Polarimetric imaging of the human brain to determine the orientation and degree of alignment of nerve fiber bundles

TL;DR

This study demonstrates that polarimetric imaging can non-invasively measure nerve fiber orientation and distinguish healthy white matter from tumor tissue in the human brain, aiding surgical precision.

Contribution

The paper introduces a polarimetric microscopy technique to assess nerve fiber alignment and tissue differentiation in the brain, enhancing intraoperative tumor delineation.

Findings

Polarimetric microscopy reliably distinguishes white and gray matter.

The technique accurately reconstructs local nerve fiber orientation.

Potential to improve brain tumor resection outcomes.

Abstract

More children and adults under the age of 40 die of brain tumor than from any other cancer. Brain surgery constitutes the first and decisive step for the treatment of such tumors. It is extremely crucial to achieve complete tumor resection during surgery, however, this is a highly challenging task, as it is very difficult to visually differentiate tumorous cells from the surrounding healthy white matter. The nerve fiber bundles constitutive of the white matter are organized in such a way that they exhibit a certain degree of structural anisotropy and birefringence. The birefringence exhibited by such aligned fibrous tissue is known to be extremely sensitive to small pathological alterations. Indeed, highly aligned anisotropic fibers exhibit higher birefringence than structures with weaker alignment and anisotropy, such as cancerous tissue. In this study, we performed experiments on thick coronal slices of a healthy human brain to explore the possibility of (i) measuring, with a polarimetric microscope (employed in the backscattering geometry to facilitate non-invasive diagnostics), the birefringence exhibited by the white matter and (ii) relating the measured birefringence to the fiber orientation and the degree of alignment. This is done by analyzing the spatial distribution of the degree of polarization of the backscattered light and its variation with the polarization state of the probing beam. We demonstrate that polarimetry can be used to reliably distinguish between white and gray matter in the brain, which might help to intraoperatively delineate unstructured tumorous tissue and well organized healthy brain tissue. In addition, we show that our technique is able to sensitively reconstruct the local mean nerve fiber orientation in the brain, which can help to guide tumor resections by identifying vital nerve fiber trajectories thereby improving the outcome of the brain surgery.