Abstract
Optical coherence tomography (OCT) has been recently suggested as a promising method to obtain in vivo and real-time high-resolution images of tissue structure in brain tumor surgery. This review focuses on the basics of OCT imaging, types of OCT images and currently suggested OCT scanner devices and the results of their application in neurosurgery. OCT can assist in achieving intraoperative precision identification of tumor infiltration within surrounding brain parenchyma by using qualitative or quantitative OCT image analysis of scanned tissue. OCT is able to identify tumorous tissue and blood vessels detection during stereotactic biopsy procedures. The combination of OCT with traditional imaging such as MRI, ultrasound and 5-ALA fluorescence has the potential to increase the safety and accuracy of the resection. OCT can improve the extent of resection by offering the direct visualization of tumor with cellular resolution when using microscopic OCT contact probes. The theranostic implementation of OCT as a part of intelligent optical diagnosis and automated lesion localization and ablation could achieve high precision, automation and intelligence in brain tumor surgery. We present this review for the increase of knowledge and formation of critical opinion in the field of OCT implementation in brain tumor surgery.
Highlights
Malignant gliomas are the most common brain tumors and account for 63% of all astrocytic tumors [1]
There are several scenarios as to how Optical coherence tomography (OCT) can be implemented in neurosurgery: (1) OCT can be used intraoperatively for brain imaging and can provide real-time feedback to the surgeons, e.g., clarifying the boundaries of the infiltrative brain tumors within surrounding tissues and the degree of white matter damage; (2) OCT can be used in histopathological studies of fresh specimens for fast determination of tissue type; (3) OCT can aid in stereotactic procedures for guiding biopsy
The initial OCT data are obtained as 2D and 3D structural and angiographic pictures (Figure 2a,b,d–f), that can be visually analyzed
Summary
Malignant gliomas are the most common brain tumors and account for 63% of all astrocytic tumors [1]. In the case of low-grade (1–2) astrocytomas, life expectancy in different studies ranges from 61.1 to 90 months [3] For these groups, the astrocyte is important for malignant tumor transformation, that is, its transition to the malignant variant (Grade 3–4), which is observed in about 45% of patients within 5 years [4,5]. The extraction of a tumor in the white light of a microscope can only achieve a maximum resection in 23–50% of cases [8,9,15] This contributes to maintaining a high interest in the development of intraoperative technologies that allow the differentiation of tumors from surrounding tissues. We present this review for the increase of knowledge and formation of critical opinion in the field of OCT implementation in brain tumor surgery
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