High-resolution Infrared Thermal Imaging (ITI) for Simultaneous Functional Mapping of the Entire Craniotomy in Awake Patients

高分辨率红外热成像 (ITI) 用于在清醒患者的整个开颅手术中同时进行功能测绘

• 批准号: 10527317
• 负责人: TODD B PARRISH
• 金额: $ 40万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-01 至 2025-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10527317
• 关键词: Address; Adult; Agreement; Algorithms; Anatomy; Area; Articulation; Attention; Auditory; Behavioral; Blood; Blood Vessels; Blood flow; Brain; Brain Mapping; Brain imaging; Brain region; Cerebral cortex; Clinical; Cognitive; Complex; Computer software; Computers; Contralateral; Craniotomy; Data; Data Display; Devices; Diffuse; Electric Stimulation; Electrodes; Epilepsy; Esthesia; Excision; Exposure to; Fingers; Functional Imaging; Functional Magnetic Resonance Imaging; Future; Glioma; Goals; High temperature of physical object; Image; Individual; Infiltration; Intractable Epilepsy; Language; Lesion; Malignant neoplasm of brain; Maps; Measures; Memory; Metabolic; Metabolism; Methodology; Methods; Modeling; Monitor; Morbidity - disease rate; Motion; Motor; Motor Cortex; Neurologic; Neurologic Deficit; Neuronavigation; Operating Rooms; Operative Surgical Procedures; Patient-Focused Outcomes; Patients; Pattern; Perfusion; Physiological; Postoperative Period; Procedures; Process; Property; Protocols documentation; Quality of life; Records; Research; Resolution; Risk; Role; Safety; Seizures; Sensitivity and Specificity; Sensory; Signal Transduction; Speech; Stimulus; Surface; System; Techniques; Technology; Temperature; Testing; Thermodynamics; Thermography; Time; Tissues; Vision; arm; awake; blood oxygen level dependent; brain based; contrast imaging; data quality; data streams; diagnostic accuracy; electric field; haptics; hemodynamics; imaging system; improved; malformation; microphone; multitask; neural; neurosurgery; neurovascular; neurovascular coupling; novel; predictive modeling; prevent; quality assurance; response; source localization; spatiotemporal; speech recognition; success; synergism; tumor; wireless

PROJECT SUMMARY Functional activation of the cerebral cortex creates a robust increase in local temperature by increasing blood flow and metabolism because of neurovascular coupling. Changes in surface brain temperature while an awake patient performs a motor, sensory, or language task can be used to infer spatial patterns of activity to create functional maps. Awake neurosurgery is used in the management of drug-resistant epilepsy, glioma, and neurovascular malformation, in order to localize seizure and/or physiologic activity. Protection of key functional areas is imperative to avoiding postoperative neurologic deficits. Currently, direct electrical stimulation (DES) is the most commonly used method of intraoperative surgical mapping, which identifies functionally critical brain regions so they are not resected. However, DES has low spatial resolution (~1 cm), may provoke seizures, and can only test one area at a time. This project investigates a new method of intraoperative functional mapping based on infrared thermography, which has high resolution (~100 micron) and simultaneously monitors the entire exposed brain surface without risk for seizures. The Intraoperative Mapping System will be developed and tested on glioma patients, as tumors have relatively static impact on brain temperature compared to epileptogenic foci and vascular malformations. Preliminary data in motor and language mapping cases shows large (~0.5oC) positive thermal activation of contralateral motor cortex and language regions that have strong agreement with DES. Aim 1 will develop a mapping system (hardware and software) required to conduct real-time thermal-based brain mapping during awake craniotomy. We will optimize and integrate the infrared recording procedure within the surgical workflow, to maximize signal quality while minimizing treatment interference. The central piece is a mobile cart containing a powerful workstation and an articulating arm to locate the IR camera over the craniotomy. The computer will deliver stimuli, monitor and collect behavioral data (audio, video, and a wireless haptic glove), record the IR images, and display the real-time functional map. Patient tasks currently used during DES will be adapted for thermographic recording. Aim 2 will explore the temporal and spatial properties of the thermodynamic response to optimize the infrared mapping procedure. The thermal response function (TRF) is the thermal equivalent of the hemodynamic response function (HRF) that is used in fMRI. Through modeling and high resolution (spatial and temporal) IR data, we will estimate the thermal impulse response and use it to develop an efficient multi-task mapping protocol. The result will be a rapid, efficient, high resolution assessment of brain function to optimize the resection and improve patient outcomes. Aim 3 will compare the functional mapping methods (DES and infrared thermal imaging) to determine optimal synergy between them to provide the best information for the safest resection. If successful, this project will create a new method for intraoperative functional mapping during awake neurosurgery. Ultimately, we hope to improve the precision of intraoperative brain mapping while increasing the safety and efficacy of surgery for patients with drug-resistant epilepsy, glioma, and neurovascular malformations.

项目概要 大脑皮层的功能激活通过增加血液导致局部温度急剧升高 由于神经血管耦合而导致的血流和代谢。大脑表面温度的变化 清醒的患者执行运动、感觉或语言任务，可用于推断活动的空间模式 创建功能地图。清醒神经外科用于治疗耐药性癫痫、神经胶质瘤、 和神经血管畸形，以便定位癫痫发作和/或生理活动。密钥保护 功能区对于避免术后神经功能缺损至关重要。目前，直接电 刺激（DES）是术中手术标测最常用的方法，它可以识别 功能关键的大脑区域，因此不会被切除。然而，DES 的空间分辨率较低（~1 cm）， 可能会引起癫痫发作，并且一次只能测试一个区域。该项目研究了一种新方法 基于红外热成像的术中功能测绘，具有高分辨率（~100 微米） 并同时监测整个暴露的大脑表面，没有癫痫发作的风险。术中 由于肿瘤对神经胶质瘤患者的影响相对静态，因此将开发映射系统并在神经胶质瘤患者上进行测试 脑温度与致癫痫病灶和血管畸形的比较。电机和的初步数据 语言映射案例显示对侧运动皮层的大量正热激活（~0.5oC） 与 DES 高度一致的语言区域。目标 1 将开发一个地图系统（硬件和 软件）需要在清醒开颅手术期间进行基于热的实时大脑绘图。我们将 在手术工作流程中优化和集成红外记录程序，以最大限度地提高信号质量 同时最大限度地减少治疗干扰。核心部件是一个移动推车，其中包含一个功能强大的工作站 以及一个用于将红外摄像机定位在开颅手术上方的铰接臂。计算机将提供刺激、监控 收集行为数据（音频、视频和无线触觉手套），记录红外图像并显示 实时功能地图。目前在 DES 期间使用的患者任务将适用于热成像记录。 目标 2 将探索热力学响应的时间和空间特性，以优化红外 映射程序。热响应函数 (TRF) 是血液动力学的热等效函数 fMRI 中使用的响应函数 (HRF)。通过建模和高分辨率（空间和时间）IR 数据，我们将估计热脉冲响应并用它来开发有效的多任务映射 协议。结果将是对大脑功能进行快速、高效、高分辨率的评估，以优化 切除并改善患者的治疗效果。目标 3 将比较功能映射方法（DES 和 红外热成像）来确定它们之间的最佳协同作用，从而为 最安全的切除术。如果成功，该项目将创建一种术中功能映射的新方法 在清醒的神经外科手术中。最终，我们希望提高术中脑图绘制的精度，同时 提高耐药性癫痫、神经胶质瘤和耐药性癫痫患者手术的安全性和有效性 神经血管畸形。