Images of Spinal Nerves and Adjacent Structures With Optical Coherence Tomography: Preliminary Animal Studies

Raphael, David T.; Yang, Changhuei; Tresser, Nancy; Wu, Jigang; Zhang, Yaoping; Rever, Linda

doi:10.1016/j.jpain.2007.04.006

Cited by 18 publications

(13 citation statements)

References 22 publications

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“…To increase the range of depths at which sensing can be performed, FOH sensors with a plano-concave cavity that have greater US sensitivity could be used 16 . Ultimately, the same fibre optic used for US sensing could also be used for optical sensing of the tissue environment with modalities such as reflectance spectroscopy 17–22 , Raman spectroscopy 23 , optical coherence tomography 24, 25 , and photoacoustic imaging 26–28 .…”

Section: Discussionmentioning

confidence: 99%

Looking beyond the imaging plane: 3D needle tracking with a linear array ultrasound probe

Xia¹,

West²,

Finlay³

et al. 2017

Sci Rep

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Ultrasound is well suited for guiding many minimally invasive procedures, but its use is often precluded by the poor visibility of medical devices. When devices are not visible, they can damage critical structures, with life-threatening complications. Here, we developed the first ultrasound probe that comprises both focused and unfocused transducer elements to provide both 2D B-mode ultrasound imaging and 3D ultrasonic needle tracking. A fibre-optic hydrophone was integrated into a needle to receive Golay-coded transmissions from the probe and these data were processed to obtain tracking images of the needle tip. The measured tracking accuracy in water was better than 0.4 mm in all dimensions. To demonstrate the clinical potential of this system, insertions were performed into the spine and the uterine cavity, in swine and pregnant ovine models in vivo. In both models, the SNR ranged from 13 to 38 at depths of 22 to 38 mm, at out-of-plane distances of 1 to 15 mm, and at insertion angles of 33 to 42 degrees relative to the probe surface normal. This novel ultrasound imaging/tracking probe has strong potential to improve procedural outcomes by providing 3D needle tip locations that are co-registered to ultrasound images, while maintaining compatibility with current clinical workflow.

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Section: Discussionmentioning

confidence: 99%

Looking beyond the imaging plane: 3D needle tracking with a linear array ultrasound probe

Xia¹,

West²,

Finlay³

et al. 2017

Sci Rep

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“…[78] The ability of this imaging technique to prevent inadvertent intraneural injection while performing transforaminal nerve root injections has been investigated in animal studies. [79] Though its use in EDS localization has been speculated, it has never been explored.…”

Section: Discussionmentioning

confidence: 99%

Localization of epidural space: A review of available technologies

Elsharkawy

Sonny

Chin

2017

J Anaesthesiol Clin Pharmacol

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Although epidural analgesia is widely used for pain relief, it is associated with a significant failure rate. Loss of resistance technique, tactile feedback from the needle, and surface landmarks are traditionally used to guide the epidural needle tip into the epidural space (EDS). The aim of this narrative review is to critically appraise new and emerging technologies for identification of EDS and their potential role in the future. The PubMed, Cochrane Central Register of Controlled Clinical Studies, and Web of Science databases were searched using predecided search strategies, yielding 1048 results. After careful review of abstracts and full texts, 42 articles were selected to be included. Newer techniques for localization of EDS can be broadly classified into techniques that (1) guide the needle to the EDS, (2) identify needle entry into the EDS, and (3) confirm catheter location in EDS. An ideal method should be easy to learn and perform, easily reproducible with high sensitivity and specificity, identifies inadvertent intrathecal and intravascular catheter placements with ease, feasible in perioperative setting and have a cost-benefit advantage. Though none of them in their current stages of development qualify as an ideal method, many show tremendous potential. Some techniques are useful in patients with difficult spinal anatomy and infants, and thus are complementary to traditional methods. In addition to improving the existing technology, future research should aim at proving the superiority of these techniques over traditional methods, specifically regarding successful EDS localization, better safety profile, and a favorable cost-benefit ratio.

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“…Optical coherence tomography (OCT), an optical analog of ultrasound, provides micron-level spatial resolution and does not require a saline bolus for imaging within the epidural space; images can be generated with probes in direct contact with tissue [31,32]. In a preliminary study, Raphael et al demonstrated that a forward-looking OCT probe could resolve structures such as arteries and nerves in a porcine model and a dural puncture in a rabbit [33]. At present, the histological correlates of OCT images acquired from the spinal region are not well understood, and more studies are required to determine whether OCT can provide sufficient image contrast for structures relevant to decreasing complications resulting from epidural injection.…”

Section: Discussionmentioning

confidence: 99%

Epidural needle with embedded optical fibers for spectroscopic differentiation of tissue: ex vivo feasibility study

Desjardins

Hendriks

Voort

et al. 2011

Biomed. Opt. Express

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Epidural injection is commonly used to provide intraoperative anesthesia, postoperative and obstetric analgesia, and to treat acute radicular pain. Identification of the epidural space is typically carried out using the loss of resistance (LOR) technique, but the usefulness of this technique is limited by false LOR and the inability to reliably detect intravascular or subarachnoid needle placement. In this study, we present a novel epidural needle that allows for the acquisition of optical reflectance spectra from tissue close to the beveled surface. This needle has optical fibers embedded in the cannula that deliver and receive light. With two spectrometers, light received from tissue is resolved across the wavelength range of 500 to 1600 nm. To determine the feasibility of optical tissue differentiation, spectra were acquired from porcine tissues during a post mortem laminectomy. The spectra were processed with an algorithm that derives estimates of the hemoglobin and lipid concentrations. The results of this study suggest that the optical epidural needle has the potential to improve the accuracy of epidural space identification.

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Images of Spinal Nerves and Adjacent Structures With Optical Coherence Tomography: Preliminary Animal Studies

Cited by 18 publications

References 22 publications

Looking beyond the imaging plane: 3D needle tracking with a linear array ultrasound probe

Looking beyond the imaging plane: 3D needle tracking with a linear array ultrasound probe

Localization of epidural space: A review of available technologies

Epidural needle with embedded optical fibers for spectroscopic differentiation of tissue: ex vivo feasibility study

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