gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

Certified prototype of an OCT – integrated operating microscope for intraoperative optical tissue analysis

CE-zertifizierter Prototyp eines OCT-integrierten Operationsmikroskops zur intraoperativen Gewebeanalyse

Meeting Abstract

  • corresponding author A. Giese - Neurochirurgische Klinik, Universitätsklinikum Göttingen
  • S. R. Kantelhardt - Neurochirurgische Klinik, Universitätsklinikum Göttingen
  • S. Oelckers - Möller-Wedel, Wedel
  • E. Lankenau - Institut für Biomedizinische Optik, Universität Lübeck
  • G. Hüttmann - Institut für Biomedizinische Optik, Universität Lübeck
  • V. Rohde - Neurochirurgische Klinik, Universitätsklinikum Göttingen

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocDI.01.01

The electronic version of this article is the complete one and can be found online at:

Published: May 30, 2008

© 2008 Giese et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Optical coherence tomography (OCT) is a non-invasive imaging technique with a micrometer resolution, which can operate with no tissue contact and generate 2, 3, and 4 dimensional image data arrays based on the reflection of infrared laser light. Preclinical studies have demonstrated that OCT may detect tumor during surgical removal of gliomas. We have developed a clinical prototype of an OCT integrated operating microscope in which the OCT laser utilizes the optical path of a modified surgical microscope now suitable for clinical routine use.

Methods: The optical path of the light router of a HR-1000 Möller-Wedel operating microscope was optimized for both the near-infrared and conventional light spectrum. The difference of the refractions of laser and visible light was corrected by adaptation of a dedicated lens system, which maintains full use of zoom and auto-focus function of the microscope. A coherence tomography was integrated into the microscope, which may be fully operated by the neurosurgeon.

Results: OCT imaging of tumor tissue depending on the cellularity of the specimen showed a loss of the light attenuation profile of 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 of normal brain tissue, invaded brain, solid tumor tissue, and necrosis. In a clinical pilot study OCT analysis of the resection cavity demonstrated residual tumor tissue following macroscopically complete resections, which was confirmed by histological analysis. The OCT integrated microscope remained fully functional for microsurgery and allowed OCT analysis of a 3–50 mm scan line at a zoom factor 2–14.3. OCT – Doppler allowed none-contact measurements of blood flow in capillaries and major vessels.

Conclusions: Integration of optical coherence tomography into an operating microscope allows continuous and immediate tissue analysis of the resection edge during neurosurgical resection of brain tumors and identifies residual tumor prior to secondary changes such as induced by tissue contusion. OCT-Doppler integration further offers functional analysis of blood flow and tissue perfusion through the microscope and therefore extents the information provided beyond conventional operating microscopes today.