Transforming neuronavigational imaging for assisting brain tumour surgery

每年有超过1300万名患者需要进行脑部手术。在神经外科手术中，测量大脑功能是至关重要的，例如，在切除脑瘤时。神经外科医生需要区分健康组织和肿瘤，并确保手术中和手术后患者大脑功能的完整性。此外，他们还需要确定肿瘤的边界，以便在保留健康组织的同时准确地切除肿瘤。为了完成任务并提高治疗效果，外科医生需要神经导航系统为他们提供关于大脑活动和肿瘤位置的定量、准确和实时的信息。目前的导航方法存在重大局限性，因为它们不能为外科医生提供足够的信息，太具侵入性，或者不能足够准确地评估大脑活动。此外，肿瘤的生化特征需要更精确的肿瘤边界检测，这可以通过先进的成像实现。因此，HyperProbe联盟将建立在实验室设备的基础上，将其转化为临床设备。该联盟将提出一种新的多功能高光谱成像设备，以便在术中提供实时、定量和准确的脑活动和肿瘤边界评估。该设备使用光学、非接触式、因此是微创的神经成像方法，将在手术和皮质活动刺激期间提供有关脑组织和肿瘤特征的详尽生化信息。佛罗伦萨大学的项目协调员Francesco Pavone解释说，HyperProbe系统将用非电离光照亮暴露的大脑，并在术中测量脑组织的反射和荧光信号。他补充说，用于图像分析的定制机器学习和人工智能算法将识别目标区域大脑活动的生物标志物。然后它将通过增强现实将这些信息实时传递给临床医生。该项目将开发和验证一种具有成本效益、可运输和易于使用的设备，将其与完全适合手术室的现有临床仪器集成在一起。卡雷吉大学医院的卡米拉·博诺说：“在HyperProbe内部，我们将开展可行性研究，以评估HyperProbe设备在患者身上的表现。我们将验证脑瘤手术期间的成像性能和大脑活动测量。这种观察性的、概念验证的分析将为将这一极具前景的新工具引入临床铺平道路。该项目将对临床实践产生重大影响，因为该联盟首次提出了一种功能成像和基于机器的神经外科决策方法。HyperProbe设备将是第一个用于图像引导手术的多生物标记物、定量光学成像设备和功能成像设备，以保护大脑功能并将术后神经损伤的风险降至最低，并显著提高患者的预期寿命。研究目标：本博士项目的目标是：(1)计量特征和(2)优化成像和光谱参数的高光谱仪器。这将通过开发数字体模平台(光扩散模拟器)和新的光学体模(固体和液体)来实现，这些体模模拟皮质血流动力学\代谢功能和结构。

More than 13 million patients require brain surgery every year. Measuring brain function is paramount during neurosurgery, for example, when removing brain tumours. Neurosurgeons need to differentiate between healthy tissue and the tumour and ensure the integrity of the patient's brain function during and after surgery. Also, they need to identify tumour borders to precisely remove the tumour while saving healthy tissue. To accomplish their task and increase treatment effectiveness, surgeons require neuro-navigation systems to provide them with quantitative, accurate and real-time information on brain activity and tumour location. Current navigation approaches present major limitations as they do not provide the surgeons with sufficient information, are too invasive, or cannot assess brain activity accurately enough. Moreover, biochemical characterisation of the tumour is needed for more precise tumour border detection, which can be achieved through advanced imaging.Therefore, the HyperProbe consortium will build on laboratory-based devices to be translated into a clinical setting. The consortium will propose a new multifunctional hyperspectral imaging device to provide real-time, quantitative, and accurate assessment of brain activity and tumour borders intraoperatively. Using an optical, contactless, and hence minimally invasive neuroimaging approach, the device will provide exhaustive biochemical information on the brain tissue and tumour features during surgery and cortical activity stimulation. "The HyperProbe system will illuminate the exposed brain with non-ionising light and measure the reflected and fluorescent signals from the brain tissue intraoperatively", explains Francesco Pavone, Project Coordinator from the University of Florence. "Tailored machine learning and artificial intelligence algorithms for image analysis will identify biomarkers of brain activity in the targeted area. It will then deliver this information to the clinician in real time via augmented reality", he adds.The project will develop and validate a cost- effective, transportable, and easy-to-use device to be integrated with existing clinical instrumentation that is fully suitable for the operating room. "Within HyperProbe, we will carry out feasibility studies to assess the performance of the HyperProbe device on patients. We will validate the imaging performance and brain activity measurements during brain tumour surgery. This observational, proof-of-concept analysis will pave the way for bringing this highly promising new tool to the clinics", states Camilla Bonaudo, Careggi University Hospital.The project will significantly impact clinical practice as the consortium proposes, for the first time, a functional-imaging and machine-based decision-making approach in neurosurgery. The HyperProbe device will be the first multi-biomarker, quantitative optical imaging device and functional imaging device used in image-guided surgery to preserve brain functions and minimise the risk of postoperative neurological impairment and considerably improve the life expectancy of patients.Research Aims:The objectives of this PhD project are: (1) the metrological characterization and (2) the optimisation of hyperspectral instruments for imaging and spectroscopic parameters. This will be done by developing a digital phantom platform (Light Diffusion Simulator) and new optical phantoms (solid and liquid) that mimic the cortical haemodynamic\metabolic function and structure.