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Label-free intraoperative nerve detection and visualization using ratiometric diffuse reflectance spectroscopy.
Graham A Throckmorton1,2, Ezekiel Haugen1,2, Giju Thomas1,2
1Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA.
Scientific Reports
|May 10, 2023
Summary
A new label-free method using diffuse reflectance spectroscopy (DRS) can now visualize nerves during surgery. This technique accurately identifies nerves, potentially reducing iatrogenic nerve injuries and improving patient outcomes.
Area of Science:
- Biomedical Optics
- Surgical Technology
- Medical Imaging
Background:
- Iatrogenic nerve injuries are a significant cause of postoperative morbidity, affecting approximately 500,000 individuals annually in the US.
- Current intraoperative nerve visualization relies solely on the surgeon's visual assessment, lacking objective technological support.
Purpose of the Study:
- To develop and validate a label-free, intraoperative method for nerve detection using diffuse reflectance spectroscopy (DRS).
- To assess the accuracy and feasibility of DRS for real-time nerve visualization in both preclinical and clinical settings.
Main Methods:
- Diffuse reflectance spectroscopy (DRS) was employed in both fiber- and imaging-based configurations.
- Experiments were conducted using an in vivo rat model and subsequently in human patients undergoing thyroidectomies.
- Optical properties of nerve and surrounding tissues were measured to understand contrast mechanisms.
Main Results:
- Both fiber- and imaging-based DRS achieved 92% accuracy in identifying nerves in a rat model.
- Optical property analysis revealed that higher scattering and differences in oxygenated hemoglobin content contribute to nerve contrast.
- Clinical studies in thyroidectomy patients demonstrated 91% accuracy for nerve identification using both probe-based and imaging-based DRS.
Conclusions:
- Diffuse reflectance spectroscopy (DRS) offers a promising label-free approach for intraoperative nerve visualization.
- This technology has the potential to significantly reduce the incidence of iatrogenic nerve injuries and associated complications.
- DRS provides surgeons with an objective tool to enhance nerve identification during surgical procedures.
