In brain cancer surgery, maximal tumor resection improves overall survival and quality of life survival in low-grade and high-grade glioma. Different technologies such as intraoperative magnetic resonance imaging and computed tomography have made major contributions; however, these technologies do not provide quantitative, real-time and three-dimensional continuous guidance. Optical Coherence Tomography (OCT) is a non-invasive, label-free, real-time, high-resolution imaging modality that has been explored for glioma infiltration detection. Here we report a novel Artificial Neural Network (ANN)-based computer-aided diagnosis (CAD) method for automated, real-time, in situ detection of glioma-infiltrated tumor margins. Near 500 volumetric OCT samples were intraoperatively obtained from resected brain tissue specimens of 21 patients with glioma tumors of different stages and labeled as either non-cancerous or glioma-infiltrated based on histopathology evaluation (gold standard). Labeled OCT images from 12 patients were used as training dataset to develop the artificial neural network. Unlabeled OCT images from the other 9 patients were used as a validation dataset to quantify the method detection performance. The CAD system achieved excellent levels of both sensitivity and specificity (~90%) for detecting glioma-infiltrated tissue with high spatial resolution (~16 μm laterally). Previous methods for OCT-based detection of glioma-infiltrated brain tissue rely on underlying optical properties such as attenuation coefficient from the OCT signal requiring sacrificing spatial resolution and cumbersome calibration procedures. By overcoming these major challenges, our novel ANN-assisted CAD system will enable implementing practical OCT-guided surgical tools for continuous, real-time and accurate intra-operative detection of glioma-infiltrated brain tissue, facilitating maximal glioma resection and superior surgical outcomes for glioma patients.
In brain cancer surgery, it is critical to achieve extensive resection without compromising adjacent healthy, non-cancerous regions. Various technological advances have made major contributions in imaging, including intraoperative magnetic imaging (MRI) and computed tomography (CT). However, these technologies have pros and cons in providing quantitative, real-time and three-dimensional (3D) continuous guidance in brain cancer detection. Optical Coherence Tomography (OCT) is a non-invasive, label-free, cost-effective technique capable of imaging tissue in three dimensions and real time. The purpose of this study is to reliably and efficiently discriminate between non-cancer and cancer-infiltrated brain regions using OCT images. To this end, a mathematical model for quantitative evaluation known as the Blind End- Member and Abundances Extraction method (BEAE). This BEAE method is a constrained optimization technique which extracts spatial information from volumetric OCT images. Using this novel method, we are able to discriminate between cancerous and non-cancerous tissues and using logistic regression as a classifier for automatic brain tumor margin detection. Using this technique, we are able to achieve excellent performance using an extensive cross-validation of the training dataset (sensitivity 92.91% and specificity 98.15%) and again using an independent, blinded validation dataset (sensitivity 92.91% and specificity 86.36%). In summary, BEAE is well-suited to differentiate brain tissue which could support the guiding surgery process for tissue resection.
In brain cancer surgery, it is critical to achieve extensive resection without compromising adjacent healthy, noncancerous regions. Various technological advances have made major contributions in imaging, including intraoperative magnetic imaging (MRI) and computed tomography (CT). However, these technologies have pros and cons in providing quantitative, real-time and three-dimensional (3D) continuous guidance in brain cancer detection. Optical Coherence Tomography (OCT) is a non-invasive, label-free, cost-effective technique capable of imaging tissue in three dimensions and real time. The purpose of this study is to reliably and efficiently discriminate between non-cancer and cancerinfiltrated brain regions using OCT images. To this end, a mathematical model for quantitative evaluation known as the Blind End-Member and Abundances Extraction method (BEAE). This BEAE method is a constrained optimization technique which extracts spatial information from volumetric OCT images. Using this novel method, we are able to discriminate between cancerous and non-cancerous tissues and using logistic regression as a classifier for automatic brain tumor margin detection. Using this technique, we are able to achieve excellent performance using an extensive cross-validation of the training dataset (sensitivity 92.91% and specificity 98.15%) and again using an independent, blinded validation dataset (sensitivity 92.91% and specificity 86.36%). In summary, BEAE is well-suited to differentiate brain tissue which could support the guiding surgery process for tissue resection.
Purpose: To compare the accuracy of detecting tumor location and size in the prostate using both manual palpation and
ultrasound elastography (UE). Methods: Tumors in the prostate were simulated using both synthetic and ex vivo tissue
phantoms. 25 participants were asked to provide the presence, size and depth of these simulated lesions using manual
palpation and UE. Ultrasound images were captured using a laparoscopic ultrasound probe, fitted with a Gore-Tetrad
transducer with frequency of 7.5 MHz and a RF capture depth of 4-5 cm. A MATLAB GUI application was employed to
process the RF data for ex vivo phantoms, and to generate UE images using a cross-correlation algorithm. Ultrasonix
software was used to provide real time elastography during laparoscopic palpation of the synthetic phantoms. Statistical
analyses were performed based on a two-tailed, student t-test with α = 0.05. Results: UE displays both a higher accuracy
and specificity in tumor detection (sensitivity = 84%, specificity = 74%). Tumor diameters and depths are better
estimated using ultrasound elastography when compared with manual palpation. Conclusions: Our results indicate that
UE has strong potential in assisting surgeons to intra-operatively evaluate the tumor depth and size. We have also
demonstrated that ultrasound elastography can be implemented in a laparoscopic environment, in which manual
palpation would not be feasible. With further work, this application can provide accurate and clinically relevant
information for surgeons during prostate resection.
Access to the requested content is limited to institutions that have purchased or subscribe to SPIE eBooks.
You are receiving this notice because your organization may not have SPIE eBooks access.*
*Shibboleth/Open Athens users─please
sign in
to access your institution's subscriptions.
To obtain this item, you may purchase the complete book in print or electronic format on
SPIE.org.
INSTITUTIONAL Select your institution to access the SPIE Digital Library.
PERSONAL Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.