Optical Coherence Tomography for Neurosurgical Imaging of

OBJECTIVE: Intraoperative identification of brain tumors and tumor margins has been limited by either the resolution of the in vivo imaging technique or the time required to obtain histological specimens. Our objective was to evaluate the feasibility of using optical coherence tomography (OCT) as a high-resolution, real-time intraoperative imaging technique to identify an intracortical melanoma. INSTRUMENTATION: OCT is a new, noncontact, high-speed imaging technology capable of resolutions on the micrometer scale. OCT is analogous to ultrasound B-mode imaging, except that reflections of infrared 1ight, rather than sound, are detected. OCT uses inherent tissue contrast, rather than enhancement with dyes, to differentiate tissue types. The compact, fiberoptic-based design is readily integrated with surgical instruments. METHODS: A portable handheld OCT surgical imaging probe has been constructed for imaging within the surgical field. Cadaveric human cortex with metastatic melanoma was harvested and imaged in two and three dimensions. Changes in optical backscatter intensity were used to identify regions of tumor and to locate tumor margins. Structures within the optical coherence tomographic images were compared with the histological slides. RESUL TS: Two-dimensional images showed increased optical backscatter from regions of tumor, which was quantitatively used to determine the tumor margin. The images correlated well with the histological findings. Three-dimensional reconstructions revealed regions of tumor penetrating normal cortex and could be resec