Hyperspectral Imaging in Brain Tumor Surgery—Evidence of Machine Learning-Based Performance

Puustinen, Sami; Vrzáková, Hana; Hyttinen, Joni; Rauramaa, Tuomas; Fält, Pauli; Hauta-Kasari, Markku; Bednarik, Roman; Koivisto, Timo; Rantala, Susanna; Fraunberg, Mikael von und zu; Jääskeläinen, Juha E.; Elomaa, Antti-Pekka

doi:10.1016/j.wneu.2023.03.149

Cited by 6 publications

(3 citation statements)

References 74 publications

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“…HSI is an optical imaging method with the potential to enhance intraoperative tissue recognition and diagnostics [2]. Light in the visual spectrum exhibits only minimal tissue penetration whereas nonvisible near-infrared light can pass through tissue for up to several millimeters [9].…”

Section: Hyperspectral Imaging In Diagnostics and Surgerymentioning

confidence: 99%

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Hyperspectral imaging and evaluation of surgical margins: where do we stand?

Pertzborn,

Bali,

Mühlig

et al. 2024

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review To highlight the recent literature on the use of hyperspectral imaging (HSI) for cancer margin evaluation ex vivo, for head and neck cancer pathology and in vivo during head and neck cancer surgery. Recent findings HSI can be used ex vivo on unstained and stained tissue sections to analyze head and neck tissue and tumor cells in combination with machine learning approaches to analyze head and neck cancer cell characteristics and to discriminate the tumor border from normal tissue. Data on in vivo applications during head and neck cancer surgery are preliminary and limited. Even now an accuracy of 80% for tumor versus nonneoplastic tissue classification can be achieved for certain tasks, within the current in vivo settings. Summary Significant progress has been made to introduce HSI for ex vivo head and neck cancer pathology evaluation and for an intraoperative use to define the tumor margins. To optimize the accuracy for in vivo use, larger HSI databases with annotations for head and neck cancer are needed.

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Section: Hyperspectral Imaging In Diagnostics and Surgerymentioning

confidence: 99%

“…This light visualizes the target organs and the head and neck cancer in natural colors. The perceived color depends on the optical properties of molecular constituents of the tumor and the neighboring tissue [1,2]. These perceived colors do not allow for a precise differentiation between tumor and nonneoplastic tissue.…”

Section: Introductionmentioning

confidence: 99%

Hyperspectral imaging and evaluation of surgical margins: where do we stand?

Pertzborn,

Bali,

Mühlig

et al. 2024

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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“…HSI has been shown to have multiple potential applications within the medical field (Spigulis, 2017 ; Leon et al, 2020 ; Torti et al, 2020 ) and the surgical field (Shapey et al, 2019 ). Specifically within the neurosurgical literature, its reported use spans from intra-operative tissue differentiation capabilities, particularly in glioma surgery (Fabelo et al, 2018 , 2019 ; Manni et al, 2020 ; Ebner et al, 2021 ; Anichini et al, 2022 ; Puustinen et al, 2023 ), to intra-operative visualization of cortical haemodynamic responses (Giannoni et al, 2018 ) including during epilepsy surgery (Pichette et al, 2016 ). There is also a growing body of work where HSI is used to try and quantify fluorescence (e.g., with 5-ALA) in brain tumor surgery (Valdes et al, 2019 ; Walke et al, 2023 ).…”

Section: Related Workmentioning

confidence: 99%

Lightfield hyperspectral imaging in neuro-oncology surgery: an IDEAL 0 and 1 study

MacCormac,

Noonan,

Janatka

et al. 2023

Front. Neurosci.

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IntroductionHyperspectral imaging (HSI) has shown promise in the field of intra-operative imaging and tissue differentiation as it carries the capability to provide real-time information invisible to the naked eye whilst remaining label free. Previous iterations of intra-operative HSI systems have shown limitations, either due to carrying a large footprint limiting ease of use within the confines of a neurosurgical theater environment, having a slow image acquisition time, or by compromising spatial/spectral resolution in favor of improvements to the surgical workflow. Lightfield hyperspectral imaging is a novel technique that has the potential to facilitate video rate image acquisition whilst maintaining a high spectral resolution. Our pre-clinical and first-in-human studies (IDEAL 0 and 1, respectively) demonstrate the necessary steps leading to the first in-vivo use of a real-time lightfield hyperspectral system in neuro-oncology surgery.MethodsA lightfield hyperspectral camera (Cubert Ultris ×50) was integrated in a bespoke imaging system setup so that it could be safely adopted into the open neurosurgical workflow whilst maintaining sterility. Our system allowed the surgeon to capture in-vivo hyperspectral data (155 bands, 350–1,000 nm) at 1.5 Hz. Following successful implementation in a pre-clinical setup (IDEAL 0), our system was evaluated during brain tumor surgery in a single patient to remove a posterior fossa meningioma (IDEAL 1). Feedback from the theater team was analyzed and incorporated in a follow-up design aimed at implementing an IDEAL 2a study.ResultsFocusing on our IDEAL 1 study results, hyperspectral information was acquired from the cerebellum and associated meningioma with minimal disruption to the neurosurgical workflow. To the best of our knowledge, this is the first demonstration of HSI acquisition with 100+ spectral bands at a frame rate over 1Hz in surgery.DiscussionThis work demonstrated that a lightfield hyperspectral imaging system not only meets the design criteria and specifications outlined in an IDEAL-0 (pre-clinical) study, but also that it can translate into clinical practice as illustrated by a successful first in human study (IDEAL 1). This opens doors for further development and optimisation, given the increasing evidence that hyperspectral imaging can provide live, wide-field, and label-free intra-operative imaging and tissue differentiation.

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