A novel Australian invention that allows neurosurgeons to illuminate parts of the brain and avoid devastating complications during a biopsy has been trialled in humans for the first time.
A brain biopsy is a delicate procedure often used to diagnose or detect abnormalities, such as a suspected tumour. It involves inserting a needle into the brain and taking small samples of tissue for further testing.
A total of 11 patients, seven women and four men, had successful brain operations using the smart imaging needle at Sir Charles Gairdner Hospital in Western Australia.
The results of the trial, led by University of Adelaide researchers, were published in Science Advances on Thursday.
The two-in-one handheld device features a tiny fibre-optic camera, the size of a human hair, which has been built into a standard clinical biopsy needle.
Once inserted into the brain, the smart needle beams a light down and sends back real-time images of tissue and blood vessels with a high degree of accuracy, the researchers said.
According to the results, the imaging needle detected blood vessels with a sensitivity of 91.2 per cent and a specificity of 97.7 per cent.
This level of real-time precision can help surgeons to detect and avoid hitting nearby blood vessels, which if ruptured, could lead to fatal haemorrhaging of the brain.
Professor Christopher Lind, a consultant neurosurgeon at Sir Charles Gairdner Hospital and the University of Western Australia, led the clinical trial and said bleeds are a risk in many types of neurosurgery.
“To have a tool that can see blood vessels as you proceed through the brain would open up new vistas of things that can be done with neurosurgery, things that we currently don’t trust our own hands to do.”
A better view into neurosurgery
Professor Robert McLaughlin, a medical engineer and chair of biophotonics at the University of Adelaide’s medical school led the team that designed and built the smart imaging needle.
He told The New Daily the new technology provides a better view into neurosurgery than using existing imaging methods alone.
Currently, surgeons track a biopsy needle in the brain using superimposed images from magnetic resonance imaging, an MRI, captured before the actual surgery.
This presented two main problems, Professor McLaughlin said. The blood vessel could have moved slightly since the MRI, and it does not pick up smaller vessels.
“The one thing that neurosurgeons really want to know is, is there a blood vessel right next to where I am right now?” he said.
“As the needle goes in, it draws out a picture of the tissue that’s next to the needle, and if we run up along a blood vessel suddenly we can see that on the imaging screen.”
The imaging feature of the smart needle worked much like an ultrasound, Professor McLaughlin said.
But instead of sound waves, it used smaller light waves to obtain an intricate picture of the brain as it is being probed for tissue samples.
Professor McLaughlin said the smart needle was not intended to replace MRI, which is still an essential imaging tool before surgery.
“That scan is really important, it tells the neurosurgeon where the cancer is, and all the major vessels they need to avoid. Our device can see the small things, and they can be just as important,” he said.
The researchers hope to one day manufacture the needles in Australia. However, it could be several years before the technology will be commercially available in hospitals, Professor McLaughlin said.
“This is the first reported use of such a probe in the human brain during live surgery, and is the first step in the long process required to bring new tools like this into clinical practice.”
“We were working with patients who were already having a tumour removed. The next step will be to trial it in people who are undergoing real biopsies.”
