Artikel
Non-invasive intraoperative optical coherence tomography of the resection cavity during surgery of intrinsic brain tumors
Intraoperative optische Kohärenz-Tomographie zur Detektion von Resttumorgewebe während der Resektion intrinsischer Hirntumore
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Veröffentlicht: | 8. Mai 2006 |
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Gliederung
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Objective: Spectral domain optical coherence tomography (SOCT) is a non-invasive imaging technique with a micrometer resolution. Optical coherence tomography can operate with no tissue contact, and similar to ultrasound B-mode imaging, can generate images in 2, 3, and 4 dimensional data arrays based on the reflection of infrared laser light using the inherent optical tissue contrast. We have developed this technology for intraoperative use and the detection of residual tumor during brain tumor surgery.
Methods: We have used a near infrared 830nm laser to analyse brain tumor tissue and areas of the resection cavity during resection of gliomas. The site of analysis was registered using a neuronavigation system and a biopsy was taken and submitted to routine histology. We have used post image acquisition processing to compensate for movements of the brain and to realign A-scan images for calculation of a light attenuation factor.
Results: OCT imaging of normal cortex and white matter showed a typical light attenuation profile. Tumor tissue depending on the cellularity of the specimen showed a loss of the normal light attenuation profile resulting in altered light attenuation coefficients compared to normal brain. Based on this parameter and the microstructure of the tumor tissue, which was entirely absent in normal tissue, OCT analysis allowed the discrimination between normal brain tissue, invaded brain, solid tumor tissue and necrosis. Following macroscopically complete resections, OCT analysis of the resection cavity displayed the typical microstructure and light attenuation profile of tumor tissue in some specimens, which in routine histology contained residual tumor tissue.
Conclusions: Spectral domain optical coherence tomography allows non-contact / non-invasive analysis of central nervous system tissues with a penetration depth of 2-3 mm, reaching a spatial resolution of approximately 4-10 µm. We have demonstrated that this technology may be applied to the intraoperative detection of residual tumor in situ.