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.

项目概要/摘要 在颅底手术中识别颅神经是避免医源性损伤的关键。连 对这些神经中的任何一个的轻微损伤都会极大地影响患者的结果。尽管重要性 在颅神经识别方面，术前影像学很难提供所需的信息。期间 在外科手术中，电刺激技术通常用于提供基于点分析 神经及其功能的能力，但他们仍然无法描绘整个领域。其实有 目前没有能够映射神经纤维并向外科医生显示其位置的临床工具 在真实的时间里。在这个项目中，我们建议开发一种成像工具，可以填补目前这一明显的空白， 技术并将其直接交给颅底外科医生。该工具将基于极化 灵敏的光学相干断层扫描（OCT），一种显示精细对比度的光学成像模式 有髓神经的激光技术的最新进展（称为圆形测距，由 导师Vakoc博士）已经将OCT激光器的使用与运动兼容 由标准手术流程诱导。这个有两个目标的项目旨在将循环测距纳入 颅底手术期间的手术室，并评估其增强颅神经可视化的能力， 独特地结合了外科和技术专长。这项工作将在两个NIH之间进行- 资助的P41持有机构：马萨诸塞州总医院的韦尔曼光医学中心 (MGH)，生物医学OCT研究中心（CBORT）和布里格姆妇女医院的所在地 (BWH)，国家图像引导治疗中心（NCIGT）的所在地， 先进的多模态图像引导手术套件（AMIGO），无论是在设备方面， 经验，将为进行此类研究提供完美的环境。该奖项的候选人是 博士Danielle J.哈珀，麻省总医院和哈佛医学院的博士后研究员。哈珀医生 在生物光子学领域训练有素她的专业领域是OCT及其功能扩展，包括 偏振映射和深度分辨光谱。她的长期职业目标是达到学术 独立性和领导一个研究小组，专注于术中光学神经成像。帮她 为了实现这一目标，哈珀博士建立了一个强大的团队，在研究和职业生涯的各个方面指导她 发展MGH/HMS的Benjamin J. Vakoc博士是光学成像专家，他将担任主要的 导师BWH的神经外科医生亚历山德拉·J·戈尔比博士和迈克尔·穆尼博士将提供指导， 指导和协助所有临床方面。波士顿大学的雷天博士将提供监督 并为该项目的深度学习方面提供指导，MGH/HMS的Tayyaba Hasan博士将 提供一般的职业发展建议。在这个团队的支持下，这个职业发展奖将 给哈珀医生所需的剩余技能和培训，使她过渡到完全独立。