Continuous blood flow visualization with laser speckle contrast imaging during neurovascular surgery

Area of Science:

• Neurosurgery
• Medical Imaging
• Cerebrovascular Surgery

Background:

• Intraoperative cerebral blood flow (CBF) monitoring is crucial for neurovascular procedures.
• Laser speckle contrast imaging (LSCI) offers noninvasive, real-time, full-field blood flow mapping.
• Existing methods may have limitations in continuous monitoring or require contrast agents.

Purpose of the Study:

• To demonstrate the capability of LSCI for continuous intraoperative CBF visualization during neurovascular procedures.
• To integrate LSCI with surgical microscopes for seamless real-time monitoring.
• To compare LSCI with indocyanine green angiography (ICGA) for assessing cerebral perfusion.

Main Methods:

• LSCI hardware was attached to a surgical microscope without disrupting its operation.
• LSCI images were overlaid onto white light microscope images for real-time display to surgeons.
• LSCI was performed throughout surgeries, and compared simultaneously with ICGA during aneurysm clipping and AVM resection.

Main Results:

• LSCI provided continuous, real-time visualization of CBF changes before, during, and after aneurysm clipping and AVM resection in human patients.
• Simultaneous acquisition of LSCI and ICGA data was enabled by the integrated hardware.
• LSCI effectively visualized blood flow dynamics without interfering with the surgical workflow.

Conclusions:

• LSCI is a viable tool for continuous, real-time CBF monitoring in neurosurgery.
• The integration of LSCI with surgical microscopes enhances intraoperative visualization.
• LSCI and ICGA provide complementary information, aiding in comprehensive assessment of cerebral perfusion.