Intraoperative Identification of Cranial Nerves in Skull Base Surgery Using Polarization Sensitive Optical Coherence Tomography

使用偏振敏感光学相干断层扫描术中识别颅底手术中的脑神经

• 批准号: 10662675
• 负责人: Danielle J. Harper
• 金额: $ 13.1万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10662675
• 关键词: Acoustic Neuroma; Address; Affect; Anatomy; Area; Award; Back; Biophotonics; Blood Vessels; Boston; Brain; Cancerous; Clinical; Collagen; Complex; Cranial Nerves; Crowding; Data; Deformity; Electric Stimulation; Electromyography; Environment; Equipment; Evaluation; Excision; Fascicle; Fluorescence; Focus Groups; Funding; General Hospitals; Goals; Growth; Hand; Home; Hospitals; Image; Image-Guided Surgery; Imaging Device; Imaging Techniques; Imaging technology; Injury; Institution; K-Series Research Career Programs; Label; Laboratories; Lasers; Lead; Lipid Bilayers; Location; Maps; Massachusetts; Measures; Mentors; Microscope; Morbidity - disease rate; Motion; Multimodal Imaging; Nerve; Nerve Fibers; Neurosurgeon; Olfactory Nerve; Operative Surgical Procedures; Optical Coherence Tomography; Optics; Outcome; Patient-Focused Outcomes; Performance; Phase; Postdoctoral Fellow; Preparation; Research; Research Design; Resolution; Resources; Sampling; Specificity; Spectrum Analysis; Supervision; Surface; Surgeon; System; Technical Expertise; Techniques; Technology; Testing; Time; Tissues; Training; Translational Research; United States National Institutes of Health; Universities; Variant; Vertebral column; Visualization; Woman; Work; career; career development; contrast enhanced; deep learning; deep learning algorithm; design; electrical measurement; experience; first-in-human; human study; iatrogenic injury; image guided; image guided therapy; imaging facilities; imaging modality; improved; invention; medical schools; meningioma; nerve damage; nerve injury; neuroimaging; neurosensory; neurosurgery; novel; optical imaging; practical application; real-time images; research and development; skills; skull base; spine bone structure; tool; tumor; validation studies

Project summary/abstract Identification of cranial nerves during skull base surgery is critical to avoid iatrogenic injury. Even the slightest damage to any one of these nerves can hugely affect patient outcomes. Despite the importance of cranial nerve identification, preoperative imaging struggles to provide the needed information. During the surgical procedure, electrostimulation techniques are often utilized to provide a point-based analysis of a nerve and its functional capability, but they remain unable to picture the whole field. In fact, there is no current clinical tool capable of mapping nerve fibers and displaying their location back to the surgeon in real time. In this project, we propose to develop an imaging tool that can fill this obvious gap in current technology and place it directly into the hands of skull base surgeons. This tool will be based on polarization sensitive optical coherence tomography (OCT), an optical imaging modality that shows exquisite contrast for myelinated nerves. Recent advances in laser technology (known as circular ranging, invented by Mentor Dr. Vakoc) have brought OCT lasers to a point where their use is compatible with the motion induced by standard surgical workflow. This two-aim project seeks to bring circular ranging into the operating theater during skull base surgery and assess its capability to enhance cranial nerve visualization, uniquely combining both surgical and technical expertise. This work will take place between two NIH- funded P41-holding institutions: the Wellman Center for Photomedicine at Massachusetts General Hospital (MGH), home to the Center for Biomedical OCT Research (CBORT), and Brigham and Women’s Hospital (BWH), home of the National Center for Image-Guided Therapy (NCIGT) where the resources of the Advanced Multi-modality Image Guided Operating suite (AMIGO), both in terms of equipment and experience, will provide the perfect environment to conduct such a study. The candidate for this award is Dr. Danielle J. Harper, a postdoctoral fellow at MGH and Harvard Medical School. Dr. Harper has been well trained in the field of biophotonics. Her area of expertise is OCT and its functional extensions, including polarization mapping and depth-resolved spectroscopy. Her long-term career goal is to reach academic independence and lead a research group focused on intraoperative optical neuroimaging. To help her achieve this, Dr. Harper has built a strong team to guide her in all aspects of research and career development. Dr. Benjamin J. Vakoc at MGH/HMS, an expert in optical imaging, will serve as the primary mentor. Neurosurgeons Dr. Alexandra J. Golby and Dr. Michael Mooney at BWH will provide mentoring, guidance, and assistance with all clinical aspects. Dr. Lei Tian of Boston University will provide supervision and guidance for the deep learning aspects of the project, and Dr. Tayyaba Hasan at MGH/HMS will provide general career development advice. Supported by this team, this career development award will give Dr. Harper the remaining skills and training she requires to make the transition to full independence.

项目概要/摘要 在颅底手术中识别颅神经对于避免医源性损伤至关重要。 尽管这些神经很重要，但对其中任何一根神经的最轻微损伤都会极大地影响患者的治疗结果。 在颅神经识别过程中，术前影像很难提供所需的信息。 在手术过程中，电刺激技术通常用于提供基于点的分析 神经及其功能能力，但他们仍然无法描绘整个领域。 目前没有能够绘制神经纤维图并将其位置显示给外科医生的临床工具 在这个项目中，我们建议开发一种成像工具来填补当前的这一明显空白。 技术并将其直接置于颅底外科医生手中。该工具将基于偏振。 灵敏的光学相干断层扫描 (OCT)，一种显示精致对比度的光学成像方式 用于有髓神经的激光技术的最新进展（称为圆形测距，由发明者发明） 导师 Vakoc 博士）已将 OCT 激光器带到了其使用与运动兼容的地步 这个有两个目标的项目旨在将循环测距引入标准手术流程中。 颅底手术期间的手术室并评估其增强颅神经可视化的能力， 这项工作将在两个 NIH 之间进行。 资助的 P41 持有机构：马萨诸塞州总医院威尔曼光医学中心 (MGH)，生物医学 OCT 研究中心 (CBORT) 和布莱根妇女医院所在地 (BWH)，国家影像引导治疗中心 (NCIGT) 的所在地，这里拥有 先进的多模态图像引导操作套件（AMIGO），无论是在设备还是在 经验，将为进行此类研究提供完美的环境。 丹妮尔·J·哈珀 (Danielle J. Harper) 博士是麻省总医院 (MGH) 和哈佛医学院的博士后研究员。 她在生物光子学领域训练有素，专业领域是 OCT 及其功能扩展，包括 她的长期职业目标是达到学术水平。 独立并领导一个专注于术中光学神经影像的研究小组来帮助她。 为了实现这一目标，哈珀博士建立了一支强大的团队来指导她研究和职业的各个方面 MGH/HMS 光学成像专家 Benjamin J. Vakoc 博士将担任主要开发人员。 BWH 的神经外科医生 Alexandra J. Golby 博士和 Michael Mooney 博士将提供指导， 波士顿大学的田雷博士将提供所有临床方面的指导和帮助。 并为该项目的深度学习方面提供指导，MGH/HMS 的 Tayyaba Hasan 博士将 在该团队的支持下，该职业发展奖将提供一般职业发展建议。 为哈珀博士提供她过渡到完全独立所需的剩余技能和培训。