Label-free intraoperative nerve detection and visualization using ratiometric diffuse reflectance spectroscopy.
Label-free intraoperative nerve detection and visualization using ratiometric diffuse reflectance spectroscopy.
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DOI：
10.1038/s41598-023-34054-6
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发表时间：
2023-05-10
影响因子：
4.6
通讯作者：
中科院分区：
文献类型：
--
作者：
医源性神经损伤对各种外科学科的术后发病率有显著影响，仅在美国每年就发生约500，000例。目前，除了外科医生的视觉评估之外，还没有临床上采用的方法来术中可视化神经。在这里，我们报告了一种无标记的方法，神经检测使用漫反射光谱（DRS）。从体内大鼠模型开始，基于纤维和成像的DRS独立地识别了相似的波长，为神经识别提供了最佳对比度，准确率为92%。大鼠和人类尸体组织的光学特性测量验证了神经和周围组织之间的对比度的来源主要是由于神经中的较高散射和氧合血红蛋白含量的差异。在使用基于探针和基于成像的方法进行甲状腺切除术的患者中证明了临床可行性，其中神经识别的准确率为91%。根据我们的初步结果，DRS有可能为外科医生提供无标签的术中神经可视化手段，并减少医源性神经损伤沿着其有害并发症的发生率。
Iatrogenic nerve injuries contribute significantly to postoperative morbidity across various surgical disciplines and occur in approximately 500,000 cases annually in the US alone. Currently, there are no clinically adopted means to intraoperatively visualize nerves beyond the surgeon’s visual assessment. Here, we report a label-free method for nerve detection using diffuse reflectance spectroscopy (DRS). Starting with an in vivo rat model, fiber- and imaging-based DRS independently identified similar wavelengths that provided optimal contrast for nerve identification with an accuracy of 92%. Optical property measurements of rat and human cadaver tissues verify that the source of contrast between nerve and surrounding tissues is largely due to higher scattering in nerve and differences in oxygenated hemoglobin content. Clinical feasibility was demonstrated in patients undergoing thyroidectomies using both probe-based and imaging-based approaches where the nerve were identified with 91% accuracy. Based on our preliminary results, DRS has the potential to both provide surgeons with a label-free, intraoperative means of nerve visualization and reduce the incidence of iatrogenic nerve injuries along with its detrimental complications.
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影响因子：
1.9
作者：
Gebhart, Steven C.;Majumder, Shovan K.;Mahadevan-Jansen, Anita
通讯作者：
Mahadevan-Jansen, Anita
影响因子：
3.5
作者：
Bigio, IJ;Mourant, JR
通讯作者：
Mourant, JR
影响因子：
3.4
作者：
Farrar, Matthew J.;Wise, Frank W.;Schaffer, Chris B.
通讯作者：
Schaffer, Chris B.
DOI：
10.1007/s00464-021-08484-0
发表时间：
2021-04-09
影响因子：
3.1
作者：
Dip, Fernando;Bregoli, Pedro;Rosenthal, Raul J.
通讯作者：
Rosenthal, Raul J.
影响因子：
4.1
作者：
Fernández-Pérez A;Marbán G
通讯作者：
Marbán G