Abstract
In light of our own experiences, we value the existing literature to critically point out possible “near” future applications of optical coherence tomography (OCT) as an intraoperative neurosurgical guidance tool. “Pub Med”, “Cochrane Library”, “Crossref Metadata Search”, and “IEEE Xplore” databases as well as the search engine “Google Scholar” were screened for “optical coherence tomography + neurosurgery”, “optical coherence tomography + intraoperative imaging + neurosurgery”, and “microscope integrated optical coherence tomography + neurosurgery”. n = 51 articles related to the use of OCT as an imaging technique in the field of neurosurgery or neurosurgical research. n = 7 articles documented the intraoperative use of OCT in patients. n = 4 articles documented the use of microscope-integrated optical coherence tomography as a neurosurgical guidance tool. The Results demonstrate that OCT is the first imaging technique to study microanatomy in vivo. Postoperative analysis of intraoperative scans holds promise to enrich our physiological and pathophysiological understanding of the human brain. No data exists to prove that OCT-guided surgery minimizes perioperative morbidity or extends tumor resection. But results suggest that regular use of microscope-integrated OCT could increase security during certain critical microsurgical steps like, e.g., dural dissection at cavernous sinus, transtentorial approaches, or aneurysm clip placement. Endoscopy integration could aid surgery in regions which are not yet accessible to real-time imaging modalities like the ventricles or hypophysis. Theranostic instruments which combine OCT with laser ablation might gain importance in the emerging field of minimal invasive tumor surgery. OCT depicts vessel wall layers and its pathologies uniquely. Doppler OCT could further visualize blood flow in parallel. These abilities shed light on promising future applications in the field of vascular neurosurgery.
Highlights
Microneurosurgery remains an exceedingly demanding and dexterous fine motor task
Detailed evaluation of the results revealed n = 51 articles related to the use of OCT as an imaging technique in neurosurgery or in the field of neurosurgical research. n = 7 articles documented the intraoperative use of OCT in patients. n = 4 articles documented the use of microscope-integrated optical coherence tomography as a neurosurgical guidance tool
Microscope-integrated OCT could well delineate the microstructural composition of cerebral vessel walls [8, 38, 42] (Fig. 2)
Summary
Microneurosurgery remains an exceedingly demanding and dexterous fine motor task. Microscope-integrated three-dimensional imaging techniques which delineate the microstructural composition of tissue in the field of view are missing so far. Depending on light microscope integration is fairly simple [25] This opens up the ability of contact free three-dimensional, real-time scanning of tissue in the field of view during microsurgical procedures [26]. (4d) Same imaging technique in a different mouse after injection of LGNRs (4e) enlarged excerpt displaying the relationship of blood and lymphatic vessels (4f) same area as in (4e) after injection of 925 nm LGNRs displaying the (arrow) junction of lymph vessels and mono directional flow (see Liba (2016)). These versatile strengths shed light on OCTs potential for microneurosurgical guidance. Materials and methods “Pub Med”, “Cochrane Library”, “Crossref Metadata Search”, and “IEEE Xplore” databases as well as the search engine “Google Scholar” were screened for “optical coherence tomography + neurosurgery”, “optical coherence tomography + intraoperative imaging + neurosurgery”, and “microscope integrated optical coherence tomography + neurosurgery”
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