Intraoperative cerebral blood flow monitoring in neurosurgery: A review of contemporary technologies and emerging perspectives |
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| Institution: | 3. Lyon Neuroscience Research Center, TIGER team and AniRA-Beliv technological platform, Inserm U2018, CNRS UMR 5292, Lyon 1 University, Lyon, France;4. Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland;5. Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Canada;6. Department of Interventional Neuroradiology, Pierre Wertheimer Neurological and Neurosurgical Hospital, Hospices Civils de Lyon, Lyon, France;7. Department of Imaging, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France;8. Creatis Lab - CNRS UMR 5220 – INSERM U1206, Lyon 1 University, INSA Lyon, Lyon, France;1. Department of Neurosurgical Oncology and Vascular Neurosurgery, Pierre Wertheimer Neurological and Neurosurgical Hospital, University of Lyon – Hospices Civils de Lyon, 59, boulevard Pinel, 69003 Lyon, France;2. Department of Neuro-Anesthesia and Neuro-Critical Care, Pierre Wertheimer Neurological and Neurosurgical Hospital, Hospices Civils de Lyon, Lyon, France;3. Lyon Neuroscience Research Center, TIGER team and AniRA-Beliv technological platform, Inserm U2018, CNRS UMR 5292, Lyon 1 University, Lyon, France;4. Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland;5. Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Canada;6. Department of Interventional Neuroradiology, Pierre Wertheimer Neurological and Neurosurgical Hospital, Hospices Civils de Lyon, Lyon, France;7. Department of Imaging, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France;8. Creatis Lab - CNRS UMR 5220 – INSERM U1206, Lyon 1 University, INSA Lyon, Lyon, France;1. Department of Preventive Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA;2. Department of Family Medicine, Memorial Medical Center, Las Cruces, NM, USA;3. Department of Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA;4. Escuela de Ciencias de la Salud, Universidad Autonoma de Baja California, Ensenada, Baja California, Mexico;5. Department of Neurosurgery, Safdarjung Hospital, New Delhi, India;6. Department of Neurological Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA;1. Department of pediatric neurosurgery, Hôpital Necker, AP–HP, Paris, France;2. Sorbonne Université, Paris, France;1. Department of Radiology, Wuxi No. 9 People''s Hospital Affiliated to Soochow University, Wuxi 214062, Jiangsu, China;2. Department of Orthopaedics, Wuwei People''s Hospital, Wuwei 733000, Ganxu, China;3. Department of Orthopaedics. Wuxi No. 9 People''s Hospital Affiliated to Soochow University, No. 999 Liangxi Road, Wuxi 214062, Jiangsu, China;1. Neurosurgeon, Neuroradiologist, Hemodynamics Division, Federal University of Parana - UFPR, Curitiba, PR, Brazil;2. Neurosurgeon, Neuroradiologist, Department of Neurosurgery - Cajuru University Hospital, Pontifical University Catholic of Parana - PUCPR, Curitiba, PR, Brazil;3. Neurosurgeon, Department of Neurosurgery - Cajuru University Hospital, Pontifical University Catholic of Parana - PUCPR, Curitiba, PR, Brazil;4. Interventional Radiologist, Department of Neurosurgery–Hospital Vita Curitiba, Curitiba, PR, Brazil;1. Geoffrey Jefferson Brain Research and Division of Neuroscience and Experimental Psychology, Faculty of Biology, University of Manchester, Manchester, UK;2. Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK;3. Vita-Salute San Raffaele University, Milan, Italy;4. Manchester Centre for Genomic Medicine, St Mary''s Hospital, Division of Evolution and Genomic Science, University of Manchester, Manchester, UK;5. Department of Cellular Pathology, Salford Royal Foundation Trust, Northern Care Alliance, Salford, UK;6. Department of Neuroradiology, Manchester Centre for Clinical Neurosciences, Salford Royal Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK;1. Service de Neurochirurgie, Hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonellé, 37044, Tours cedex 9, France;2. Service d’anatomie et cytologie pathologiques, Hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonellé, 37044, Tours cedex 9, France |
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| Abstract: | Intraoperative monitoring of cerebral blood flow (CBF) has become an invaluable adjunct to vascular and oncological neurosurgery, reducing the risk of postoperative morbidity and mortality. Several technologies have been developed during the last two decades, including laser-based techniques, videomicroscopy, intraoperative MRI, indocyanine green angiography, and thermography. Although these technologies have been thoroughly studied and clinically applied outside the operative room, current practice lacks an optimal technology that perfectly fits the workflow within the neurosurgical operative room. The different available technologies have specific strengths but suffer several drawbacks, mainly including limited spatial and/or temporal resolution. An optimal CBF monitoring technology should meet particular criteria for intraoperative use: excellent spatial and temporal resolution, integration in the operative workflow, real-time quantitative monitoring, ease of use, and non-contact technique. We here review the main contemporary technologies for intraoperative CBF monitoring and their current and potential future applications in neurosurgery. |
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| Keywords: | Cerebral blood flow Intraoperative imaging Laser speckle contrast imaging Microcirculation Sidestream dark field imaging |
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