Transforming neuronavigational imaging for assisting brain tumour surgery

More than 13 million patients require brain surgery every year. Measuring brain function is paramount during neurosurgery, for example, when removing brain tumours. Neurosurgeons need to differentiate between healthy tissue and the tumour and ensure the integrity of the patient's brain function during and after surgery. Also, they need to identify tumour borders to precisely remove the tumour while saving healthy tissue. To accomplish their task and increase treatment effectiveness, surgeons require neuro-navigation systems to provide them with quantitative, accurate and real-time information on brain activity and tumour location. Current navigation approaches present major limitations as they do not provide the surgeons with sufficient information, are too invasive, or cannot assess brain activity accurately enough. Moreover, biochemical characterisation of the tumour is needed for more precise tumour border detection, which can be achieved through advanced imaging.

Therefore, the HyperProbe consortium will build on laboratory-based devices to be translated into a clinical setting. The consortium will propose a new multifunctional hyperspectral imaging device to provide real-time, quantitative, and accurate assessment of brain activity and tumour borders intraoperatively. Using an optical, contactless, and hence minimally invasive neuroimaging approach, the device will provide exhaustive biochemical information on the brain tissue and tumour features during surgery and cortical activity stimulation. "The HyperProbe system will illuminate the exposed brain with non-ionising light and measure the reflected and fluorescent signals from the brain tissue intraoperatively", explains Francesco Pavone, Project Coordinator from the University of Florence. "Tailored machine learning and artificial intelligence algorithms for image analysis will identify biomarkers of brain activity in the targeted area. It will then deliver this information to the clinician in real time via augmented reality", he adds.

The project will develop and validate a cost- effective, transportable, and easy-to-use device to be integrated with existing clinical instrumentation that is fully suitable for the operating room. "Within HyperProbe, we will carry out feasibility studies to assess the performance of the HyperProbe device on patients. We will validate the imaging performance and brain activity measurements during brain tumour surgery. This observational, proof-of-concept analysis will pave the way for bringing this highly promising new tool to the clinics", states Camilla Bonaudo, Careggi University Hospital.

The project will significantly impact clinical practice as the consortium proposes, for the first time, a functional-imaging and machine-based decision-making approach in neurosurgery. The HyperProbe device will be the first multi-biomarker, quantitative optical imaging device and functional imaging device used in image-guided surgery to preserve brain functions and minimise the risk of postoperative neurological impairment and considerably improve the life expectancy of patients.

Research Aims:

The objectives of this PhD project are: (1) the metrological characterization and (2) the optimisation of hyperspectral instruments for imaging and spectroscopic parameters. This will be done by developing a digital phantom platform (Light Diffusion Simulator) and new optical phantoms (solid and liquid) that mimic the cortical haemodynamic\metabolic function and structure.