Spatially Registered Tissue Fluorescence for Tumor Resection
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Solution Overview
Problem
Current surgical methods for tumor resection, particularly in glioblastoma, face challenges in achieving gross total resection (GTR) due to brain shift during procedures, and existing fluorescence-guided surgery systems fail to effectively integrate fluorescence data with MRI images, making it difficult to identify tumor margins in lower-grade tumors.
Innovation Solution
A neurosurgical system and method that utilizes a suction tool equipped with an optical fiber and navigation tracker to emit excitation light, collect fluorescence, and integrate this data with surgical navigation systems to display real-time indicators on medical images, enabling precise tumor margin identification and residual tumor detection.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If intraoperative MRI is performed to account for brain shift and confirm GTR, then measurement precision and reliability are improved, but device complexity, cost, and time consumption increase significantly
Solution Approach 1:
The patent creates a virtual copy of the preoperative MRI dataset that can be transformed and overlaid onto the surgical field. This virtual model replicates the anatomical structures and tumor boundaries without requiring physical re-imaging, thereby eliminating the need for expensive and time-consuming intraoperative MRI systems while maintaining measurement precision through continuous spatial updating
Solution Approach 2:
The patent introduces a navigation system as an intermediary between the preoperative MRI data and the surgical field. This intermediary continuously tracks surgical tool positions and transforms the static MRI dataset into a dynamic visual representation that accounts for brain shift, replacing the need for direct intraoperative MRI imaging
2Measurement precision
If fluorescence guided surgery is used to identify tumor margins, then measurement precision is improved, but the ability to detect lower-grade tumors with low fluorescence emission remains insufficient
Solution Approach 1:
The patent merges fluorescence-guided surgery with navigation system integration. By combining the real-time fluorescence signal with the transformed MRI dataset, the system creates a composite visualization that overlays fluorescence intensity data onto the anatomical context, enhancing both the precision of margin detection and the reliability of tumor identification including lower-grade tumors with weaker fluorescence signals
Solution Approach 2:
The patent adds a new dimension to fluorescence detection by integrating spatial location data from the navigation system with the fluorescence intensity data. This transforms the fluorescence information from a simple intensity measurement into a multi-dimensional dataset that includes spatial coordinates, allowing for more sensitive and accurate detection of tumor margins and lower-grade tumors within the contextual framework of the transformed MRI dataset
3Measurement precision
If multiple intraoperative MRIs are captured throughout the procedure to account for brain shift, then measurement precision is improved, but productivity and time efficiency deteriorate due to 30-60 minute capture times
Solution Approach 1:
The patent performs preliminary action by acquiring the complete MRI dataset before surgery and preparing the transformation algorithms in advance. This pre-processing allows the system to rapidly update the virtual anatomical model during surgery by applying pre-computed transformation matrices to account for brain shift, eliminating the need for time-consuming intraoperative MRI captures while maintaining measurement precision through continuous spatial registration
Solution Approach 2:
The patent establishes continuity of useful action by implementing a navigation system that continuously tracks surgical tool positions and continuously updates the visual representation of the transformed MRI dataset throughout the procedure. This continuous updating provides real-time brain shift compensation without interrupting the surgical flow, thereby maintaining measurement precision while preserving surgical productivity and time efficiency
4Device complexity
If ultrasound imaging is used to account for brain shift, then device complexity is reduced, but loss of biochemical/cellular information occurs
Solution Approach 1:
The patent makes the navigation system universal by enabling it to handle multiple types of information simultaneously. The system processes both the structural anatomical data from MRI and the biochemical/cellular information from fluorescence signals through the same transformation and visualization framework. This multi-functionality allows the system to account for brain shift using navigation data while preserving and displaying biochemical information, eliminating the trade-off between simplicity and information loss
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enhances the chances of achieving GTR by providing real-time biochemical/cellular information and accurate tumor margin detection, reducing the need for costly intraoperative MRIs and improving surgical precision.
Implementation Method 1
High-grade tumor cells containing PpIX absorb the excitation light and emit fluorescence (i.e., red fluorescence) having specific optical characteristics
Implementation Method 2
5-ALA is a compound that occurs naturally in the hemoglobin synthesis pathway. In cancer cells, the hemoglobin synthesis is disrupted and the pathway stalls at an intermediate compound called Protoporphyrin IX (PpIX)
Data Source
AI summary
A neurosurgical method for determining a resection status of a tumor is described. The method includes acquiring a medical image of a human organ including a segmented tumor. The method further includes determining a pose of a suction tool including at least one optical fiber and a navigation tracker. The method further includes generating excitation light for the at least one optical fiber to excite the target area which includes the tumor and a margin area surrounding the tumor. The method further includes receiving collected fluorescence emitted from the target area. The method further includes determining whether tissue in the target area corresponds to the tumor based on the collected fluorescence at the pose of the suction tool. The method further includes displaying the resection status of the target area relative to the medical image.