An Intelligent Theranostics Method Using Optical Coherence Tomography Guided Automatic Laser Ablation for Neurosurgery.

Methods to reduce the high disability and fatality rate of neurosurgery caused by surgeon tremor and uncertainty of intraoperative tumor boundary have long been greatly concerned. We have proposed an intelligent theranostics method for a compact integrated diagnosis and therapeutic platform to automatically excise the brain tumor with high precision. To perform this operation, hardware combination of a benchtop spectral domain optical coherence tomography (SD-OCT) and a high-power laser has been implemented by a customized fiber combiner. By the double-clad fiber out of the combiner which works as both the OCT sample arm fiber and the ablation laser output fiber, an in situ theranostics process without registration can be conducted. The SD-OCT image analysis from both en face and depth perspectives shows the structural information intuitively and accordingly generate the ablation-guiding grid. Based on the grid, the continuous wave high-power laser ablates ex vivo porcine brain models in submillimeter automatically. The feasibility of this theranostics method has been verified by the comparison of attenuation maps before and after ablation, and the contrast of its pathology.