Optical imaging system for neurosurgery

• US 5,215,095 A
• Filed: 08/10/1990
• Issued: 06/01/1993
• Est. Priority Date: 08/10/1990
• Status: Expired due to Term

• Current Assignee: Washington University In St Louis
• Original Assignee: University Technologies International, Inc.
• Inventors: Hochman, Daryl W., Macvicar, Brian A., Watson, Timothy W.
• Primary Examiner(s): Cohen, Lee S.
• Assistant Examiner(s): PONTIUS, KEVIN LANE
• Application Number:
  US07/565,454
• Time in Patent Office: 1,026 Days
• Field of Search: 128/633, 128/634, 128/664, 128/665, 250/461.2, 350/320, 350/418, 356/39-41
• US Class Current: 600/425
• CPC Class Codes: A61B 5/0042 for the brain
• CPC Class Codes: A61B 5/0059 using light, e.g. diagnosis by transillumination, diascopy, fluorescence A61B5/0093, A61B5/1455, A61B5/02416 and A61B5/0261 take precedence
• CPC Class Codes: A61B 5/14553 specially adapted for cerebral tissue
• CPC Class Codes: A61B 5/4064 Evaluating the brain A61B5/031, A61B5/369, A61B5/14553 take precedence
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

In accordance with the present invention a method and apparatus are disclosed for real time imaging of functional activity in cortical areas of a mammalian brain using intrinsic signals. The present invention enables dynamic, on-line imaging of, for example, a human brain during neurosurgery to permit more accurate identification of dysfunctional cortical areas. Cortical areas are identified on the basis of stimulus evoked changes which occur in the optical properties of the brain so that real time localization of seizure (e.g., epileptic seizure) foci and functional mapping can be observed during neurosurgery. Areas of pathological tissue such as epileptic foci and tumors can thus be identified and removed during neurosurgery without damaging important functional areas in the cortex near the tissue.

Claims

1. Method for optically imaging neuronal activity of in vivo mammalian cortical areas comprising the steps of:

illuminating an in vivo cortical area of a mammalian brain with a regulated light source;

focusing a magnification lens on said cortical area;

detecting light reflected from said cortical area along a path through said magnification lens as an analog video signal representative of intrinsic signals, said intrinsic signals being generated in response to intrinsic characteristics of said cortical area;

digitizing said detected analog video signal to provide at least one frame of digitized image data;

acquiring and analyzing a plurality of frames of said digitized image data to identify changes in said intrinsic signals, said step of acquiring and analyzing further including the steps of;

averaging a series of frames of said digital image data during a control period to provide a first averaged image frame, said control period being characterized by a substantial absence of input stimuli to the brain;

storing said first averaged image frame;

applying a predetermined input stimuli to the brain during a stimulation period;

averaging a second series of frames of said digitized image data during said stimulation period to provide a second averaged image frame;

storing said second averaged image frame;

subtractively combining said first averaged image frame with said second averaged image frame to provide a first difference frame, said step of subtractively combining further including a step of spatially translating said first averaged image frame relative to said second averaged image frame;

filtering said first difference frame to reduce noise;

enhancing said first difference frame using a linear look-up table to stretch pixel values composing said difference frame;

filtering said stretched difference frame;

compressing and color-coding said difference frame; and

,

superimposing an image of said color-coded difference frame upon a video image of said first or second averaged image frame to provide a composite image for identifying those portions of said cortical area subject to neuronal activity in response to said predetermined input stimuli.

2. Method according to claim 1, wherein said step of acquiring and analyzing further includes the steps of:

repeating said steps of averaging and storing to acquire at least one additional averaged image frame during said control period; and

,

subtractively combining said first averaged image frame and said at least one additional averaged image frame to confirm a substantial absence of input stimuli during the control period.

3. Method according to claim 1, wherein said step of acquiring and analyzing further includes the steps of:

applying at least one additional predetermined input stimuli to the brain during at least one additional stimulation period to acquire at least one additional stimulated averaged image frame;

repeating said steps of subtractively combining, enhancing, filtering, compressing and superimposing for each of said additional stimulated averaged image frames to provide an updated composite image.

4. Method according to claim 1, wherein said step of superimposing further includes a step of comparing each pixel value used to compose said difference frame with at least one threshold value to provide an enhanced color-coded difference frame.

5. Method according to claim 1, wherein said mammalian brain is an in vivo, human brain.

6. Method for optically imaging neuronal activity during neurosurgery comprising the steps of:

illuminating a cortical area;

detecting light reflected from said cortical area; and

acquiring and analyzing a digitized image obtained from said detected light during neurosurgery to provide on-line identification of those portions of said cortical area where neuronal activity has occurred, wherein said step of acquiring and analyzing further includes a step of obtaining said digitized image by subtractively combining at least two image frames of data obtained from said reflected light, said two image frames being spatially translated relative to one another.

7. Method according to claim 6, wherein said step of acquiring and analyzing further includes the steps of:

displaying an analog video image of said cortical area; and

superimposing said digitized image on said analog video image of said cortical area to provide a composite image which identifies said cortical area portions where neuronal activity has occurred.

8. Method according to claim 7, wherein said step of acquiring and analyzing further includes the step of updating said composite image in real time during said neurosurgery.

9. Method according to claim 8, wherein said step of updating occurs at a rate of at least 1/30th of a second.

10. Method for optically imaging cortical activity of a mammalian brain comprising the steps of:

detecting light reflected from a cortical area;

storing at least two frames of data obtained from said reflected light;

analyzing said at least two frames to identify intrinsic signal changes of said cortical area, said step of analyzing further including the steps of;

spatially translating said at least two frames relative to one another; and

,

subtractively combining said at least two frames to provide a difference frame.

11. Method according to claim 10, wherein said difference frame is composed of an array of data elements representative of reflective light intensity differences in said cortical area and said step of analyzing further includes the steps of:

identifying an acceptable range of intensity differences; and

,

stretching intensity differences in said acceptable range over a larger range of values.

12. Method according to claim 11, wherein said step of stretching includes linearly stretching said intensity differences in said acceptable range to retain relative differences between said intensity differences.

13. Method according to claim 12, wherein said step of analyzing further includes the steps of:

assigning an intensity value to each data element in said array based on an average of intensities associated with data elements in a predetermined proximity to each data element; and

,

subsequently assigning an intensity value to each data element in said array based on a median value associated with data elements in a predetermined proximity to each data element.

14. Method according to claim 13, wherein said steps of assigning are performed prior to said step of stretching.

15. Method according to claim 13, wherein said step of analyzing further includes the steps of:

compressing a range of intensity values used to represent said data elements; and

,

color-coding said data elements based on said compressed range of intensity values.

16. Method according to claim 10, wherein said difference frame is composed of an array of data elements representative of reflective light intensity differences in said cortical area, and wherein said step of analyzing further includes the steps of:

color-coding said difference frame based on said intensity values; and

,

superimposing said color-coded difference frame upon an image corresponding to one of said at least two frames.

17. Method according to claim 10, wherein said steps of storing and analyzing are dynamically performed in real time.

18. Method according to claim 17, wherein said mammalian brain is an in vivo, human brain.

19. Method according to claim 10, wherein each of said at least two frames is composed of averaged data from a plurality of frames of said detected light.

20. Method according to claim 10, wherein at least one of said at least two frames is obtained during a control period characterized by a substantial absence of external stimuli to the cortical area.

21. Method according to claim 20, wherein at least another of said at least two frames is obtained during a stimulation period characterized by the presence of a stimulus to the cortical area.

22. Method according to claim 21, wherein said stimulus is a medication.

23. Method according to claim 21, wherein said stimulus is applied to a non-cortical part of a patient to evoke a reaction in said cortical area.

24. Method according to claim 20, wherein at least another of said at least two frames is obtained during a post-stimulation period characterized by a recovery of the cortical area to a discontinued stimulus.

25. Apparatus for optically imagining neuronal activity of in vivo mammalian cortical areas comprising:

a regulated light source for illuminating an in vivo cortical area of a mammalian brain;

a magnification lens for focusing said light source on said cortical area;

a filter for filtering light reflected from said cortical area along a path through said magnification lens;

means for detecting said filtered light as an analog video signal representative of intrinsic signals, said intrinsic signals being generated in response to intrinsic characteristics of said cortical area;

means for digitizing said detecting analog video signal to provide at least one frame of digitized image data;

means for acquiring and analyzing a plurality of frames of said digitized image data to identify changes in said intrinsic signals, said acquiring and analyzing means further including;

means for averaging a series of frames of said digital image data during a control period to provide a first averaged image frame, said control period being characterized by a substantial absence of input stimuli to the brain, said averaging means averaging a second series of frames of said digitized image data during a first stimulation period to provide a second averaged image frame and for spatially translating said first averaged image frame and said second averaged image frame relative to one another;

means for storing said first averaged image frame and said second averaged image frame;

means for subtractively combining said first averaged image frame with said second averaged image frame to provide a first difference frame;

means for enhancing said first difference frame using a linear look-up table to stretch pixel values composing said difference frame;

means for filtering said stretched difference frame;

means for compressing said stretched difference frame and for color-coding said compressed difference frame; and

a monitor for superimposing an image of said color-coded difference frame upon an analog video image of said first or second averaged image frame to provide a composite image for identifying those portions of said cortical area subject to neuronal activity in response to said predetermined input stimuli.

26. Apparatus for optically imaging neuronal activity during neurosurgery comprising:

means for illuminating a cortical area;

means for detecting light reflected from aid cortical area; and

,

means for acquiring and analyzing a digitized image obtained from said detected light during neurosurgery to provide on-line identification of those portions of said cortical area where neuronal activity has occurred, wherein said acquiring and analyzing means further includes means for obtaining said digitized image by subtractively combining at least two image frames of data obtained from said reflected light, said two image frames being spatially translated relative to one another.

27. Apparatus according to claim 26, further comprising:

means for displaying an analog video image of said cortical area; and

means for superimposing said digitized image on said analog video image of said cortical area to provide a composite image which identifies said cortical area portions where neuronal activity has occurred.

28. Apparatus according to claim 27, wherein aid acquiring and analyzing means updates said composite image in real time during said neurosurgery.

29. Apparatus according to claim 287, wherein said updating occurs at a rate of at least 1/30th of a second.

30. Apparatus for optically imaging cortical activity of a mammalian brain comprising:

means for detecting light reflected from a cortical area;

means for storing at least two frames of data obtained from said reflected light; and

,

means for analyzing said at least two frames to identify intrinsic signal changes of said cortical area by spatially translating said at least two frames relative to one another and subtractively combining said at least two frames to provide a difference frame.

31. Apparatus according to claim 30, wherein said difference frame is composed of an array of data elements representative of reflective light intensity differences in said cortical area and said analyzing means identifies an acceptable range of said intensity differences and, stretches said intensity differences in said acceptable range over a larger range of values.

32. Apparatus according to claim 31, wherein said stretching includes linearly stretching said intensity differences in said acceptable range to retain relative differences between said intensity differences.

33. Apparatus according to claim 31, wherein said analyzing means further assigns an intensity value to each data element in said array based on an average of intensities associated with data elements in a predetermined proximity to each data element and, subsequently assigns an intensity value to each data element in said array based on a median value associated with data elements in a predetermined proximity to each data element.

34. Apparatus according to claim 33, wherein said analyzing means further includes:

means for compressing a range of intensity values used to represent said data elements; and

,

means for color-coding said data elements based on said compressed range of intensity values.

35. Apparatus according to claim 30, wherein said difference frame is composed of an array of data elements representative of reflective light intensity differences in said cortical area, and wherein said analyzing means further includes:

means for color-coding said difference frame based on said intensity values; and

,

means for superimposing said color-coded difference frame upon an image corresponding to one of said at least two frames.

36. Apparatus according to claim 30, wherein said detecting means, said storing means and said analyzing means dynamically operate in real time.

37. Apparatus according to claim 30, wherein each of said at least two frames is composed of averaged data from a plurality of frames of said detected light.

38. Apparatus according to claim 30, wherein at least one of said at least two frames is obtained during a stimulation period characterized by the presence of a stimulus to a non-cortical part of a patient to evoke a reaction in the cortical area.