title: Optical technologies for intraoperative neurosurgical guidance.
abstract: Biomedical optics is a broadly interdisciplinary field at the interface of optical engineering, biophysics, computer science, medicine, biology, and chemistry, helping us understand light-tissue interactions to create applications with diagnostic and therapeutic value in medicine. Implementation of biomedical optics tools and principles has had a notable scientific and clinical resurgence in recent years in the neurosurgical community. This is in great part due to work in fluorescence-guided surgery of brain tumors leading to reports of significant improvement in maximizing the rates of gross-total resection. Multiple additional optical technologies have been implemented clinically, including diffuse reflectance spectroscopy and imaging, optical coherence tomography, Raman spectroscopy and imaging, and advanced quantitative methods, including quantitative fluorescence and lifetime imaging. Here we present a clinically relevant and technologically informed overview and discussion of some of the major clinical implementations of optical technologies as intraoperative guidance tools in neurosurgery.
authors.affiliation: Departments of 1 Neurosurgery and.|Department of Neurosurgery, Harvard Medical School, Boston Children's Hospital, Boston;
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Valdés
authors.affiliation: Section of Neurosurgery, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
authors.forename: David W
authors.initials: DW
authors.lastname: Roberts
authors.forename: Fa-Ke
authors.initials: FK
authors.lastname: Lu
authors.affiliation: Departments of 1 Neurosurgery and.|Radiology, and.|Dana Farber Cancer Institute, Harvard Medical School, Brigham and Women's Hospital;
authors.forename: Alexandra
authors.initials: A
authors.lastname: Golby
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D013059:Spectrum Analysis, Raman / Q000379:methods*; D041623:Tomography, Optical Coherence / Q000379:methods*
keywords: ALA-PpIX = 5-aminolevulinic acid-induced protoporphyrin IX; BBB = blood-brain barrier; CARS = coherent anti-Stokes Raman scattering; CBF = cerebral blood flow; CCD = charge-coupled device; GBM = glioblastoma multiforme; GTR = gross-total resection; ICG = indocyanine green; LSCI = laser speckle contrast imaging; NIR = near-infrared; OCT = optical coherence tomography; Raman spectroscopy and imaging; SRS = stimulated Raman scattering; biomedical optics; diffuse reflectance spectroscopy and imaging; fluorescence lifetime; fluorescence-guided surgery; image-guided surgery; laser speckle contrast imaging; optical coherence tomography; λem = emission wavelength; λex = excitation wavelength