Enhanced Tumor Resection in Neurosurgery Using Combined Hyperspectral and pCLE Imaging

Overview

This study introduces a novel multimodal imaging platform integrating hyperspectral imaging (HSI) and probe-based confocal laser endomicroscopy (pCLE) to improve brain tumor resection. The combined approach leverages HSI's broad-field spectral data and pCLE's cellular-level resolution, enhancing tumor margin identification and surgical navigation.

Background

Neuro-oncological surgery requires precise tumor resection to improve patient prognosis, but infiltrative tumors like gliomas challenge conventional imaging methods. Existing intraoperative technologies such as neuronavigation, ultrasound, fluorescence imaging, and MRI have limitations including accuracy, operator dependency, and cost. pCLE offers high-resolution cellular imaging but with a limited field of view, while HSI provides wide-field spectral information but lacks cellular detail. Integrating these complementary modalities may overcome individual limitations and support more effective tumor removal.

Data Highlights

Key Findings

• Development of a novel integrated platform combining HSI and pCLE with an operating microscope for multimodal imaging.
• HSI provides rapid, wide-area detection of tumor regions using spectral data across 40 bands within 450–762 nm.
• pCLE offers real-time, high-resolution cellular imaging enabling precise optical biopsies around tumor margins.
• Integration includes a tracking system using a high-frame-rate RGB camera to correlate pCLE probe position with HSI images, improving navigation accuracy.
• Calibration protocols ensure consistent color and spectral data across modalities, using white-balance and reflectance targets.
• Ex vivo lamb brain phantom studies demonstrate the platform’s capability to identify tumor margins by leveraging complementary strengths of HSI and pCLE.

Clinical Implications

The combined HSI and pCLE platform enhances intraoperative tumor margin detection by providing both broad spectral context and detailed cellular morphology, potentially improving resection accuracy. This integration addresses limitations of each modality alone, offering surgeons improved navigation and decision-making tools without workflow disruption. Ultimately, this approach may reduce residual tumor presence and preserve functional brain tissue.

Conclusion

This innovative multimodal imaging approach successfully integrates hyperspectral and confocal laser endomicroscopy techniques, demonstrating enhanced capability for precise brain tumor margin identification. The platform holds promise for improving neurosurgical outcomes through better tumor delineation and surgical guidance.

References

1. Neuro-oncological surgery challenges and tumor infiltration [1-7]
2. Intraoperative supportive technologies and limitations [8-14]
3. pCLE imaging capabilities and limitations [15-17]
4. Hyperspectral imaging principles and applications [18-20]
5. pCLE system configuration and optical components [21]