Sensitivity analysis aimed at blood vessels detection using interstitial optical tomography during brain needle biopsy procedures

Abstract

A brain needle biopsy procedure is performed for suspected brain lesions in order to sample tissue that is subsequently analysed using standard histopathology techniques. A common complication resulting from this procedure is brain hemorrhaging from blood vessels clipped off during tissue extraction. Interstitial optical tomography (iOT) has recently been introduced by our group as a mean to assess the presence of blood vessels in the vicinity of the needle. The clinical need to improve safety requires the detection of blood vessels within 2 mm from the outer surface of the needle, since this distance is representative of the volume of tissue that is aspirated durirng tissue extraction. Here, a sensitivity analysis is presented to establish the intrinsic detection limits of iOT based on simulations and experiments using brain tissue phantoms. It is demonstrated that absorbers can be detected with diameters >300 μm located up to >2 mm from the biopsy needle core for bulk optical properties consistent with brain tissue.

Remission spectrometry for blood vessel detection during stereotactic biopsy of brain tumors

“…In opposition to LDF, no laser with high coherence length , but only a less expensive LED is required. Furthermore, data acquisition is possible within 1s, in opposition to LDF and iOT where several seconds and several minutes are required, respectively. Furthermore, compared to iOT, a much simpler probe design is possible as only two instead of 24 fibers are needed .…”

“…Furthermore, data acquisition is possible within 1s, in opposition to LDF and iOT where several seconds and several minutes are required, respectively. Furthermore, compared to iOT, a much simpler probe design is possible as only two instead of 24 fibers are needed . Finally, in contrast to the ICG technique, no drug injection is necessary, which would bear further risks and most importantly would limit the time period during which blood vessel detection is possible to only a few minutes as the retention time of ICG in the blood circulation is limited .…”

“…There have already been several approaches to detect blood vessels during stereotactic biopsy or similar neurosurgical interventions, including Doppler sonography , laser Doppler flowmetry (LDF) , Indocyanine Green (ICG) fluorescence , and interstitial optical tomography (iOT) . Especially LDF, which seems to be the method with the highest clinical potential, has already been tested in surgical interventions .…”

5-ALA fluorescence and laser Doppler flowmetry for guidance in a stereotactic brain tumor biopsy

“…A similar approach has been reported using fluorescein [14]. Several dual-mode optical probes have been described including a probe combining Raman spectroscopy for tumor detection [15] and interstitial white light optical tomography for vessel detection [16,17]. A combination of PpIX fluorescence detection by red-excitation and re-emission spectrometry for vessel detection is proposed by Markwardt et al [18,19].…”

Introduction to the optics and the brain 2015 feature issue

“…Finally, new tools for in vivo human brain imaging are presented. Progress in fluorescence guided surgery [10] now provide surgeons with more intuitive and accurate image renderings [7] and give them standardized quantitative maps of fluorescent markers during a procedure; interstitial optical tomography is presented as a guide to improve the safety of biopsy procedures [8] and an application of fNIRS imaging of brain activation is shown [9].…”