Laser speckle imaging identification of increases in cortical microcirculatory blood flow induced by motor activity during awake craniotomy

Klijn, Eva; Hulscher, H. C.; Balvers, Rutger K.; Holland, Wim; Bakker, Jan; Vincent, Arnaud J P E; Dirven, Clemens; İnce, Can

doi:10.3171/2012.10.jns1219

Cited by 48 publications

(46 citation statements)

References 30 publications

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“…23 For this purpose, intraoperative laser speckle contrast imaging was recently shown suitable for continuous realtime blood flow and perfusion monitoring in a simple, fast and cost-effective manner with minimal disruption of surgical workflow and reduced infrastructure requirements. [14][15][16][17]24,25 To date, however, the potential of iLSI to deliver quantitative information on relative perfusion with the possibility of immediately identifying tissue in danger of irreversible infarction during neurosurgical procedures has not yet been explored. Therefore, the present study was designed to characterize the prognostic value of iLSI by identifying critical iLSI-specific perfusion thresholds for prediction or exclusion of cortical infarction in the human brain.…”

Section: Infarct Prediction In the Human Brain By Laser Speckle Contrmentioning

confidence: 99%

Infarct prediction by intraoperative laser speckle imaging in patients with malignant hemispheric stroke

Hecht

Müller

Sandow

et al. 2015

J Cereb Blood Flow Metab

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Currently, a reliable method for real-time prediction of ischemia in the human brain is not available. Here, we took a first step towards validating non-invasive intraoperative laser speckle imaging (iLSI) for prediction of infarction in 22 patients undergoing decompressive surgery for treatment of malignant hemispheric stroke. During surgery, cortical perfusion was visualized and recorded in real-time with iLSI. The true morphological infarct extension within the iLSI imaging field was superimposed onto the iLSI blood flow maps according to a postoperative MRI (16 h [95% CI: 13, 19] after surgery) with three-dimensional magnetization-prepared rapid gradient-echo and diffusion-weighted imaging reconstruction. Based on the frequency distribution of iLSI perfusion values within the infarcted and non-infarcted territories, probability curves and perfusion thresholds of normalized cerebral blood flow predictive of eventual infarction or non-infarction were calculated. Intraoperative LSI predicted and excluded cortical ischemia with 95% probability at normalized perfusion levels below 40% and above 110%, respectively, which represented 73% of the entire cortical surface area. Together, our results suggest that iLSI is valid for (pseudo-) quantitative assessment of blood flow in the human brain and may be used to identify tissue at risk for infarction at a given time-point in the course of ischemic stroke.

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Section: Infarct Prediction In the Human Brain By Laser Speckle Contrmentioning

confidence: 99%

Infarct prediction by intraoperative laser speckle imaging in patients with malignant hemispheric stroke

Hecht

Müller

Sandow

et al. 2015

J Cereb Blood Flow Metab

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“…[21][22][23][24][31][32][33] As LSCI gains popularity and clinical investigations increase, it is important to assess the impact of physiological motion and investigate methods to compensate for these artifacts. Because LSCI is inherently sensitive to motion, the recorded images are impacted by both pulsatile flow and tissue deformation from the cardiac cycle and respiration.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies have examined the utility of a commercial LSCI system during direct surgical revascularization, 21,22 awake functional mapping, 23 and cortical spreading depolarization after malignant stroke. 24 All of these studies demonstrate the feasibility and usefulness of LSCI as an intraoperative tool for monitoring changes in CBF.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative laser speckle contrast imaging with retrospective motion correction for quantitative assessment of cerebral blood flow

et al. 2014

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Abstract. Although multiple intraoperative cerebral blood flow (CBF) monitoring techniques are currently available, a quantitative method that allows for continuous monitoring and that can be easily integrated into the surgical workflow is still needed. Laser speckle contrast imaging (LSCI) is an optical imaging technique with a high spatiotemporal resolution that has been recently demonstrated as feasible and effective for intraoperative monitoring of CBF during neurosurgical procedures. This study demonstrates the impact of retrospective motion correction on the quantitative analysis of intraoperatively acquired LSCI images. LSCI images were acquired through a surgical microscope during brain tumor resection procedures from 10 patients under baseline conditions and after a cortical stimulation in three of those patients. The patient's electrocardiogram (ECG) was recorded during acquisition for postprocess correction of pulsatile artifacts. Automatic image registration was retrospectively performed to correct for tissue motion artifacts, and the performance of rigid and nonrigid transformations was compared. In baseline cases, the original images had 25% AE 27% noise across 16 regions of interest (ROIs). ECG filtering moderately reduced the noise to 20% AE 21%, while image registration resulted in a further noise reduction of 15% AE 4%. Combined ECG filtering and image registration significantly reduced the noise to 6.2% AE 2.6% (p < 0.05). Using the combined motion correction, accuracy and sensitivity to small changes in CBF were improved in cortical stimulation cases. There was also excellent agreement between rigid and nonrigid registration methods (15/16 ROIs with <3% difference). Results from this study demonstrate the importance of motion correction for improved visualization of CBF changes in clinical LSCI images. © The Authors.Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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“…The laser -speckle imaging monitor MoorFLPI-2 TM that is equipped with the class 1 near -infrared laser source with the wavelength of 758 nm is capable of evaluating the tissue blood flow at a distance of 30 cm above the skin surface, and the monitor expresses tissue blood flow as the relative value (9). The blood flow imager uses the laser speckle contrast technique to deliver real-time, high-resolution blood flow images (9).…”

Section: Methodsmentioning

confidence: 99%

“…C9183 TM employs a white light-emitting diode as the light source, which has the wavelength of the visible light at 520 to 580 nm, and the monitor can detect the oxygenation only at the 1 -2 mm depth from the skin surface [The personal communication with Hamamatsu Photonics, Hamamatsu, Japan]. The laser -speckle imaging monitor MoorFLPI-2 TM that is equipped with the class 1 near -infrared laser source with the wavelength of 758 nm is capable of evaluating the tissue blood flow at a distance of 30 cm above the skin surface, and the monitor expresses tissue blood flow as the relative value (9). The blood flow imager uses the laser speckle contrast technique to deliver real-time, high-resolution blood flow images (9).…”

Section: Methodsmentioning

confidence: 99%

Tissue oxygenation index reflects changes in forearm blood flow after brief ischemia

et al. 2017

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: Whether the near-infrared spectroscopy (NIRS) technology correctly detects the changes in oxygenation related to ischemia and reperfusion of organs and tissues other than brain remains unclear. The present study examined how different tissue oxygenation parameters derived from NIRS reflect the changes in the forearm blood flow (FBF) according to the brief ischemia and the subsequent reperfusion, and whether values of these parameters move in parallel with the medial and lateral sides of FBF. Thirteen volunteers underwent the prospective observational study. The tissue oxygenation index (TOI), regional saturation of oxygen (rSO2), skin tissue oxygenation (StO2), and FBF values were evaluated in the forearm. Medial rSO2 values at 1 to 3 minutes after the termination of brief ischemia were higher than lateral rSO2 and respective TOI values. FBF and StO2 values quickly increased according to the cessation of brief ischemia, whereas the medial and lateral values did not differ during and after the brief ischemia. TOI and StO2, but not rSO2, reflected changes in FBF of both medial and lateral sides simultaneously in response to the reperfusion after brief ischemia. The muscle tissue oxygenation during reperfusion favors the use of TOI and StO2, but not rSO2, as the surrogate parameter.

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Laser speckle imaging identification of increases in cortical microcirculatory blood flow induced by motor activity during awake craniotomy

Cited by 48 publications

References 30 publications

Infarct prediction by intraoperative laser speckle imaging in patients with malignant hemispheric stroke

Infarct prediction by intraoperative laser speckle imaging in patients with malignant hemispheric stroke

Intraoperative laser speckle contrast imaging with retrospective motion correction for quantitative assessment of cerebral blood flow

Tissue oxygenation index reflects changes in forearm blood flow after brief ischemia

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