Real-time, label-free, intraoperative visualization of peripheral nerves and micro-vasculatures using multimodal optical imaging techniques

Abstract

Accurate, real-time identification and display of critical anatomic structures, such as the nerve and vasculature structures, are critical for reducing complications and improving surgical outcomes. Human vision is frequently limited in clearly distinguishing and contrasting these structures. We present a novel imaging system, which enables noninvasive visualization of critical anatomic structures during surgical dissection. Peripheral nerves are visualized by a snapshot polarimetry that calculates the anisotropic optical properties. Vascular structures, both venous and arterial, are identified and monitored in real-time using a near-infrared laser-speckle-contrast imaging. We evaluate the system by performing animal studies with qualitative comparison by contrast-agent-aided fluorescence imaging.

Toward optical coherence tomography angiography-based biomarkers to assess the safety of peripheral nerve electrostimulation

“…While the challenge of light penetration, exposed nerve access, and motion will need to be overcome to use optical imaging for in vivo peripheral nerve applications, technological progress points to several potential areas where this tool may add value. First, one can envision incorporating OCT modalities for surgical guidance to identify nerves intraoperatively [ 48 ], This can potentially identify nerves and plexus without the use of contrast agents for peripheral neuromodulation applications. For applications involving implants, such as nerve cuff electrodes, OCT can be used in real-time to prevent mechanical trauma or overstimulation.…”

Dual-display laparoscopic laser speckle contrast imaging for real-time surgical assistance

“…At this specification, the system is capable of operating at 89FPS, limited by the camera, with an 11.13 ms processing time per frame. In our previous work, the GPU implementation performed approximately 67.2 times faster than a CPU-only approach, which had a processing time of 748 ms per image and was not sufficient for real-time visualization [20].…”

“…Heat maps were then copied from the device back to the host machine and stored in a dynamic buffer capable of holding up to 30 of the most-recently computed heat maps.The stored heat maps were used for equally weighted temporal blending of the alpha channels to increase the signal-to-noise ratio (SNR). The final image is displayed to the user via an OpenGL front end GUI, STARControl [20]. The user controls parameters including the number of blending frames, colormap alpha, colormap gamma, camera exposure time, and camera FPS.…”

Fluorescence labeling of a NaV1.7-targeted peptide for near-infrared nerve visualization

“…Oncologic surgery, in particular, poses a risk of nerve injury as anatomy is often distorted by the disease [10][11][12][13][14][15][16][17]. Tools for pre and perioperative nerve enhancement exist [18][19][20] and fluorescent nerve imaging agents, as well as multimodal optical imaging techniques, are raising interest for intraoperative applications [21][22][23][24][25][26][27][28][29][30][31].…”