SignificanceCerebral oximeters have the potential to detect abnormal cerebral blood oxygenation to allow for early intervention. However, current commercial systems have two major limitations: (1) spatial coverage of only the frontal region, assuming that surgery-related hemodynamic effects are global and (2) susceptibility to extracerebral signal contamination inherent to continuous-wave near-infrared spectroscopy (NIRS).AimThis work aimed to assess the feasibility of a high-density, time-resolved (tr) NIRS device (Kernel Flow) to monitor regional oxygenation changes across the cerebral cortex during surgery.ApproachThe Flow system was assessed using two protocols. First, digital carotid compression was applied to healthy volunteers to cause a rapid oxygenation decrease across the ipsilateral hemisphere without affecting the contralateral side. Next, the system was used on patients undergoing shoulder surgery to provide continuous monitoring of cerebral oxygenation. In both protocols, the improved depth sensitivity of trNIRS was investigated by applying moment analysis. A dynamic wavelet filtering approach was also developed to remove observed temperature-induced signal drifts.ResultsIn the first protocol (28±5 years; five females, five males), hair significantly impacted regional sensitivity; however, the enhanced depth sensitivity of trNIRS was able to separate brain and scalp responses in the frontal region. Regional sensitivity was improved in the clinical study given the age-related reduction in hair density of the patients (65±15 years; 14 females, 13 males). In five patients who received phenylephrine to treat hypotension, different scalp and brain oxygenation responses were apparent, although no regional differences were observed.ConclusionsThe Kernel Flow has promise as an intraoperative neuromonitoring device. Although regional sensitivity was affected by hair color and density, enhanced depth sensitivity of trNIRS was able to resolve differences in scalp and brain oxygenation responses in both protocols.
Tissue mimicking phantoms are widely used to test and validate near-infrared spectroscopy (NIRS) devices and algorithms. The two main constituents of phantoms for NIRS applications are a light scatterer, typically Intralipid, and one or multiple light-absorbing dyes, which are most commonly methylene blue, indocyanine green (ICG), and India ink. The current study investigated the spectral shape of tissue mimicking phantoms made of different combinations of Intralipid and these three dyes. The results reveal that Intralipid interacts with the dyes and alters their molar extinction coefficients, thereby hindering the ability to accurately estimate the phantom chromophore concentrations when either the dye or scatterer concentrations change. Furthermore, inorganic light scatterers, such as glass microspheres and titanium oxide, have less interaction with the dyes, with glass microspheres being the least interactive and therefore the best scatterer. These findings are significant, because NIRS phantoms continue to depend on methylene blue, ICG, and India ink as chromophores. Therefore, glass microspheres should be used as a light scatterer instead of Intralipid, which is currently the most common scatterer for NIRS liquid phantoms.
Access to the requested content is limited to institutions that have purchased or subscribe to SPIE eBooks.
You are receiving this notice because your organization may not have SPIE eBooks access.*
*Shibboleth/Open Athens users─please
sign in
to access your institution's subscriptions.
To obtain this item, you may purchase the complete book in print or electronic format on
SPIE.org.
INSTITUTIONAL Select your institution to access the SPIE Digital Library.
PERSONAL Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.