Intraoperative Identification of Cranial Nerves in Skull Base Surgery Using Polarization Sensitive Optical Coherence Tomography

使用偏振敏感光学相干断层扫描术中识别颅底手术中的脑神经

• 批准号: 10662675
• 负责人: Danielle J. Harper
• 金额: $ 13.1万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10662675
• 关键词: Acoustic Neuroma; Address; Affect; Anatomy; Area; Award; Back; Biophotonics; Blood Vessels; Boston; Brain; Cancerous; Clinical; Collagen; Complex; Cranial Nerves; Crowding; Data; Deformity; Electric Stimulation; Electromyography; Environment; Equipment; Evaluation; Excision; Fascicle; Fluorescence; Focus Groups; Funding; General Hospitals; Goals; Growth; Hand; Home; Hospitals; Image; Image-Guided Surgery; Imaging Device; Imaging Techniques; Imaging technology; Injury; Institution; K-Series Research Career Programs; Label; Laboratories; Lasers; Lead; Lipid Bilayers; Location; Maps; Massachusetts; Measures; Mentors; Microscope; Morbidity - disease rate; Motion; Multimodal Imaging; Nerve; Nerve Fibers; Neurosurgeon; Olfactory Nerve; Operative Surgical Procedures; Optical Coherence Tomography; Optics; Outcome; Patient-Focused Outcomes; Performance; Phase; Postdoctoral Fellow; Preparation; Research; Research Design; Resolution; Resources; Sampling; Specificity; Spectrum Analysis; Supervision; Surface; Surgeon; System; Technical Expertise; Techniques; Technology; Testing; Time; Tissues; Training; Translational Research; United States National Institutes of Health; Universities; Variant; Vertebral column; Visualization; Woman; Work; career; career development; contrast enhanced; deep learning; deep learning algorithm; design; electrical measurement; experience; first-in-human; human study; iatrogenic injury; image guided; image guided therapy; imaging facilities; imaging modality; improved; invention; medical schools; meningioma; nerve damage; nerve injury; neuroimaging; neurosensory; neurosurgery; novel; optical imaging; practical application; real-time images; research and development; skills; skull base; spine bone structure; tool; tumor; validation studies

Project summary/abstract Identification of cranial nerves during skull base surgery is critical to avoid iatrogenic injury. Even the slightest damage to any one of these nerves can hugely affect patient outcomes. Despite the importance of cranial nerve identification, preoperative imaging struggles to provide the needed information. During the surgical procedure, electrostimulation techniques are often utilized to provide a point-based analysis of a nerve and its functional capability, but they remain unable to picture the whole field. In fact, there is no current clinical tool capable of mapping nerve fibers and displaying their location back to the surgeon in real time. In this project, we propose to develop an imaging tool that can fill this obvious gap in current technology and place it directly into the hands of skull base surgeons. This tool will be based on polarization sensitive optical coherence tomography (OCT), an optical imaging modality that shows exquisite contrast for myelinated nerves. Recent advances in laser technology (known as circular ranging, invented by Mentor Dr. Vakoc) have brought OCT lasers to a point where their use is compatible with the motion induced by standard surgical workflow. This two-aim project seeks to bring circular ranging into the operating theater during skull base surgery and assess its capability to enhance cranial nerve visualization, uniquely combining both surgical and technical expertise. This work will take place between two NIH- funded P41-holding institutions: the Wellman Center for Photomedicine at Massachusetts General Hospital (MGH), home to the Center for Biomedical OCT Research (CBORT), and Brigham and Women’s Hospital (BWH), home of the National Center for Image-Guided Therapy (NCIGT) where the resources of the Advanced Multi-modality Image Guided Operating suite (AMIGO), both in terms of equipment and experience, will provide the perfect environment to conduct such a study. The candidate for this award is Dr. Danielle J. Harper, a postdoctoral fellow at MGH and Harvard Medical School. Dr. Harper has been well trained in the field of biophotonics. Her area of expertise is OCT and its functional extensions, including polarization mapping and depth-resolved spectroscopy. Her long-term career goal is to reach academic independence and lead a research group focused on intraoperative optical neuroimaging. To help her achieve this, Dr. Harper has built a strong team to guide her in all aspects of research and career development. Dr. Benjamin J. Vakoc at MGH/HMS, an expert in optical imaging, will serve as the primary mentor. Neurosurgeons Dr. Alexandra J. Golby and Dr. Michael Mooney at BWH will provide mentoring, guidance, and assistance with all clinical aspects. Dr. Lei Tian of Boston University will provide supervision and guidance for the deep learning aspects of the project, and Dr. Tayyaba Hasan at MGH/HMS will provide general career development advice. Supported by this team, this career development award will give Dr. Harper the remaining skills and training she requires to make the transition to full independence.

项目摘要/摘要 颅底手术期间颅神经的鉴定对于避免肠胃损伤至关重要。甚至是 对这些神经中的任何一条的丝毫损害都会极大地影响患者的结果。尽管很重要 颅神经识别，术前成像努力提供所需信息。期间 手术程序，电刺激技术通常用于提供基于点的分析 神经及其功能能力，但他们仍然无法描绘整个领域。实际上，有 当前没有能够绘制神经纤维并将其位置归还给外科医生的临床工具 实时。在这个项目中，我们建议开发一个成像工具，以填补当前的明显空白 技术并将其直接放在颅底外科医生的手中。该工具将基于极化 敏感的光学相干断层扫描（OCT），一种光学成像方式，显示了独家对比度 对于髓神经。激光技术的最新进展（称为圆形范围，由 导师Vakoc博士）将OCT激光器带到了其使用与运动兼容的地步 由标准手术工作流程诱导。这个两个aim项目旨在将圆形范围带入 在颅底手术和评估其增强颅神经可视化的能力时，操作剧院的能力， 独特地结合外科和技术专长。这项工作将在两个NIH- 资助的P41持有机构：马萨诸塞州综合医院的Wellman摄影医学中心 （MGH），是生物医学OCT研究中心（CBORT）的所在地，以及杨百翰和妇女医院 （BWH），国家图像引导治疗中心（NCIGT）的故乡 在设备和 经验，将为进行此类研究提供理想的环境。该奖项的候选人是 MGH和哈佛医学院的博士后研究员Danielle J. Harper博士。哈珀博士一直是 在生物光谱领域接受良好的训练。她的专家领域是十月及其功能扩展，包括 极化映射和深度分辨光谱。她的长期职业目标是达到学术 独立并领导着专注于术中光学神经影像学的研究小组。帮助她 实现这一目标，哈珀博士建立了一个强大的团队，以指导她在研究和职业的各个方面 发展。光学成像专家MGH/HMS Benjamin J. Vakoc博士将作为主要 神经外科医生Alexandra J. Golby博士和BWH的Michael Mooney博士将提供指导， 指导和所有临床方面的帮助。波士顿大学的Lei Tian博士将提供监督 以及该项目深度学习方面的指导，MGH/HMS的Tayyaba Hasan博士将 提供一般职业发展建议。在这个团队的支持下，这个职业发展奖将 为哈珀博士提供她所需的剩余技能和培训，以使其过渡到完全独立。