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A.I. Comes to the Operating Room

Images made by lasers and read by computers can help speed up the diagnosis of brain tumors during surgery.

Credit…Michigan Medicine
  • Brain surgeons are bringing artificial intelligence and new imaging techniques into the operating room, to diagnose tumors as accurately as pathologists, and much faster, according to a report in the journal Nature Medicine.

The new approach streamlines the standard practice of analyzing tissue samples while the patient is still on the operating table, to help guide brain surgery and later treatment.

The traditional method, which requires sending the tissue to a lab, freezing and staining it, then peering at it through a microscope, takes 20 to 30 minutes or longer. The new technique takes two and a half minutes. Like the old method, it requires that tissue be removed from the brain, but uses lasers to create images and a computer to read them in the operating room.

“Although we often have clues based on preoperative M.R.I., establishing diagnosis is a primary goal of almost all brain tumor operations, whether we’re removing a tumor or just taking a biopsy,” said Dr. Daniel A. Orringer, a neurosurgeon at N.Y.U. Langone Health and the senior author of the report.

In addition to speeding up the process, the new technique can also detect some details that traditional methods may miss, like the spread of a tumor along nerve fibers, he said. And unlike the usual method, the new one does not destroy the sample, so the tissue can be used again for further testing.

The new process may also help in other procedures where doctors need to analyze tissue while they are still operating, such as head and neck, breast, skin and gynecologic surgery, the report said. It also noted that there is a shortage of neuropathologists, and suggested that the new technology might help fill the gap in medical centers that lack the specialty.

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Doctors demonstrated acquiring a tissue sample and putting it through the AI pipeline to test for brain cancer. Video by Michigan MedicineCreditCredit…Michigan Medicine

Algorithms are also being developed to help detect lung cancers on CT scans, diagnose eye disease in people with diabetes and find cancer on microscope slides. The new report brings artificial intelligence — so-called deep neural networks — a step closer to patients and their treatment.

The study involved brain tissue from 278 patients, analyzed while the surgery was still going on. Each sample was split, with half going to A.I. and half to a neuropathologist. The diagnoses were later judged right or wrong based on whether they agreed with the findings of lengthier and more extensive tests performed after the surgery.

 

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