Transforming neuronavigational imaging for assisting brain tumour surgery

每年有超过1300万患者需要脑部手术。测量大脑功能在神经外科手术中是至关重要的，例如，在切除脑肿瘤时。神经外科医生需要区分健康组织和肿瘤，并确保手术期间和手术后患者脑功能的完整性。此外，他们还需要识别肿瘤边界，以便在保留健康组织的同时精确切除肿瘤。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定量、准确和实时的大脑活动和肿瘤位置信息。目前的导航方法存在很大的局限性，因为它们不能为外科医生提供足够的信息，过于侵入性，或者不能足够准确地评估大脑活动。此外，更精确的肿瘤边界检测需要肿瘤的生化特征，这可以通过先进的成像来实现。因此，HyperProbe联盟将建立在实验室为基础的设备转化为临床环境。该联盟将提出一种新的多功能高光谱成像设备，用于术中实时、定量和准确地评估大脑活动和肿瘤边界。该设备采用光学、非接触式和微创神经成像方法，将在手术和皮质活动刺激期间提供关于脑组织和肿瘤特征的详尽生化信息。来自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在外的大脑，并测量术中脑组织的反射和荧光信号。”“为图像分析量身定制的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，它将通过增强现实技术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、可运输且易于使用的设备，该设备将与现有的临床仪器集成，完全适合手术室。“在HyperProbe内部，我们将进行可行性研究，以评估HyperProbe设备在患者身上的性能。我们将验证脑肿瘤手术期间的成像性能和脑活动测量。这一观察性的概念验证分析将为将这一极具前景的新工具引入诊所铺平道路。”卡米拉·博纳多说，他来自卡雷吉大学医院。该项目将对临床实践产生重大影响，因为该联盟首次在神经外科中提出了一种功能成像和基于机器的决策方法。HyperProbe设备将是第一个多生物标志物、定量光学成像设备和功能成像设备，用于图像引导手术，以保持大脑功能，最大限度地降低术后神经损伤的风险，并显着提高患者的预期寿命。研究目标：该博士项目的目标是：(1)计量特性和(2)高光谱仪器成像和光谱参数的优化。这将通过开发数字幻影平台（光扩散模拟器）和模拟皮质血流动力学代谢功能和结构的新型光学幻影（固体和液体）来实现。

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.