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Multimodal imaging platform for surgical guidance during epilepsy surgery

Epilepsy is a neurological disorder characterized by chronic excessive neuronal discharges. Epilepsy surgery may be considered in patients who are resistant to drug treatment, and several tests are used during pre-operative planning to locate the epileptic focus to be resected (MRI, PET, SPECT, EEG, MEG). In some cases, intracranial EEG monitoring or intraoperative electrocorticography is required to confirm and better delineate the area to be resected. Despite available tests, epilepsy surgery outcome remains modest. We present a multimodal imaging platform connected to a neurosurgical microscope allowing intraoperative detection of intrinsic optical brain biomarkers for surgical guidance during epilepsy surgery. Hyperspectral imaging (HSI) allows detection of the hemodynamic response associated with epileptic activity, spatial frequency domain imaging (SFDI) is used for optical properties reconstruction (absorption and reduced scattering), and auto-fluorescence imaging (AFI) allows metabolic markers identification. Validation of SFDI and AFI systems was performed on optical phantoms. Acquisitions on ex vivo tissue samples demonstrate the capabilities of the system to produce fluorescence intensity maps, calibrated with optical properties obtained from SFDI to account for tissue attenuation. In vivo acquisition during epilepsy surgery with HSI allows characterization of the hemodynamic response associated with epileptic spikes.