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Journal of Biomedical Optics / Volume 17 / Issue 1 / Research Papers: Imaging

Application of a time-resolved optical brain imager for monitoring cerebral oxygenation during carotid surgery

J. Biomed. Opt. 17, 016002 (Feb 08, 2012); http://dx.doi.org/10.1117/1.JBO.17.1.016002

Michal Kacprzak, Adam Liebert, Piotr Sawosz, and Roman Maniewski

Nalecz Institute of Biocybernetics and Biomedical Engineering PAS, Trojdena 4, 02-109 Warsaw, Poland

Walerian Staszkiewicz, Andrzej Gabrusiewicz, and Grzegorz Madycki

Centre for Postgraduate Medical Education, Department of Vascular Surgery and Angiology, Marymoncka 99/103, 01-813 Warsaw, Poland

Recent studies have shown that time-resolved optical measurements of the head can estimate changes in the absorption coefficient with depth discrimination. Thus, changes in tissue oxygenation, which are specific to intracranial tissues, can be assessed using this advanced technique, and this method allows us to avoid the influence of changes to extracerebral tissue oxygenation on the measured signals. We report the results of time-resolved optical imaging that was carried out during carotid endarterectomy. This surgery remains the “gold standard” treatment for carotid stenosis, and intraoperative brain oxygenation monitoring may improve the safety of this procedure. A time-resolved optical imager was utilized within the operating theater. This instrument allows for the simultaneous acquisition of 32 distributions of the time-of-flight of photons at two wavelengths on both hemispheres. Analysis of the statistical moments of the measured distributions of the time-of-flight of photons was applied for estimating changes in the absorption coefficient as a function of depth. Time courses of changes in oxy- and deoxyhemoglobin of the extra- and intracerebral compartments during cross-clamping of the carotid arteries were obtained. A decrease in the oxyhemoglobin concentration and an increase in the deoxyhemoglobin concentrations were observed in a large area of the head. Large changes were observed in the hemisphere ipsilateral to the site of clamped carotid arteries. Smaller amplitude changes were noted at the contralateral site. We also found that changes in the hemoglobin signals, as estimated from intracerebral tissue, are very sensitive to clamping of the internal carotid artery, whereas its sensitivity to clamping of the external carotid artery is limited. We concluded that intraoperative multichannel measurements allow for imaging of brain tissue hemodynamics. However, when monitoring the brain during carotid surgery, a single-channel measurement may be sufficient.

© 2012 Society of Photo-Optical Instrumentation Engineers

History
Received Jun 30, 2011
Accepted Nov 02, 2011
Revised Oct 28, 2011
Published online Feb 08, 2012
Digital Object Identifier
http://dx.doi.org/10.1117/1.JBO.17.1.016002
Citation
Michal Kacprzak, Adam Liebert, Walerian Staszkiewicz, Andrzej Gabrusiewicz, Piotr Sawosz, Grzegorz Madycki and Roman Maniewski, "Application of a time-resolved optical brain imager for monitoring cerebral oxygenation during carotid surgery", J. Biomed. Opt. 17, 016002 (Feb 08, 2012); http://dx.doi.org/10.1117/1.JBO.17.1.016002

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