Surgical procedures on the human body are always a significant stress factor. Operations on the head – and particularly the brain – also represent a special challenge for all involved. This is especially the case when the condition must first be diagnosed and then treated. This usually takes place in several steps, which makes the procedure extremely difficult. In this age of system solutions, an obvious approach to surgical procedures on the human body is to combine diagnosis with treatment. This is more convenient for the patient, provides faster results, and saves time and money. The combination of therapeutics and diagnostics is known as theranostics. In the area of neurosurgery, Fraunhofer ENAS researchers working within the “DeNeCor” project have taken a significant step towards this approach: the purpose of the project was to integrate ultrasound and optical components in a MRsafe micro-endoscope. MR conditions are taken into account and, at the same time, various processes are put in place for different applications running in parallel in order to maintain the position of the tool even more precisely.

Combination of light and ultrasound

Light and optical fibers guide the tip of the endoscope and enable viewing of the areas of the brain tissue that are affected by disease. The endoscope can be fixed in the desired position for the duration of the examination. The ultrasound function of the micro-endoscope is then used to examine the target tissue selectively. Thanks to the high resolution and depth of field, tiny areas of brain tissue can be analyzed and abnormalities can be identified. Acoustic energy is then used to treat the affected cells. Possible areas of application include neuronal diseases such as epilepsy, Alzheimer’s, Parkinson’s, and cancer.

More precise diagnostics and treatment thanks to complementary methods

The diameter of the endoscope’s tip is currently 5 mm. The aim now is to make this tip even smaller in order to be able to get closer to the affected areas of tissue and uncover even smaller anomalies. This is because the earlier the abnormalities are detected, the greater the chances of effectively and completely treating diseases . The process also makes it possible to use complementary methods and thus to improve the precision of diagnosis and treatment – in parallel with an endoscopic examination in the brain, it is now also possible to carry out a MR. The advantages achieved with this method in extremely challenging neurosurgery can also be transferred to the rest of the body. By simplifying the combination of diagnostics and therapeutic techniques, patients with several chronic illnesses, in particular, can receive a more holistic treatment.

About the project:

This research and development was carried out within the European research project DeNeCor as part of the ENIAC joint undertaking with the German partners PolyDiagnost GmbH, Fraunhofer ENAS, and MR:Comp GmbH.