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

Abstract

Stereotactic biopsy is used to enable diagnostic confirmation of brain tumors and treatment planning. Despite being a well-established technique, it is related to significant morbidity and mortality rates mostly caused by hemorrhages due to blood vessel ruptures. This paper presents a method of vessel detection during stereotactic biopsy that can be easily implemented by integrating two side-view fibers into a conventional side-cutting biopsy needle. Tissue within the needle window is illuminated through the first fiber; the second fiber detects the remitted light. By taking the ratio of the intensities at two wavelengths with strongly differing hemoglobin absorption, blood vessels can be recognized immediately before biopsy sampling. Via ray tracing simulations and phantom experiments, the dependency of the remission ratio R = I578 /I650 on various parameters (blood oxygenation, fiber-to-vessel and inter-fiber distance, vessel diameter and orientation) was investigated for a bare-fiber probe. Up to 800-1200µm away from the probe, a vessel can be recognized by a considerable reduction of the remission ratio from the background level. The technique was also successfully tested with a real biopsy needle probe on both optical phantoms and ex-vivo porcine brain tissue, thus showing potential to improve the safety of stereotactic biopsy. Dual-wavelength remission measurement for the detection of blood vessels during stereotactic biopsy.