Real-time augmented reality for delineation of surgical margins during neurosurgery using autofluorescence lifetime contrast.
Real-time augmented reality for delineation of surgical margins during neurosurgery using autofluorescence lifetime contrast.
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DOI：
10.1002/jbio.201900108
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发表时间：
2020-01
影响因子：
2.8
通讯作者：
Marcu L
中科院分区：
文献类型：
--
作者：
Alfonso-Garcia A;Bec J;Sridharan Weaver S;Hartl B;Unger J;Bobinski M;Lechpammer M;Girgis F;Boggan J;Marcu L
目前用于肿瘤切除手术计划的临床脑成像技术缺乏术中和实时反馈;因此外科医生最终依赖于主观评估来识别肿瘤区域和边缘。我们报告了一种荧光寿命成像（FLIm）仪器（激发：355 nm;发射光谱带：390/40 nm，470/28 nm，542/50 nm和629/53 nm），该仪器与手术显微镜集成，以提供实时术中增强手术视野，并使用荧光衍生参数编码诊断信息。我们展示了在接受开颅手术切除脑肿瘤和/或辐射损伤组织的患者的神经外科手术中该器械的功能和安全性特征。我们在三个案例研究中证明了该仪器能够分辨不同的组织类型和病理，包括皮质、白色物质、肿瘤和辐射引起的坏死。特别是，两名患者与辐射诱导的坏死的影响表现出较长的荧光寿命和增加的光学氧化还原比的坏死组织相对于非受影响的皮质，和少突胶质细胞瘤切除的第三例患者报告较短的荧光寿命和减少的光学氧化还原比比周围的白色的问题。这些结果鼓励使用FLIm作为神经外科引导的无标记和非侵入性术中工具。术中荧光寿命成像（FLIm）仪器在人脑手术中安全使用，以解决不同的组织类型和病理，如三个案例研究所报告的。自体荧光寿命对比提供了不同脑组织（包括皮质、肿瘤和辐射诱导的坏死）的无标记生化信息。FLIm仪器与手术显微镜集成，通过编码诊断信息的荧光衍生参数提供手术视野的实时术中增强。
Current clinical brain imaging techniques used for surgical planning of tumor resection lack intraoperative and real-time feedback; hence surgeons ultimately rely on subjective evaluation to identify tumor areas and margins. We report a fluorescence lifetime imaging (FLIm) instrument (excitation: 355 nm; emission spectral bands: 390/40 nm, 470/28 nm, 542/50 nm, and 629/53 nm) that integrates with surgical microscopes to provide real-time intraoperative augmentation of the surgical field of view with fluorescent derived parameters encoding diagnostic information. We show the functionality and safety features of this instrument during neurosurgical procedures in patients undergoing craniotomy for the resection of brain tumors and/or tissue with radiation damage. We demonstrate in three case studies the ability of this instrument to resolve distinct tissue types and pathology including cortex, white matter, tumor, and radiation-induced necrosis. In particular, two patients with effects of radiation induced necrosis exhibited longer fluorescence lifetimes and increased optical redox ratio on the necrotic tissue with respect to non-affected cortex, and an oligodendroglioma resected from a third patient reported shorter fluorescence life-time and a decrease in optical redox ratio than the surrounding white matter. These results encourage the use of FLIm as a label-free and non-invasive intraoperative tool for neurosurgical guidance. An intraoperative fluorescence lifetime imaging (FLIm) instrument is safely used during human brain surgery to resolve distinct tissue types and pathologies, as reported in three case studies. Autofluorescence lifetime contrast provides label-free biochemical information of distinct brain tissues including cortex, tumors, and radiation induced necrosis. The FLIm instrument integrates with surgical microscopes to provide real-time intraoperative augmentation of the surgical field of view with fluorescent-derived parameters encoding diagnostic information.
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影响因子：
10
作者：
Hu S;Kang H;Baek Y;El Fakhri G;Kuang A;Choi HS
通讯作者：
Choi HS
DOI：
10.1073/pnas.0708425104
发表时间：
2007-12-04
影响因子：
11.1
作者：
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影响因子：
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作者：
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影响因子：
3.4
作者：
Hartl, Brad A.;Ma, Htet S. W.;Marcu, Laura
通讯作者：
Marcu, Laura