Nerve detection during surgery: optical spectroscopy for peripheral nerve localization.

Abstract:

:Precise nerve localization is of major importance in both surgery and regional anesthesia. Optically based techniques can identify tissue through differences in optical properties, like absorption and scattering. The aim of this study was to evaluate the potential of optical spectroscopy (diffuse reflectance spectroscopy) for clinical nerve identification in vivo. Eighteen patients (8 male, 10 female, age 53 ± 13 years) undergoing inguinal lymph node resection or resection or a soft tissue tumor in the groin were included to measure the femoral or sciatic nerve and the surrounding tissues. In vivo optical measurements were performed using Diffuse Reflectance Spectroscopy (400-1600 nm) on nerve, near nerve adipose tissue, muscle, and subcutaneous fat using a needle-shaped probe. Model-based analyses were used to derive verified quantitative parameters as concentrations of optical absorbers and several parameters describing scattering. A total of 628 optical spectra were recorded. Measured spectra reveal noticeable tissue specific characteristics. Optical absorption of water, fat, and oxy- and deoxyhemoglobin was manifested in the measured spectra. The parameters water and fat content showed significant differences (P < 0.005) between nerve and all surrounding tissues. Classification using k-Nearest Neighbor based on the derived parameters revealed a sensitivity of 85% and a specificity of 79%, for identifying nerve from surrounding tissues. Diffuse Reflectance Spectroscopy identifies peripheral nerve bundles. The differences found between tissue groups are assignable to the tissue composition and structure.

journal_name

Lasers Med Sci

authors

Langhout GC,Kuhlmann KFD,Wouters MWJM,van der Hage JA,van Coevorden F,Müller M,Bydlon TM,Sterenborg HJCM,Hendriks BHW,Ruers TJM

doi

10.1007/s10103-017-2433-1

subject

Has Abstract

pub_date

2018-04-01 00:00:00

pages

619-625

issue

3

eissn

0268-8921

issn

1435-604X

pii

10.1007/s10103-017-2433-1

journal_volume

33

pub_type

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