Abstract

.Significance: Although the clinical potential for Raman spectroscopy (RS) has been anticipated for decades, it has only recently been used in neurosurgery. Still, few devices have succeeded in making their way into the operating room. With recent technological advancements, however, vibrational sensing is poised to be a revolutionary tool for neurosurgeons.Aim: We give a summary of neurosurgical workflows and key translational milestones of RS in clinical use and provide the optics and data science background required to implement such devices.Approach: We performed an extensive review of the literature, with a specific emphasis on research that aims to build Raman systems suited for a neurosurgical setting.Results: The main translatable interest in Raman sensing rests in its capacity to yield label-free molecular information from tissue intraoperatively. Systems that have proven usable in the clinical setting are ergonomic, have a short integration time, and can acquire high-quality signal even in suboptimal conditions. Moreover, because of the complex microenvironment of brain tissue, data analysis is now recognized as a critical step in achieving high performance Raman-based sensing.Conclusions: The next generation of Raman-based devices are making their way into operating rooms and their clinical translation requires close collaboration between physicians, engineers, and data scientists.

Highlights

  • Because of the complex microenvironment of brain tissue, data analysis is recognized as a critical step in achieving high performance Raman-based sensing

  • The generation of Raman-based devices are making their way into operating rooms and their clinical translation requires close collaboration between physicians, engineers, and data scientists

  • Neurosurgery can be used to treat a multitude of disorders ranging from brain tumors and cancers to traumatic brain injury, epilepsy, and Parkinson’s disease (PD). 13.8 million neurosurgical procedures are carried out worldwide every year, and it is estimated that an additional 5 million neurosurgical conditions go untreated annually.[1]

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Summary

Results

The main translatable interest in Raman sensing rests in its capacity to yield label-free molecular information from tissue intraoperatively. Systems that have proven usable in the clinical setting are ergonomic, have a short integration time, and can acquire high-quality signal even in suboptimal conditions. Because of the complex microenvironment of brain tissue, data analysis is recognized as a critical step in achieving high performance Raman-based sensing

Conclusions
Introduction
Clinical Challenges in Neurosurgery
Raman Spectroscopy Techniques: A Short Primer
Spontaneous Raman Scattering
Coherent Anti-Stokes Raman Scattering
Stimulated Raman Scattering
Spectral Imaging with Coherent Raman Techniques
Spectroscopy Systems for Tissue Characterization in Neurosurgery
Intact Brain Tissue Interrogation Using Point Probes
Strengths and Limitations of in situ Raman Spectroscopy in Neurosurgery
Rapid Spectroscopic Blood Vessel Detection
Rapid and Portable Raman Microscopes for Operating Room Histopathology
Objective
CARS or SRS Endoscopy
Optical Exposure to Brain Tissue
Data Analysis for Spectroscopic Information
Spectra Data Processing
Data Analysis Methods
Supervised machine learning
Classification
Single band to hyperspectral imaging
Biomolecular identification of spectral features
Registering Optical Information in Neuronavigation Systems
Outlook
Conclusion

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