Cross-Polarization Optical Coherence Tomography for Brain Tumor Imaging

Area of Science:

• Neuroscience
• Medical Imaging
• Oncology

Background:

• Distinguishing between tumorous and non-tumorous brain tissue intraoperatively is critical for effective glioma resection.
• Optical coherence tomography (OCT) offers high-resolution imaging, but functional extensions are needed for enhanced tissue characterization.

Purpose of the Study:

• To establish visual assessment criteria using cross-polarization OCT (CP OCT) for intraoperative differentiation of tumorous and non-tumorous brain tissues.
• To evaluate the diagnostic accuracy of these criteria in distinguishing glioma from white matter.

Main Methods:

• 176 ex vivo human glioma specimens and 30 patients' tissues were analyzed using CP OCT.
• Three blinded investigators visually assessed CP OCT image parameters (signal intensity, homogeneity, attenuation) against histology.
• Intraoperative CP OCT was performed during brain tumor resections in 17 patients.

Main Results:

• Key visual CP OCT parameters identified for differentiation include signal intensity, homogeneity, and attenuation uniformity.
• Significant correlation was found between CP OCT parameters and histological findings, particularly signal intensity and homogeneity in co-polarization.
• The developed visual criteria achieved a diagnostic accuracy of 87-88% for distinguishing white matter from tumors.

Conclusions:

• Visual assessment of CP OCT images is effective for intraoperative differentiation of tumorous and non-tumorous brain tissues.
• Signal intensity in CP OCT images is the most powerful criterion for differentiating tumorous tissue from white matter.
• CP OCT provides valuable complementary information for neurosurgeons during tumor resection, integrating with neurophysiological and neuronavigation data.