Catheter-based polarimetric imaging to complement MRI for deep brain stimulation neurosurgery

Deep brain stimulation (DBS) is an established treatment for movement disorders and other neurological conditions. Accurate localization of small deep brain nuclei, such as the subthalamic nucleus (STN) and internal pallidum (GPi), is crucial for successful DBS outcomes. However, magnetic resonance imaging (MRI), commonly used for DBS planning, lacks the resolution and contrast needed to directly delineate these target structures.

We aim to explore the potential of catheter-based polarization-sensitive optical coherence tomography (PS-OCT) as a complementary imaging tool for high-resolution visualization of tissue surrounding the DBS insertion trajectory.

We simulated DBS implantation surgery at three targets in a post-mortem nonhuman primate head. PS-OCT, using advanced reconstruction algorithms for absolute depth-resolved birefringence, was compared with MRI for its ability to visualize and differentiate structural details.

PS-OCT provided more detailed and accurate structural information than MRI while maintaining consistency with MRI results. Its compact form factor and imaging paradigm integrate seamlessly into the surgical workflow, offering new insights for intraoperative decision-making.

PS-OCT functions as an intraoperative imaging tool, offering valuable guidance during the procedure. These findings establish PS-OCT as a promising complementary tool for DBS, with potential for further clinical validation and in vivo studies.