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Zagzoog N, Rastgarjazi S, Ramjist J, Lui J, Hopfgartner A, Jivraj J, Yeretsian T, Zadeh G, Lin V, Yang VXD. Pilot Study of Optical Topographic Imaging Based Neuronavigation for Mastoidectomy. World Neurosurg 2022; 166:e790-e798. [PMID: 35953033 DOI: 10.1016/j.wneu.2022.07.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Mastoidectomy involves drilling the temporal bone while avoiding the facial nerve, semicircular canals, sigmoid sinus, and tegmen. Optical topographic imaging (OTI) is a novel registration technique that allows rapid registration with minimal navigational error. To date, no studies have examined the use of OTI in skull-base procedures. METHODS In this cadaveric study, 8 mastoidectomies were performed in 2 groups-4 free-hand (FH) and 4 OTI-assisted mastoidectomies. Registration accuracy for OTI navigation was quantified with root mean square (RMS) and target registration error (TRE). Procedural time, percent of mastoid resected, and the proximity of the mastoidectomy cavity to critical structures were determined. RESULTS The average RMS and TRE associated with OTI-based registration were 1.44 mm (±0.83 mm) and 2.17 mm (±0.89 mm), respectively. The volume removed, expressed as a percentage of the total mastoid volume, was 37.5% (±10.2%) versus 31.2% (±2.3%), P = 0.31, for FH and OTI-assisted mastoidectomy. There were no statistically significant differences between FH and OTI-assisted mastoidectomies with respect to proximity to critical structures or procedural time. CONCLUSIONS This work is the first examining the application of OTI neuronavigation in lateral skull-base procedures. This pilot study revealed the RMS and TRE for OTI-based navigation in the lateral skull base are 1.44 mm (±0.83 mm) and 2.17 mm (±0.89 mm), respectively. This pilot study demonstrates that an OTI-based system is sufficiently accurate and may address barriers to widespread adoption of navigation for lateral skull-base procedures.
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Affiliation(s)
- Nirmeen Zagzoog
- Institute of Medical Science, School of Graduate Studies, Faculty of Medicine, Toronto, Ontario, Canada; Brain Sciences Program/Imaging Research, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Division of Neurosurgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Bioengineering and Biophotonics Laboratory, Ryerson University, Toronto, Ontario, Canada.
| | - Siavash Rastgarjazi
- Bioengineering and Biophotonics Laboratory, Ryerson University, Toronto, Ontario, Canada
| | - Joel Ramjist
- Brain Sciences Program/Imaging Research, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Bioengineering and Biophotonics Laboratory, Ryerson University, Toronto, Ontario, Canada
| | - Justin Lui
- Department of Otolaryngology - Head and Neck Surgery, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Division of Otolaryngology, Head and Neck Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Adam Hopfgartner
- Orthopedic Biomechanics Laboratory, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Jamil Jivraj
- Bioengineering and Biophotonics Laboratory, Ryerson University, Toronto, Ontario, Canada
| | - Tiffany Yeretsian
- Brain Sciences Program/Imaging Research, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Gelareh Zadeh
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Vincent Lin
- Department of Otolaryngology - Head and Neck Surgery, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Victor X D Yang
- Brain Sciences Program/Imaging Research, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Bioengineering and Biophotonics Laboratory, Ryerson University, Toronto, Ontario, Canada; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Neurosurgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Jivraj J, Ameis SH. Is Repetitive Transcranial Magnetic Stimulation (rTMS) Ready for Clinical Use as a Treatment Tool for Mental Health Targets in Children and Youth? J Can Acad Child Adolesc Psychiatry 2022; 31:93-99. [PMID: 35614951 PMCID: PMC9084373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/10/2022] [Indexed: 06/15/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation tool with potential for broad application in individuals with neuropsychiatric conditions. As in adults, most rTMS research in youth has focused on treatment-resistant depression. A limited number of rTMS studies have also been conducted in children and youth with primary diagnoses of Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD) or Tourette's syndrome. Across the available rTMS literature, rTMS appears to be well tolerated with few adverse effects reported when applied to child and youth research samples. However, the potential efficacy of rTMS treatment for a variety of targets in children and youth remains unclear, due in part to limitations of the current literature, including studies using diverse protocols, potential for bias in existing clinical trial designs, variability in the research samples, and the use of heterogenous outcome measures. While rTMS is unlikely to take the place of more accessible treatments (e.g., psychopharmacological, psychosocial, psychotherapeutic), rTMS may provide a valuable alternative treatment option, particularly for those individuals where conventional treatments are inaccessible, poorly tolerated, or ineffective. A more robust body of well-designed, controlled trials, is needed in order to clarify rTMS treatment efficacy across relevant neuropsychiatric conditions, optimize treatment protocols, and meet the critical need for novel mental health interventions in children and youth.
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Affiliation(s)
- Jamil Jivraj
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Stephanie H Ameis
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario
- Centre for Brain and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario
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Zagzoog N, Rastgarjazi S, Ramjist J, Lui J, Hopfgartner A, Jivraj J, Zadeh G, Lin V, Yang VX. Real-time synchronized recording of force and position data during a mastoidectomy – Toward robotic mastoidectomy development. Interdisciplinary Neurosurgery 2022. [DOI: 10.1016/j.inat.2021.101439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Jivraj J, Chen C, Barrows D, Gu X, Yang VXD. Optimization of laser osteotomy at 1064 nm using a graphite topical absorber and a nitrogen assist gas jet. Biomed Opt Express 2019; 10:3114-3123. [PMID: 31467772 PMCID: PMC6706023 DOI: 10.1364/boe.10.003114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/09/2019] [Accepted: 05/13/2019] [Indexed: 06/10/2023]
Abstract
Laser ablation of bone for the purposes of osteotomy is not as well understood as ablation of homogeneous, non-biological materials such as metals and plastics. Ignition times and etch rate can vary during ablation of cortical bone. In this study, we propose the use of two techniques to optimize bone ablation at 1064nm using a coaxial nitrogen jet as an assist gas and topical application of graphite as a highly absorbing chromophore. We show a two order of magnitude reduction in mean time to ignition and variance by using the graphite topical chromophore. We also show that an increase in volumetric flow rate of the assist gas jet does show an initial increase in etch rate, but increased pressure beyond a certain point shows decreased return. This study also demonstrates a 2 nd order relationship between exposure time, volumetric flow rate of nitrogen, and etch rate of cortical bone. The results of this study can be used to optimize the performance of laser ablation systems for osteotomy. This is a companion study to an earlier one carried out by Wong et al. [Biomedical Opt. Express6, 1 (2015)].
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Affiliation(s)
- Jamil Jivraj
- Biophotonics and Bioengineering Lab, Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, Canada
| | - Chaoliang Chen
- Biophotonics and Bioengineering Lab, Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, Canada
| | | | - Xijia Gu
- Fiber Optics Communications and Sensing Lab, Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, Canada
| | - Victor X D Yang
- Biophotonics and Bioengineering Lab, Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, Canada
- Division of Neurosurgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Surgery, Faculty of Medicine, University of Toronto, Ontario, Canada
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Shi W, Chen C, Jivraj J, Dobashi Y, Gao W, Yang VX. 2D MEMS-based high-speed beam-shifting technique for speckle noise reduction and flow rate measurement in optical coherence tomography. Opt Express 2019; 27:12551-12564. [PMID: 31052795 DOI: 10.1364/oe.27.012551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 04/01/2019] [Indexed: 06/09/2023]
Abstract
In this manuscript, a two-dimensional (2D) micro-electro-mechanical system (MEMS)-based, high-speed beam-shifting spectral domain optical coherence tomography (MHB-SDOCT) is proposed for speckle noise reduction and absolute flow rate measurement. By combining a zigzag scanning protocol, the frame rates of 45.2 Hz for speckle reduction and 25.6 Hz for flow rate measurement are achieved for in-vivo tissue imaging. Phantom experimental results have shown that by setting the incident beam angle to ϕ = 4.76° (between optical axis of objective lens and beam axis) and rotating the beam about the optical axis in 17 discrete angular positions, 91% of speckle noise in the structural images can be reduced. Furthermore, a precision of 0.0032 µl/s is achieved for flow rate measurement with the same beam angle, using three discrete angular positions around the optical axis. In-vivo experiments on human skin and chicken embryo were also implemented to further verify the performance of speckle noise reduction and flow rate measurement of MHB-SDOCT.
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Jivraj J, Deorajh R, Lai P, Chen C, Nguyen N, Ramjist J, Yang VXD. Robotic laser osteotomy through penscriptive structured light visual servoing. Int J Comput Assist Radiol Surg 2019; 14:809-818. [PMID: 30730030 DOI: 10.1007/s11548-018-01905-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/19/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Planning osteotomies is a task that surgeons do as part of standard surgical workflow. This task, however, becomes more difficult and less intuitive when a robot is tasked with performing the osteotomy. In this study, we aim to provide a new method for surgeons to allow for highly intuitive trajectory planning, similar to the way an attending surgeon would instruct a junior. METHODS Planning an osteotomy, especially during a craniotomy, is performed intraoperatively using a sterile surgical pen or pencil directly on the exposed bone surface. This paper presents a new method for generating osteotomy trajectories for a multi-DOF robotic manipulator using the same method and relaying the penscribed cut path to the manipulator as a three-dimensional trajectory. The penscribed cut path is acquired using structured light imaging, and detection, segmentation, optimization and orientation generation of the Cartesian trajectory are done autonomously after minimal user input. RESULTS A 7-DOF manipulator (KUKA IIWA) is able to follow fully penscribed trajectories with sub-millimeter accuracy in the target plane and perpendicular to it (0.46 mm and 0.36 mm absolute mean error, respectively). CONCLUSIONS The robot is able to precisely follow cut paths drawn by the surgeon directly onto the exposed boney surface of the skull. We demonstrate through this study that current surgical workflow does not have to be drastically modified to introduce robotic technology in the operating room. We show that it is possible to guide a robot to perform an osteotomy in much the same way a senior surgeon would show a trainee by using a simple surgical pen or pencil.
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Affiliation(s)
- Jamil Jivraj
- Biophotonics & Bioengineering Laboratory, Department of Electrical & Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, Canada.
| | - Ryan Deorajh
- Biophotonics & Bioengineering Laboratory, Department of Electrical & Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, Canada
| | - Phillips Lai
- Biophotonics & Bioengineering Laboratory, Department of Electrical & Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, Canada
| | - Chaoliang Chen
- Biophotonics & Bioengineering Laboratory, Department of Electrical & Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, Canada
| | - Nhu Nguyen
- Biophotonics & Bioengineering Laboratory, Department of Electrical & Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, Canada
| | - Joel Ramjist
- Biophotonics & Bioengineering Laboratory, Department of Electrical & Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, Canada
| | - Victor X D Yang
- Biophotonics & Bioengineering Laboratory, Department of Electrical & Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, Canada.,Division of Neurosurgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada
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Jivraj J, Chen C, Huang Y, Ramjist J, Lu Y, Vuong B, Gu X, Yang VXD. Smart laser osteotomy: integrating a pulsed 1064nm fiber laser into the sample arm of a fiber optic 1310nm OCT system for ablation monitoring. Biomed Opt Express 2018; 9:6374-6387. [PMID: 31065435 PMCID: PMC6491001 DOI: 10.1364/boe.9.006374] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/09/2018] [Accepted: 11/12/2018] [Indexed: 06/09/2023]
Abstract
Real-time depth metrology during material removal via laser ablation is useful in many forms of laser machining. Until now, coaxial optical coherence tomography (OCT) metrology was achieved by the coupling of an OCT imaging beam and ablating beams using a dichroic filter. We present an alternative design with all fiber delivery that is more suitable for surgical laser ablation applications. The novel system design integrates a high peak-power pulsed Yb-doped fiber laser (1064nm) coupled directly into the sample arm of a swept-source OCT system (λc = 1310nm). We measured the OCT signal degradation due to dispersion and attenuation through the ablation fiber laser cavity. Ablation progression is measured in real-time using M-mode OCT. The mean depth targeting error was found to range from 10µm to 80µm in phantom ablation experiments and 21µm to 60µm in bone ablation. A number of issues have been solved, including point-spread function (PSF) peak broadening due to signal delay and dispersion, high bending loss due to dissimilar fiber used throughout the design, and problems due to the extremely high ablation power to swept-source power ratio (> 2×104 peak to average power). To our knowledge, this is the first demonstration of thermal-mediated laser ablation drilling integrated with coaxial OCT imaging through a single-mode, single-cladded output fiber, without using dichroic beam splitters or free-space optic filters anywhere in the optical path and with this high ablation laser power to OCT source power ratio. The removal of bulk optics compared to existing designs opens a new path for compact integration of the entire system. Also, since the ablation laser and OCT feedback system exist along the same fiber path, the need for maintenance and repair are greatly reduced since spatial beam alignment and the potential open-air contamination of optical surfaces are virtually eliminated. We believe that this integrated system is a great candidate for adoption in depth-controlled surgical ablation applications.
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Affiliation(s)
- Jamil Jivraj
- Biophotonics and Bioengineering Lab, Department of Electrical and Computer Engineering, Ryerson University, Toronto,
Canada
| | - Chaoliang Chen
- Biophotonics and Bioengineering Lab, Department of Electrical and Computer Engineering, Ryerson University, Toronto,
Canada
| | - Yize Huang
- Biophotonics and Bioengineering Lab, Department of Electrical and Computer Engineering, Ryerson University, Toronto,
Canada
| | - Joel Ramjist
- Biophotonics and Bioengineering Lab, Department of Electrical and Computer Engineering, Ryerson University, Toronto,
Canada
| | - Yi Lu
- Fiber Optics Communications and Sensing Lab, Department of Electrical and Computer Engineering, Ryerson University, Toronto,
Canada
| | - Barry Vuong
- Biophotonics and Bioengineering Lab, Department of Electrical and Computer Engineering, Ryerson University, Toronto,
Canada
| | - Xijia Gu
- Fiber Optics Communications and Sensing Lab, Department of Electrical and Computer Engineering, Ryerson University, Toronto,
Canada
| | - Victor X. D. Yang
- Biophotonics and Bioengineering Lab, Department of Electrical and Computer Engineering, Ryerson University, Toronto,
Canada
- Division of Neurosurgery, Sunnybrook Health Sciences Centre, Toronto,
Canada
- Department of Surgery, Faculty of Medicine, University of Toronto,
Canada
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Jakubovic R, Guha D, Gupta S, Lu M, Jivraj J, Standish BA, Leung MK, Mariampillai A, Lee K, Siegler P, Skowron P, Farooq H, Nguyen N, Alarcon J, Deorajh R, Ramjist J, Ford M, Howard P, Phan N, Costa LD, Heyn C, Tan G, George R, Cadotte DW, Mainprize T, Yee A, Yang VXD. High Speed, High Density Intraoperative 3D Optical Topographical Imaging with Efficient Registration to MRI and CT for Craniospinal Surgical Navigation. Sci Rep 2018; 8:14894. [PMID: 30291261 PMCID: PMC6173775 DOI: 10.1038/s41598-018-32424-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 09/05/2018] [Indexed: 11/09/2022] Open
Abstract
Intraoperative image-guided surgical navigation for craniospinal procedures has significantly improved accuracy by providing an avenue for the surgeon to visualize underlying internal structures corresponding to the exposed surface anatomy. Despite the obvious benefits of surgical navigation, surgeon adoption remains relatively low due to long setup and registration times, steep learning curves, and workflow disruptions. We introduce an experimental navigation system utilizing optical topographical imaging (OTI) to acquire the 3D surface anatomy of the surgical cavity, enabling visualization of internal structures relative to exposed surface anatomy from registered preoperative images. Our OTI approach includes near instantaneous and accurate optical measurement of >250,000 surface points, computed at >52,000 points-per-second for considerably faster patient registration than commercially available benchmark systems without compromising spatial accuracy. Our experience of 171 human craniospinal surgical procedures, demonstrated significant workflow improvement (41 s vs. 258 s and 794 s, p < 0.05) relative to benchmark navigation systems without compromising surgical accuracy. Our advancements provide the cornerstone for widespread adoption of image guidance technologies for faster and safer surgeries without intraoperative CT or MRI scans. This work represents a major workflow improvement for navigated craniospinal procedures with possible extension to other image-guided applications.
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Affiliation(s)
- Raphael Jakubovic
- Department of Biomedical Physics, Ryerson University, Toronto, ON, Canada.,Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Daipayan Guha
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, School of Graduate Studies, University of Toronto, Toronto, ON, Canada
| | - Shaurya Gupta
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Michael Lu
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Jamil Jivraj
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada
| | - Beau A Standish
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Michael K Leung
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Adrian Mariampillai
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Kenneth Lee
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Peter Siegler
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Patryk Skowron
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada
| | - Hamza Farooq
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada
| | - Nhu Nguyen
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada
| | - Joseph Alarcon
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada
| | - Ryan Deorajh
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada
| | - Joel Ramjist
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada
| | - Michael Ford
- Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Peter Howard
- Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Nicolas Phan
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Leo da Costa
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Chris Heyn
- Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Gamaliel Tan
- Jurong Health, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Rajeesh George
- Jurong Health, Ng Teng Fong General Hospital, Singapore, Singapore
| | - David W Cadotte
- Spine Program and Division of Neurosurgery, Department of Clinical Neurosciences, Department of Radiology, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Todd Mainprize
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Albert Yee
- Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Victor X D Yang
- Biophotonics and Bioengineering Laboratory, Ryerson University Sunnybrook Health Sciences Centre, Toronto, ON, Canada. .,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada. .,Institute of Medical Science, School of Graduate Studies, University of Toronto, Toronto, ON, Canada. .,Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada.
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Chen C, Cheng KHY, Jakubovic R, Jivraj J, Ramjist J, Deorajh R, Gao W, Barnes E, Chin L, Yang VXD. High speed, wide velocity dynamic range Doppler optical coherence tomography (Part V): Optimal utilization of multi-beam scanning for Doppler and speckle variance microvascular imaging. Opt Express 2017; 25:7761-7777. [PMID: 28380895 DOI: 10.1364/oe.25.007761] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this paper, a multi-beam scanning technique is proposed to optimize the microvascular images of human skin obtained with Doppler effect based methods and speckle variance processing. Flow phantom experiments were performed to investigate the suitability for combining multi-beam data to achieve enhanced microvascular imaging. To our surprise, the highly variable spot sizes (ranging from 13 to 77 μm) encountered in high numerical aperture multi-beam OCT system imaging the same target provided reasonably uniform Doppler variance and speckle variance responses as functions of flow velocity, which formed the basis for combining them to obtain better microvascular imaging without scanning penalty. In vivo 2D and 3D imaging of human skin was then performed to further demonstrate the benefit of combining multi-beam scanning to obtain improved signal-to-noise ratio (SNR) in microvascular imaging. Such SNR improvement can be as high as 10 dB. To our knowledge, this is the first demonstration of combining different spot size, staggered multiple optical foci scanning, to achieve enhanced SNR for blood flow OCT imaging.
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Huang Y, Jivraj J, Zhou J, Ramjist J, Wong R, Gu X, Yang VXD. Pulsed and CW adjustable 1942 nm single-mode all-fiber Tm-doped fiber laser system for surgical laser soft tissue ablation applications. Opt Express 2016; 24:16674-16686. [PMID: 27464121 DOI: 10.1364/oe.24.016674] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A surgical laser soft tissue ablation system based on an adjustable 1942 nm single-mode all-fiber Tm-doped fiber laser operating in pulsed or CW mode with nitrogen assistance is demonstrated. Ex vivo ablation on soft tissue targets such as muscle (chicken breast) and spinal cord (porcine) with intact dura are performed at different ablation conditions to examine the relationship between the system parameters and ablation outcomes. The maximum laser average power is 14.4 W, and its maximum peak power is 133.1 W with 21.3 μJ pulse energy. The maximum CW power density is 2.33 × 106 W/cm2 and the maximum pulsed peak power density is 2.16 × 107 W/cm2. The system parameters examined include the average laser power in CW or pulsed operation mode, gain-switching frequency, total ablation exposure time, and the input gas flow rate. The ablation effects were measured by microscopy and optical coherence tomography (OCT) to evaluate the ablation depth, superficial heat-affected zone diameter (HAZD) and charring diameter (CD). Our results conclude that the system parameters can be tailored to meet different clinical requirements such as ablation for soft tissue cutting or thermal coagulation for future applications of hemostasis.
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Farooq H, Genis H, Alarcon J, Vuong B, Jivraj J, Yang VXD, Cohen-Adad J, Fehlings MG, Cadotte DW. High-resolution imaging of the central nervous system: how novel imaging methods combined with navigation strategies will advance patient care. Prog Brain Res 2015; 218:55-78. [PMID: 25890132 DOI: 10.1016/bs.pbr.2014.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This narrative review captures a subset of recent advances in imaging of the central nervous system. First, we focus on improvements in the spatial and temporal profile afforded by optical coherence tomography, fluorescence-guided surgery, and Coherent Anti-Stokes Raman Scattering Microscopy. Next, we highlight advances in the generation and uses of imaging-based atlases and discuss how this will be applied to specific clinical situations. To conclude, we discuss how these and other imaging tools will be combined with neuronavigation techniques to guide surgeons in the operating room. Collectively, this work aims to highlight emerging biomedical imaging strategies that hold potential to be a valuable tool for both clinicians and researchers in the years to come.
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Affiliation(s)
- Hamza Farooq
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada
| | - Helen Genis
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada
| | - Joseph Alarcon
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada
| | - Barry Vuong
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada
| | - Jamil Jivraj
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada
| | - Victor X D Yang
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, ON, Canada; Physical Science-Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada; Division of Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Julien Cohen-Adad
- Institute of Biomedical Engineering, Ecole Polytechnique de Montréal, SensoriMotor Rehabilitation Research Team of the Canadian Institute of Health Research, Montreal, QC, Canada
| | - Michael G Fehlings
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - David W Cadotte
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
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Wong R, Jivraj J, Vuong B, Ramjist J, Dinn NA, Sun C, Huang Y, Smith JA, Yang VX. Development of an integrated optical coherence tomography-gas nozzle system for surgical laser ablation applications: preliminary findings of in situ spinal cord deformation due to gas flow effects. Biomed Opt Express 2015; 6:43-53. [PMID: 25657873 PMCID: PMC4317111 DOI: 10.1364/boe.6.000043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 11/26/2014] [Accepted: 11/26/2014] [Indexed: 06/04/2023]
Abstract
Gas assisted laser machining of materials is a common practice in the manufacturing industry. Advantages in using gas assistance include reducing the likelihood of flare-ups in flammable materials and clearing away ablated material in the cutting path. Current surgical procedures and research do not take advantage of this and in the case for resecting osseous tissue, gas assisted ablation can help minimize charring and clear away debris from the surgical site. In the context of neurosurgery, the objective is to cut through osseous tissue without damaging the underlying neural structures. Different inert gas flow rates used in laser machining could cause deformations in compliant materials. Complications may arise during surgical procedures if the dura and spinal cord are damaged by these deformations. We present preliminary spinal deformation findings for various gas flow rates by using optical coherence tomography to measure the depression depth at the site of gas delivery.
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Affiliation(s)
- Ronnie Wong
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, M5B 2K3,
Canada
| | - Jamil Jivraj
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, M5B 2K3,
Canada
| | - Barry Vuong
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, M5B 2K3,
Canada
| | - Joel Ramjist
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, M5B 2K3,
Canada
| | - Nicole A. Dinn
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, M5B 2K3,
Canada
- Department of Surgical Neuromonitoring, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario, M4N 3M5,
Canada
| | - Cuiru Sun
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, M5B 2K3,
Canada
| | - Yize Huang
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, M5B 2K3,
Canada
| | - James A. Smith
- Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, M5B 2K3,
Canada
| | - Victor X.D. Yang
- Biophotonics and Bioengineering Laboratory, Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, M5B 2K3,
Canada
- Division of Neurosurgery, Faculty of Medicine, University of Toronto, 27 King’s College Circle, Toronto, Ontario, M5S 1A1,
Canada
- Division of Neurosurgery, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario, M4N 3M5,
Canada
- Physical Sciences Program, Sunnybrook Research Institute, 2075 Bayview Ave., Toronto, Ontario, M4N 3M5,
Canada
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Vuong B, Genis H, Wong R, Ramjist J, Jivraj J, Farooq H, Sun C, Yang VX. Evaluation of flow velocities after carotid artery stenting through split spectrum Doppler optical coherence tomography and computational fluid dynamics modeling. Biomed Opt Express 2014; 5:4405-16. [PMID: 25574447 PMCID: PMC4285614 DOI: 10.1364/boe.5.004405] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 11/17/2014] [Accepted: 11/19/2014] [Indexed: 06/04/2023]
Abstract
Hemodynamics plays a critical role in the development of atherosclerosis, specifically in regions of curved vasculature such as bifurcations exhibiting irregular blood flow profiles. Carotid atherosclerotic disease can be intervened by stent implantation, but this may result in greater alterations to local blood flow and consequently further complications. This study demonstrates the use of a variant of Doppler optical coherence tomography (DOCT) known as split spectrum DOCT (ssDOCT) to evaluate hemodynamic patterns both before and after stent implantation in the bifurcation junction in the internal carotid artery (ICA). Computational fluid dynamics (CFD) models were constructed to simulate blood velocity profiles and compared to the findings achieved through ssDOCT images. Both methods demonstrated noticeable alterations in hemodynamic patterns following stent implantation, with features such as slow velocity regions at the neck of the bifurcation and recirculation zones at the stent struts. Strong correlation between CFD models and ssDOCT images demonstrate the potential of ssDOCT imaging in the optimization of stent implantation in the clinical setting.
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Affiliation(s)
- Barry Vuong
- Biophotonics and Bioengineering Laboratory, Dept. Electrical and Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3,
Canada
| | - Helen Genis
- Biophotonics and Bioengineering Laboratory, Dept. Electrical and Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3,
Canada
| | - Ronnie Wong
- Biophotonics and Bioengineering Laboratory, Dept. Electrical and Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3,
Canada
| | - Joel Ramjist
- Biophotonics and Bioengineering Laboratory, Dept. Electrical and Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3,
Canada
| | - Jamil Jivraj
- Biophotonics and Bioengineering Laboratory, Dept. Electrical and Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3,
Canada
| | - Hamza Farooq
- Biophotonics and Bioengineering Laboratory, Dept. Electrical and Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3,
Canada
| | - Cuiru Sun
- Biophotonics and Bioengineering Laboratory, Dept. Electrical and Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3,
Canada
| | - Victor X.D. Yang
- Biophotonics and Bioengineering Laboratory, Dept. Electrical and Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3,
Canada
- Physical Science - Brain Sciences Research Program, Sunnybrook Research Institute, 2075 Bayview Avenue,Toronto, ON, M4N 3M5,
Canada
- Division of Neurosurgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue Toronto, ON, M4N 3M5,
Canada
- Division of Neurosurgery, Faculty of Medicine, University of Toronto, 1 King’s College Circle, Toronto, ON, M5S 1A8,
Canada
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Jivraj J, Sacrey LA, Newton A, Nicholas D, Zwaigenbaum L. Assessing the influence of researcher-partner involvement on the process and outcomes of participatory research in autism spectrum disorder and neurodevelopmental disorders: a scoping review. Autism 2014; 18:782-93. [PMID: 24989447 DOI: 10.1177/1362361314539858] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Participatory research aims to increase the relevance and broaden the implementation of health research by involving those affected by the outcomes of health studies. Few studies within the field of neurodevelopmental disorders, particularly autism spectrum disorders, have involved autistic individuals as partners. This study sought to identify and characterize published participatory research partnerships between researchers and individuals with autism spectrum disorder or other neurodevelopmental disorders and examine the influence of participatory research partnerships on the research process and reported study outcomes. A search of databases and review of gray literature identified seven studies that described participatory research partnerships between academic researchers and individuals with autism spectrum disorder or other neurodevelopmental disorders. A comparative analysis of the studies revealed two key themes: (1) variations in the participatory research design and (2) limitations during the reporting of the depth of the partner's involvement. Both themes potentially limit the application and generalizability of the findings. The results of the review are discussed in relation to the use of evaluative frameworks for such participatory research studies to determine the potential benefits of participatory research partnerships within the neurodevelopmental and autism spectrum disorder populations.
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Jivraj J, Jivraj I, Tennant M, Rudnisky C. Prevalence and impact of depressive symptoms in patients with age-related macular degeneration. Can J Ophthalmol 2014; 48:269-73. [PMID: 23931465 DOI: 10.1016/j.jcjo.2013.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 12/06/2012] [Accepted: 03/14/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study sought to identify the point prevalence of depressive symptoms, quality-of-life (QOL) impairment, and demographic parameters associated with depression in patients with age-related macular degeneration (AMD) attending a retina clinic in Edmonton, Alberta. DESIGN A cross-sectional design was used. METHODS Consecutive patients with AMD were invited to participate in the study. Demographic data, as well as ophthalmic, medical, and psychiatric histories, were collected. Participants completed the Center for Epidemiological Studies Depression Scale (CES-D) and the Visual Function Questionnaire (VFQ-25) scales to quantify the burden of depressive symptoms and vision-related QOL impairment. RESULTS The study enrolled 101 patients, of whom 7 (6.9%) had a previous history of depression. Twenty (21.3%) of the remaining patients endorsed severe symptoms of depression that had not yet been diagnosed. Significant differences in vision-related QOL between depressed and not depressed patients were identified. Depressed patients were also found to have worse visual acuity (p = 0.047) and were less likely to live with others (p = 0.020) than those who were not depressed. CONCLUSIONS After excluding patients with a history of diagnosed depression, 20 (21.3%) patients demonstrated severe symptoms of depression. Development of depression screening protocols for patients with AMD would improve identification and referral of patients at risk. The finding that patients who lived with others had a lower prevalence of depressive symptoms suggests that further research into the relationship between mood symptoms and environmental supports is merited.
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Affiliation(s)
- Jamil Jivraj
- Departments of Pediatrics and Ophthalmology, University of Alberta, Royal Alexandra Hospital, Edmonton, Alta., Canada.
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