Method and apparatus for vasculature visualization with applications in neurosurgery and neurology
View Patent ↗The invention provides methods and systems for neurovascular imaging ( 150 ).
1. A computer implemented method of intra-operatively confirming the removal of at least one vessel comprising an arteriovenous malformation in a subject, comprising:
a. administering a fluorescent dye to a recipient subject;
b. applying a sufficient amount of energy to a vessel in the subject such that the fluorescent dye fluoresces;
c. detecting pixel data in a detection area to be imaged;
d. transmitting the pixel data to a processor;
e. obtaining a fluorescing image of the vessel;
f. observing the fluorescing image to identify a location of an arteriovenous malformation;
g. surgically removing the vessel including the arteriovenous malformation;
h. intraoperatively confirming the removal of the vessel including the arteriovenous malformation by observing the fluorescing image to determine if a fluorescent signal stops at a point of removal of the vessel, wherein a lack of a fluorescent signal downstream of the point of removal indicates the arteriovenous malformation has been removed; and
i. calculating on the processor a relative maximum fluorescent intensity in an area of fluorescence, the area of fluorescence indicated by a number of pixels associated with the fluorescing dye in a pre treatment image and a post treatment image corresponding to the detection area, wherein a fewer number of pixels and less fluorescent intensity at the detector area indicates a removal of the arteriovenous malformation, and a greater number of pixels and greater fluorescent intensity at the detection area indicates a non-removal of the arteriovenous malformation.
2. The method of claim 1 , wherein the recipient subject is an animal.
3. The method of claim 1 , wherein the animal is a human.
4. The method of claim 1 , wherein the fluorescent dye is a tricarbocyanine dye or an analog thereof.
5. The method of claim 4 , wherein the tricarbocyanine dye is indocyanine green.
6. The method of claim 1 , wherein the fluorescent dye comprises a mixture or combination of multiple fluorescent dyes or analogs thereof.
7. The method of claim 1 , wherein the dye is administered intravenously.
8. The method of claim 1 , wherein the dye is administered by catheter or cannula.
9. The method of claim 1 , wherein the dye is administered as a bolus injection.
10. The method of claim 1 , wherein the dye is administered less than an hour before confirming removal of the arteriovenous malformation.
11. The method of claim 1 , wherein the dye is administered more than 30 seconds confirming removal of the arteriovenous malformation.
12. The method of claim 1 , wherein the energy is light energy.
13. The method of claim 12 , wherein the light energy is provided by a laser.
14. The method of claim 13 , wherein the laser power output is about 2.5 watts.
15. The method of claim 14 , wherein the laser power output lasts for about 30 seconds.
16. The method of claim 14 , wherein the output is a continuous wave.
17. The method of claim 12 , wherein the light energy is provided by an incandescent light and a filter.
18. The method of claim 12 , wherein the wavelength of the light energy is in the infra-red spectrum.
19. The method of claim 12 , wherein the wavelength of the light energy is about 805 nanometers.
20. The method of claim 1 , wherein the image is obtained by a camera.
21. The method of claim 20 , wherein the camera is a charge coupled device.
22. The method of claim 20 , wherein the camera is a video recorder.
23. The method of claim 1 , wherein the vessel is a blood vessel.
24. The method of claim 1 , wherein the vessel is an artery.
25. The method of claim 1 , wherein the vessel is a vein.
26. The method of claim 1 , wherein the vessel is a nidus associated with AVM.
27. The method of claim 1 , wherein the vessel is surgically exposed.
28. A computer implemented method of intra-operatively locating at least one vessel comprising an arteriovenous malformation in a subject, comprising:
a. administering a fluorescent dye to a recipient subject;
b. applying a sufficient amount of energy to at least one vessel to the subject such that the fluorescent dye fluoresces;
c. detecting pixel datain a detection area to be imaged;
d. transmitting the pixel data to a processor;
e. obtaining a fluorescing image of the at least one vessel;
f. intraoperatively locating a suspect vessel of said at least one vessel, the suspect vessel having an arteriovenous malformation;
g. observing the image to determine if the fluorescent signal leaks from the suspected vessel, wherein a leak of a fluorescent signal from the suspected vessel indicates an arteriovenous malformation; and
h. calculating on the processor a relative maximum fluorescent intensity in an area of fluorescence, the area of fluorescence indicated by a number of pixels associated with the fluorescing dye in a pre treatment image and a post treatment image corresponding to the detection area, wherein a fewer number of pixels and less fluorescent intensity at the detector area indicates a removal of the arteriovenous malformation, and a greater number of pixels and greater fluorescent intensity at the detection area indicates a non-removal of the arteriovenous malformation.
29. The method of claim 28 , wherein the recipient subject is an animal.
30. The method of claim 29 , wherein the animal is a human.
31. The method of claim 28 , wherein the fluorescent dye is a tricarbocyanine dye or an analog thereof.
32. The method of claim 31 , wherein the fluorescent dye comprises a mixture or combination of a first fluorescent dye or analogs thereof and a second fluorescent dye or analog thereof.
33. The method of claim 31 , wherein the tricarbocyanine dye is indocyanine green.
34. The method of claim 28 , wherein the dye is administered intravenously.
35. The method of claim 28 , wherein the dye is administered as a bolus injection.
36. The method of claim 28 , wherein the dye is administered by catheter or annula.
37. The method of claim 28 , wherein the dye is administered less than an hour before confirming removal of the arteriovenous malformation.
38. The method of claim 28 , wherein the dye is administered more than 30 seconds confirming removal of the arteriovenous malformation.
39. The method of claim 28 , wherein the energy is light energy.
40. The method of claim 39 , wherein the light energy is provided by a laser.
41. The method of claim 40 , wherein the laser power output is about 2.5 watts.
42. The method of claim 41 , wherein output is a continuous wave.
43. The method of claim 40 , wherein the laser power output lasts for about 30 seconds.
44. The method of claim 39 , wherein the light energy is provided by an incandescent light and a filter.
45. The method of claim 39 , wherein the wavelength of the light energy is in the infra-red spectrum.
46. The method of claim 39 , wherein the wavelength of the light energy is about 805 nanometers.
47. The method of claim 28 , wherein the image is obtained by a camera.
48. The method of claim 47 , wherein the camera is a charge coupled device.
49. The method of claim 47 , wherein the camera is a video recorder.
50. The method of claim 28 , wherein the vessel is a blood vessel.
51. The method of claim 28 , wherein the vessel is an artery.
52. The method of claim 28 , wherein the vessel is a vein.
53. The method of claim 28 , wherein the vessel is a nidus associated with AVM.
54. The method of claim 28 , wherein the vessel is surgically exposed.
55. A portable system comprising:
a) a device for administering fluorescent dye to a subject;
b) an energy source capable of emitting two laser beams of sufficient energy such that the fluorescent dye fluoresces;
c) an imaging head for imaging at least one vessel; and
d) a processor coupled to perform the method of claim 1 or claim 28 .
56. The system of claim 55 , comprising a field of view having a first dimension of about 0.5 to 1.5 inches and a second dimension of about 0.5 to about 1.5 inches.
57. The system of claim 55 , wherein the first and second dimension are approximately 1 inch.
58. The system of claim 55 , wherein the system has an irradiance in the range of about 15-25 mW/cm 2 .
59. The system of claim 55 , wherein the two laser beams converge at a common focal point.
60. The system of claim 55 , wherein the two laser beams comprise green light.
61. The system of claim 55 , wherein the two laser beams comprise radiation in the infrared spectrum.
62. The system of claim 55 , said system comprising a second energy source capable of emitting sufficient energy to excite a second fluorescent dye such that said second fluorescent dye fluoresces.
63. The system of claim 55 , wherein the imaging head is contained in an endoscope.
64. The system of claim 55 , wherein the imaging head is contained in a surgical microscope.