title: Real-time three-dimensional Fourier-domain optical coherence tomography video image guided microsurgeries.
abstract: The authors describe the development of an ultrafast three-dimensional (3D) optical coherence tomography (OCT) imaging system that provides real-time intraoperative video images of the surgical site to assist surgeons during microsurgical procedures. This system is based on a full-range complex conjugate free Fourier-domain OCT (FD-OCT). The system was built in a CPU-GPU heterogeneous computing architecture capable of video OCT image processing. The system displays at a maximum speed of 10 volume/s for an image volume size of 160 × 80 × 1024(X × Y × Z) pixels. We have used this system to visualize and guide two prototypical microsurgical maneuvers: microvascular anastomosis of the rat femoral artery and ultramicrovascular isolation of the retinal arterioles of the bovine retina. Our preliminary experiments using 3D-OCT-guided microvascular anastomosis showed optimal visualization of the rat femoral artery (diameter<0.8 mm), instruments, and suture material. Real-time intraoperative guidance helped facilitate precise suture placement due to optimized views of the vessel wall during anastomosis. Using the bovine retina as a model system, we have performed "ultra microvascular" feasibility studies by guiding handheld surgical micro-instruments to isolate retinal arterioles (diameter ~0.1 mm). Isolation of the microvessels was confirmed by successfully passing a suture beneath the vessel in the 3D imaging environment.
authors.affiliation: Johns Hopkins University, Department of Electrical and Computer Engineering, 3400 N. Charles Street, Baltimore, MD 21218, USA. jkang@jhu.edu
authors.forename: Jin U
authors.initials: JU
authors.lastname: Kang
authors.forename: Yong
authors.initials: Y
authors.lastname: Huang
authors.forename: Kang
authors.initials: K
authors.lastname: Zhang
authors.forename: Zuhaib
authors.initials: Z
authors.lastname: Ibrahim
authors.forename: Jaepyeong
authors.initials: J
authors.lastname: Cha
authors.forename: W P Andrew
authors.initials: WP
authors.lastname: Lee
authors.forename: Gerald
authors.initials: G
authors.lastname: Brandacher
authors.forename: Peter L
authors.initials: PL
authors.lastname: Gehlbach
mesh_terms: D000818:Animals; D002417:Cattle; D003199:Computer Systems; D017076:Computer-Aided Design; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005583:Fourier Analysis; D007089:Image Enhancement / Q000295:instrumentation; D007090:Image Interpretation, Computer-Assisted / Q000295:instrumentation; D021621:Imaging, Three-Dimensional / Q000295:instrumentation*; D008866:Microsurgery / Q000295:instrumentation*; D015203:Reproducibility of Results; D012171:Retinal Vessels / Q000033:anatomy & histology* / Q000601:surgery*; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D041623:Tomography, Optical Coherence / Q000295:instrumentation*; D014741:Video Recording / Q000295:instrumentation*