Accessible Unlicensed Requires Authentication Published by De Gruyter May 10, 2013

Intraoperative optical imaging of functional brain areas for improved image-guided surgery

Tobias Meyer, Stephan B. Sobottka, Matthias Kirsch, Gabriele Schackert, Ralf Steinmeier, Edmund Koch and Ute Morgenstern


Intraoperative optical imaging of intrinsic signals can improve the localization of functional areas of the cortex. On the basis of a review of the current state of technology, a setup was developed and evaluated. The aim was to implement an easy-to-use and robust imaging setup that can be used in clinical routine with standard hardware equipment (surgical microscope, high-resolution camera, stimulator for peripheral nerve stimulation) and custom-made software for intraoperative and postoperative data analysis. Evaluation of different light sources (halogen, xenon) showed a sufficient temporal behavior of xenon light without using a stabilized power supply. Spatial binning (2×2) of the camera reduces temporal variations in the images by preserving a high spatial resolution. The setup was tested in eight patients. Images were acquired continuously for 9 min with alternating 30-s rest and 30-s stimulation conditions. Intraoperative measurement and visualization of high-resolution two-dimensional activity maps could be achieved in <15 min. The detected functional regions corresponded with anatomical and electrophysiological validation. The integration of optical imaging in clinical routine could successfully be achieved using standard hardware, which improves guidance for the surgeon during interventions near the eloquent areas of the brain.

Corresponding author: Tobias Meyer, Department of Neurosurgery, University Hospital Carl Gustav Carus, Dresden University of Technology, Fetscherstrasse 74, 01307 Dresden, Germany, Phone: +49 351 458 3982, Fax: +49 351 458 4304

This work was supported by Carl Zeiss Meditec AG, Oberkochen, Germany, and the Bundesministerium für Bildung und Forschung, Germany. We would like to thank Anita Menschner, Enrico Noback, Titus Troisch, and Barbara Eilmes for performing the electrophysiological measurements. Furthermore, we thank Falk Uhlemann, Hans Dietrich, and Andreas Schöppe for their technical assistance and support.


[1] Cannestra AF, Black KL, Martin NA, et al. Topographical and temporal specificity of human intraoperative optical intrinsic signals. Neuroreport 1998; 9: 2557–2563. Search in Google Scholar

[2] Cannestra AF, Blood AJ, Black KL, Toga AW. The evolution of optical signals in human and rodent cortex. Neuroimage 1996; 3: 202–208. Search in Google Scholar

[3] Cannestra AF, Bookheimer SY, Pouratian N, et al. Temporal and topographical characterization of language cortices using intraoperative optical intrinsic signals. Neuroimage 2000; 12: 41–54. Search in Google Scholar

[4] Cannestra AF, Pouratian N, Bookheimer SY, Martin NA, Beckerand DP, Toga AW. Temporal spatial differences observed by functional MRI and human intraoperative optical imaging. Cereb Cortex 2001; 11: 773–782. Search in Google Scholar

[5] Cannestra AF, Pouratian N, Shomer MH, Toga AW. Refractory periods observed by intrinsic signal and fluorescent dye imaging. J Neurophysiol 1998; 80: 1522–1532. Search in Google Scholar

[6] Culver JP, Siegel AM, Franceschini MA, Mandeville JB, Boas DA. Evidence that cerebral blood volume can provide brain activation maps with better spatial resolution than deoxygenated hemoglobin. Neuroimage 2005; 27: 947–959. Search in Google Scholar

[7] Grinvald A, Shoham D, Shmuel A, et al. In-vivo optical imaging of cortical architecture and dynamics. In: Windhorst U, Johansson H, editors. Modern techniques in neuroscience research. Berlin: Springer-Verlag 1999: 893–969. Search in Google Scholar

[8] Haglund MM, Hochman DW. Optical imaging of epileptiform activity in human neocortex. Epilepsia 2004; 45(Suppl 4): 43–47. Search in Google Scholar

[9] Haglund MM, Ojemann GA, Hochman DW. Optical imaging of epileptiform and functional activity in human cerebral cortex. Nature 1992; 358: 668–671. Search in Google Scholar

[10] Nariai T, Sato K, Hirakawa K, et al. Imaging of somatotopic representation of sensory cortex with intrinsic optical signals as guides for brain tumor surgery. J Neurosurg 2005; 103: 414–423. Search in Google Scholar

[11] Oelschlägel M, Meyer T, Wahl H, et al. Evaluation of intraoperative optical imaging analysis methods by phantom and patient measurements. Biomed Tech 2013; 1 accepted for publication (acceptance letter 29.04.2013). Search in Google Scholar

[12] Pouratian N, Bookheimer SY, O’Farrell AM, et al. Optical imaging of bilingual cortical representations. Case report. J Neurosurg 2000; 93: 676–681. Search in Google Scholar

[13] Pouratian N, Sheth SA, Martin NA, Toga AW. Shedding light on brain mapping: advances in human optical imaging. Trends Neurosci 2003; 26: 277–282. Search in Google Scholar

[14] Pouratian N, Sicotte N, Rex D, et al. Spatial/temporal correlation of BOLD and optical intrinsic signals in humans. Magn Reson Med 2002; 47: 766–776. Search in Google Scholar

[15] Prakash N, Uhlemann F, Sheth SA, Bookheimer S, Martin N, Toga AW. Current trends in intraoperative optical imaging for functional brain mapping and delineation of lesions of language cortex. Neuroimage 2009; 47(Suppl 2): T116–T126. Search in Google Scholar

[16] Raabe A, Van De Ville D, Leutenegger M, et al. Laser Doppler imaging for intraoperative human brain mapping. Neuroimage 2009; 44: 1284–1289. Search in Google Scholar

[17] Sato K, Nariai T, Sasaki S, et al. Intraoperative intrinsic optical imaging of neuronal activity from subdivisions of the human primary somatosensory cortex. Cereb Cortex 2002; 12: 269–280. Search in Google Scholar

[18] Sato K, Nariai T, Tanaka Y, et al. Functional representation of the finger and face in the human somatosensory cortex: intraoperative intrinsic optical imaging. Neuroimage 2005; 25: 1292–1301. Search in Google Scholar

[19] Schwartz TH. The application of optical recording of intrinsic signals to simultaneously acquire functional, pathological and localizing information and its potential role in neurosurgery. Stereotact Funct Neurosurg 2005; 83: 36–44. Search in Google Scholar

[20] Schwartz TH, Chen LM, Friedman RM, Spencer DD, Roe AW. Intraoperative optical imaging of human face cortical topography: a case study. Neuroreport 2004; 15: 1527–1531. Search in Google Scholar

[21] Sheth SA, Nemoto M, Guiou M, et al. Columnar specificity of microvascular oxygenation and volume responses: implications for functional brain mapping. J Neurosci 2004; 24: 634–641. Search in Google Scholar

[22] Shoham D, Grinvald A. The cortical representation of the hand in macaque and human area S-I: high resolution optical imaging. J Neurosci 2001; 21: 6820–6835. Search in Google Scholar

[23] Sobottka SB, Meyer T, Kirsch M, et al. Assessment of visual function during brain surgery near the visual cortex by intraoperative optical imaging. Biomed Tech 2013;0:1–8, ISSN (Online) 1862–278X, ISSN (Print) 0013-5585, DOI: 10.1515/bmt-2012-0074. Search in Google Scholar

[24] Sobottka SB, Meyer T, Kirsch M, et al. Intraoperative optical imaging of intrinsic signals is a reliable method to visualize stimulated functional brain areas during surgery. J Neurosurg 2013; [accepted for publication]. Search in Google Scholar

[25] Thirion JP. Image matching as a diffusion process: an analogy with Maxwell’s demons. Med Image Anal 1998; 2: 243–260. Search in Google Scholar

[26] Toga AW, Cannestra AF, Black KL. The temporal/spatial evolution of optical signals in human cortex. Cereb Cortex 1995; 5: 561–565. Search in Google Scholar

[27] Yoo TS, Ackerman MJ, Lorensen WE, et al. Engineering and algorithm design for an image processing Api: a technical report on ITK – the Insight Toolkit. Stud Health Technol Inform 2002; 85: 586–592. Search in Google Scholar

[28] Zhao M, Suh M, Ma H, Perry C, Geneslaw A, Schwartz TH. Focal increases in perfusion and decreases in hemoglobin oxygenation precede seizure onset in spontaneous human epilepsy. Epilepsia 2007; 48: 2059–2067. Search in Google Scholar

Received: 2012-11-8
Accepted: 2013-4-3
Published Online: 2013-05-10
Published in Print: 2013-06-01

©2013 by Walter de Gruyter Berlin Boston