UltraLas: Optical measurement methods combined with ultrasound or laser tissue resection in neurosurgery for the local detection of tissue boundaries, elasticity, and vascular architecture

n Germany, around 43,000 new cases of cancer of the central nervous system (CNS) occur annually, and this number is expected to rise in the future due to demographic changes. Microsurgical resection is the standard treatment for the majority of CNS tumors. The survival rate depends, among other things, on the extent of the resection. To date, the tumor margins to the intact tissue can be identified intraoperatively, but only with difficulty or with considerable technological effort. Further problems are the highly variable dissection rate when using ultrasound or laser instruments and the poor visualization of the underlying vascular systems. This results in difficult selection of device parameters for the surgeon and intraoperative bleeding, which is currently usually controlled with current-carrying bipolar forceps. Disadvantages of this contact-based hemostasis include problems caused by tissue adhesion to the electrodes and an induced further difficulty in distinguishing the tumorous tissue by color/tactile characteristics. The overarching goal of the collaborative work is therefore to improve the extent of resection during surgery through the automatic detection of tumor characteristics and tumor margins. At the same time, the surgical risk associated with the procedure should be minimized for the patient, thus leading to a longer survival time with a high quality of life.

Optical measurement techniques combined with ultrasound or laser tissue resection for clinical practice

This project aims to develop and evaluate various methods for the intraoperative in vivo assessment of tumor extent, vascular architecture, and tumor elasticity in neurosurgery. Several innovative photonic techniques will be used, on the one hand, to rapidly and non-invasively measure lesions and, on the other hand, in conjunction with therapeutic instruments, to effectively dissect and coagulate tumor tissue. Sub-goals include novel system solutions combining optical measurement techniques with laser or ultrasound instruments. This combination of different technologies combines intraoperative, comparatively cost-effective optomechanical tissue analysis with high local resolution and visualization of the deep vascular architecture with an improved laser or ultrasound instrument. This novel optimization of the resection procedure enables significantly improved tumor resection in clinical practice through assisted resection margin detection and optimized dissection performance.