Optical guidance in neurosurgery 

Optical techniques as laser Doppler flowmetry (LDF), diffuse reflectance spectroscopy (DRS) and fluorescence systems, and their related measurement probes, are adapted and translate for use during the neurosurgery.

Optical guidance in stereotactic neurosurgery

With LDF our research has defined typical optical trajectories towards brain targets commonly used in deep brain stimulation (DBS) implantations. LDF records the microvascular blood flow along a trajectory and can thus indicate increased blood flow with the forward looking probe. Both LDF and DRS can detect shades of grey-white tissue intraoperatively and thus help define tissue type during surgery. The methods have been used in more than 130 DBS implantations including over 3000 recordings. LDF also make unique studies of the brain’s microcirculation possible. Recently LDF probes were also combined with fluorescence, and microelectrode recording (MER).

Data from DRS can either be processed as similar optical trajectories as for LDF, if the same wavelength of 780 nm is processed. DRS can also be used for estimation of the brain tissues SO2 saturation. This method has been evaluated during DBS implantations and neurointensive care monitoring.

Fluorescence guided brain tumor surgery

5-ALA fluorescence measurements of high grade brain tumor tissue can be detected either with the blue-light neurosurgical microscope or with the in-house developed fluorescence probe system. Under the microscope, the hand-held probe enhances the fluorescence in the tumor marginal zone. The hand-held probe can also be used as stand-alone fluorescence measurements in open surgery. Modification of the probe’s outer dimensions to a stereotactic frame it can be applied also for identification of tumor tissue during stereotactic biopsies.

Publications
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Key publications:

Wårdell K, Hemm-Ode S, Zsigmond P, A System for Combined Laser Doppler Flowmetry and Microelectrode Recording during Deep Brain Stimulation Implantation, 41st IEEE-EMBC, pp 3759-3761, 2019


Johansson D, Alonso F, Wårdell K, Patient-Specific Simulations of Deep Brain Stimulation Electric Field with Aid of In-house Software ELMA, 41stIEEE-EMBC, pp 5212-5216, 2019

Zsigmond P., Hemm-Ode S., Wårdell K. Optical Measurements during Deep Brain Stimulation Lead Implantation: Safety Aspects , Stereotact Funct Neurosurg., 95(6):392-399, 2018.

Haj-Hosseini N., Richter J, Milos P., Hallbeck M., Wårdell K 5-ALA fluorescence and laser Doppler flowmetry for guidance in a stereotactic brain tumor biopsy , Biomedical Optics Express, 9(5), 2018

Richter J, Haj-Hosseini N, Hallbeck M, Wårdell K, Combination of Hand-Held Probe and Microscopy for Fluorescence Guided Surgery in the Brain Tumor Marginal Zone , Journal of Photodiagnosis and Photodynamic Therapy, Vol. 18, pp 185-192, 2017.

Rejmstad P, Zsigmond P, Wårdell K, Oxygen saturation estimation in brain tissue using diffuse reflectance spectroscopy along stereotactic trajectories, Optics Express. vol 25, no. 7, pp8192:8201, 2017.

Wårdell K, Optical Techniques for Navigation during in Stereotactic Neurosurgery, Sensors and Materials, Vol. 28, No. 10, 1105–1116, 2016.

Wårdell K, Zsigmond P, Richter J, Hemm S Relationship between laser Doppler signals and anatomy during deep brain stimulation electrode implantation toward the ventral intermediate nucleus and subthalamic nucleus. Neurosurgery, Jun;72(2 Suppl Operative):ons127-40; disc. ons140, 2013.

 

Thesis:

Johan Richter, Fluorescence Guided Resection of Brain Tumors: Evaluation of a Hand-held Spectroscopic Probe, Linköping University Medical Dissertations, Doctorate Thesis No. 1581, 2017, ISSN 0345-0082.

Peter Rejmstad, Optical Monitoring of Cerebral Microcirculation , Linköping studies in Science and Technology, Doctorate Thesis No. 1807, 2017, ISBN 0345-7524.

Neda Haj-Hosseini, Fluorescence Spectroscopy for Quantitative Demarcation of Glioblastoma Using 5-Aminolevulinic Acid Linköping Studies in Science and Technology, Dissertation No. 1463, LiU-Tryck, Linköping 2012, ISBN 978-91-7519-845-3

 

More:

List of all of the Neuroengineering group publications.

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