles or hypophysis. Theranostic instruments which combine OCT with laser ablation might gain importance in the emerging field of minimal invasive tumor surgery. OCT depicts vessel wall layers and its pathologies uniquely. Doppler OCT could further visualize blood flow in parallel. These abilities shed light on promising future applications in the field of vascular neurosurgery.
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Affiliation(s)
- Karl Hartmann
- Universitätsklinik Für Neurochirurgie, Otto-Von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland.
| | - Klaus-Peter Stein
- Universitätsklinik Für Neurochirurgie, Otto-Von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - Belal Neyazi
- Universitätsklinik Für Neurochirurgie, Otto-Von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - I Erol Sandalcioglu
- Universitätsklinik Für Neurochirurgie, Otto-Von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
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Yang B, Feng Y, Ma Y, Wang Y, Chen J, Li L, Dong J, Zhang B, Gao P, Chen Y, Dmytriw AA, Jiao L. Frequency-Domain Optical Coherence Tomography for Intracranial Atherosclerotic Stenosis: Feasibility, Safety, and Preliminary Experience. Front Neurol 2021; 12:678443. [PMID: 34220686 PMCID: PMC8247572 DOI: 10.3389/fneur.2021.678443] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Despite advances in non-invasive imaging, the characterization of atherosclerotic plaque remains superior with frequency-domain optical coherence tomography (FD-OCT) in the clinical coronary and experimental cerebrovascular literature. An assessment of the feasibility and safety of FD-OCT for intracranial atherosclerotic stenosis (ICAS) is desirable. Methods: We analyzed a cohort of all consecutive FD-OCT evaluations for ICAS performed at our institution from April 2017 to August 2018 (16 months) in patients who suffered from transient ischemic attack (TIA) or non-disabling stroke despite optimal medical management within 90 days of admission attributable to angiographically verified 70-99% stenosis of an intracranial artery. Results: Thirty-three patients harboring 36 lesions with an average age of (57.6 ± 7.1) years (male sex 27 cases) comprising nine cases of lesions located within the anterior circulation and 24 cases within the posterior circulation were identified. Of the 33 patients with 36 lesions, the FD-OCT imaging catheter detected 35/36 (97%) lesions except in one case in which the FD-OCT catheter failed to navigate excessively tortuous vessels, and FD-OCT images in 27 patients (81.8%) were finally obtained successful, where the target lesion was fully visible, and image quality under at least one pullback was graded 2 or 3. There were no symptomatic complications. Blood flow was the most common artifact encountered (51.9%). Conclusion: FD-OCT is safe and feasible for the assessment of ICAS in the anterior and posterior circulation. The use of diagnostic interferometry will have to be weighed against its cost, and these preliminary findings should be verified by prospective large-scale studies.
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Affiliation(s)
- Bin Yang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yiding Feng
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yan Ma
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yabing Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jian Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Long Li
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jia Dong
- Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Bairu Zhang
- Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Peng Gao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yanfei Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Adam A Dmytriw
- Neuroradiology & Neurointervention Service, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Liqun Jiao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Cooperative Three-View Imaging Optical Coherence Tomography for Intraoperative Vascular Evaluation. APPLIED SCIENCES-BASEL 2018. [DOI: 10.3390/app8091551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Real-time intraoperative optical coherence tomography (OCT) imaging of blood vessels after anastomosis operation can provide important information the vessel, such as patency, flow speed, and thrombosis morphology. Due to the strong scattering and absorption effect of blood, normal OCT imaging suffers from the problem of incomplete cross-sectional view of the vessel under investigation when the diameter is large. In this work, we present a novel cooperative three-view imaging spectral domain optical coherence tomography system for intraoperative exposed vascular imaging. Two more side views (left view and right view) were realized through a customized sample arm optical design and corresponding mechanical design and fabrication, which could generate cross-sectional images from three circumferential view directions to achieve a larger synthetic field of view (FOV). For each view, the imaging depth was 6.7 mm (in air) and the lateral scanning range was designed to be 3 mm. Therefore, a shared synthetic rectangle FOV of 3 mm × 3 mm was achieved through cooperative three view scanning. This multi-view imaging method can meet the circumferential imaging demands of vessels with an outer diameter less than 3 mm. Both phantom tube and rat vessel imaging confirmed the increased system FOV performance. We believe the intraoperative application of this cooperative three-imaging optical coherence tomography for objective vascular anastomosis evaluation can benefit patient outcomes in the future.
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Mokbul MI. Optical Coherence Tomography: Basic Concepts and Applications in Neuroscience Research. J Med Eng 2017; 2017:3409327. [PMID: 29214158 PMCID: PMC5682075 DOI: 10.1155/2017/3409327] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/22/2017] [Accepted: 09/14/2017] [Indexed: 12/28/2022] Open
Abstract
Optical coherence tomography is a micrometer-scale imaging modality that permits label-free, cross-sectional imaging of biological tissue microstructure using tissue backscattering properties. After its invention in the 1990s, OCT is now being widely used in several branches of neuroscience as well as other fields of biomedical science. This review study reports an overview of OCT's applications in several branches or subbranches of neuroscience such as neuroimaging, neurology, neurosurgery, neuropathology, and neuroembryology. This study has briefly summarized the recent applications of OCT in neuroscience research, including a comparison, and provides a discussion of the remaining challenges and opportunities in addition to future directions. The chief aim of the review study is to draw the attention of a broad neuroscience community in order to maximize the applications of OCT in other branches of neuroscience too, and the study may also serve as a benchmark for future OCT-based neuroscience research. Despite some limitations, OCT proves to be a useful imaging tool in both basic and clinical neuroscience research.
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Affiliation(s)
- Mobin Ibne Mokbul
- Notre Dame College, Motijheel Circular Road, Arambagh, Motijheel, Dhaka 1000, Bangladesh
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Evaluation of microvascular anastomosis using real-time, ultra-high-resolution, Fourier domain Doppler optical coherence tomography. Plast Reconstr Surg 2015; 135:711e-720e. [PMID: 25811583 DOI: 10.1097/prs.0000000000001124] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Evolution in microsurgical techniques and tools has paved the way for supermicrosurgical anastomoses, with vessel diameters often approaching below 0.8 mm in the clinical realm and even smaller (0.2 to 0.3 mm) in murine models. Several imaging and monitoring devices have been introduced for postoperative monitoring, but intraoperative guidance, assessment, and predictability have remained limited to binocular optical microscopy and the surgeon's experience. The authors present a high-resolution, real-time, three-dimensional imaging modality for intraoperative evaluation of luminal narrowing, thrombus formation, and flow alterations. METHODS An imaging modality that provides immediate, in-depth, high-resolution, three-dimensional structure view and flow information of the anastomosed site, called phase-resolved Doppler optical coherence tomography, was developed. Twenty-two mouse femoral artery anastomoses and 17 mouse venous anastomoses were performed and evaluated. Flow status, vessel inner lumen three-dimensional structure, and early thrombus detection were analyzed based on imaging results. Predictions formed correlated with actual long-term surgical outcomes. Eventually, four cases of mouse orthotopic limb transplantation were carried out, and predicted long-term patency based on imaging results was confirmed by actual results. RESULTS The assessments based on high-resolution three-dimensional visualization of the vessel flow status and inner lumen provided by phase-resolved Doppler optical coherence tomography show 92 percent sensitivity and 90 percent specificity for arterial anastomoses and 90 percent sensitivity and 86 percent specificity for venous anastomoses. CONCLUSIONS Phase-resolved Doppler optical coherence tomography is an effective evaluation tool for microvascular anastomosis. It can predict the long-term vessel patency with high sensitivity and specificity.
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Zammar SG, Hamade YJ, El Tecle NE, El Ahmadieh TY, Caughel KCM, Carroll TJ, Bendok BR. Optical coherence tomography as a potential tool for extravascular imaging in vascular neurosurgery. Neurosurgery 2014; 75:N17-8. [PMID: 25033360 DOI: 10.1227/01.neu.0000452315.99484.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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