Real-time, functional intra-operative localization of rat cavernous nerve network using near-infrared cyanine voltage-sensitive dye imaging

Abstract

<jats:title>Abstract</jats:title><jats:p>Despite current progress achieved in the surgical technique of radical prostatectomy, post-operative complications such as erectile dysfunction and urinary incontinence persist at high incidence rates. In this paper, we present a methodology for functional intra-operative localization of the cavernous nerve (CN) network for nerve-sparing radical prostatectomy using near-infrared cyanine voltage-sensitive dye (VSD) imaging, which visualizes membrane potential variations in the CN and its branches (CNB) in real time. As a proof-of-concept experiment, we demonstrate a functioning complex nerve network in response to electrical stimulation of the CN, which was clearly differentiated from surrounding tissues in an <jats:italic>in vivo</jats:italic> rat prostate model. Stimulation of an erection was confirmed by correlative intracavernosal pressure (ICP) monitoring. Within 10 minutes, we performed trans-fascial staining of the CN by direct VSD administration. Our findings suggest the applicability of VSD imaging for real-time, functional imaging guidance during nerve-sparing radical prostatectomy.</jats:p>

Towards photoacoustic prostate imaging using continuous wave laser excitation

“…Nerve imaging can be performed with PA imaging and voltage-sensitive dyes (VSD) 14 , as demonstrated for brain neural activity 15 . Rat prostate nerves 16 and ex vivo pig sciatic nerves 3 were visualized using fluorescence (FL) VSD imaging. For rapid recording of voltage membrane variations using fast VSD and to mitigate blood flow effect, simultaneous multi wavelength PA sensing is recommended.…”