Stereotactic procedures that require insertion of needle-based instruments into the brain serve important roles in a variety of neurosurgical interventions, such as biopsy, catheterization, and electrode placement. A fundamental limitation of these stereotactic procedures is that they are blind procedures in that the operator does not have real-time feedback as to what lies immediately ahead of the advancing needle. Therefore, there is a great clinical need to navigate the instrument safely and accurately to the targets. Towards that end, we developed a forwarding-imaging needle-type optical coherence tomography (OCT) probe for avoiding the hemorrhage and guiding neurosurgical interventions. The needle probe has a thin diameter of 0.7 mm. The feasibility of vessel detection and neurosurgical guidance were demonstrated on sheep brain in vivo and human brain ex vivo. In addition, we further reduced the probe size to 0.3 mm using an optical Doppler sensing (ODS) fiber probe that can integrate with microelectrode recording (MER) to detect the blood vessels lying ahead to improve the safety of this procedure. Furthermore, to overcome the field-of-view limitation of OCT probe, we developed an MRI-compatible OCT imaging probe for neurosurgery. MRI/OCT multi-scale imaging integrates micro-resolution optical imaging with wide-field MRI imaging, and has potential to further improve the targeting accuracy.
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