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

Abstract

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.

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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