Publications by authors named "Luca Giannoni"

Significance: Intraoperative optical imaging is a localization technique for the functional areas of the human brain cortex during neurosurgical procedures. These areas can be assessed by monitoring cerebral hemodynamics and metabolism. Robust quantification of these biomarkers is complicated to perform during neurosurgery due to the critical context of the operating room.

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Significance: Diffuse optical modalities such as broadband near-infrared spectroscopy (bNIRS) and hyperspectral imaging (HSI) represent a promising alternative for low-cost, non-invasive, and fast monitoring of living tissue. Particularly, the possibility of extracting the molecular composition of the tissue from the optical spectra deems the spectroscopy techniques as a unique diagnostic tool.

Aim: No established method exists to streamline the inference of the biochemical composition from the optical spectrum for real-time applications such as surgical monitoring.

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Significance: Histopathological examination of surgical biopsies, such as in glioma and glioblastoma resection, is hindered in current clinical practice by the long time required for the laboratory analysis and pathological screening, typically taking several days or even weeks to be completed.

Aim: We propose here a transportable, high-density, spectral scanning-based hyperspectral imaging (HSI) setup, named HyperProbe1, that can provide , fast biochemical analysis, and mapping of fresh surgical tissue samples, right after excision, and without the need for fixing, staining nor compromising the integrity of the tissue properties.

Approach: HyperProbe1 is based on spectral scanning via supercontinuum laser illumination filtered with acousto-optic tunable filters.

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: The validation of laser usage during laparoscopic procedures, notably by Camran Nezhat in the late 1980s, has been significant. Lasers offer precision and depth control in tissue vaporization without bleeding. Surgical intervention remains central in managing endometriosis-associated pain and infertility, especially for patients unresponsive to hormonal therapy.

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The authors review their experience in transoral laryngeal microsurgery (TLM) that they performed with two different CO laser devices from the same company, which were both equipped with a micromanipulator and digital scanner. A total of 91 glottic and glotto-supraglottic cancers were treated during the years 2009-2016 and then analyzed in relation to the laser performances and the long-term oncologic results. Laser devices proved to be very efficient and the UP mode was confirmed to be the best in terms of cutting precision and lowest thermal damage.

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Surgery for chronic anal fissure is challenging for every proctologist. Solving the pain by guaranteeing rapid and effective healing is the objective, but what is the price to pay today in functional terms? Though this result is nowadays partially achievable through interventions that include the execution of an internal sphincterotomy among the procedures, it is necessary to underline the high rate of patients who can present faecal incontinence. The aim of this study is to explore the effectiveness of scanner-assisted CO laser fissurectomy.

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Article Synopsis
  • - Dura mater repair is a critical step in neurosurgery, and improper reconstruction can lead to serious complications, making the search for effective dural substitutes essential.
  • - Previous studies introduced a laser-based technique to bond porcine dura mater using Indocyanine Green-loaded patches made from chitosan, known for its durability and compatibility with physiological conditions.
  • - In ex vivo experiments, it was found that using a specific laser setting (3W, pulsed mode) effectively welded the patches to the dura mater, achieving strong bonding while limiting thermal damage, and encouraging further testing in living models.
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Article Synopsis
  • The study focuses on the SmartXide CO laser system in neurosurgery, highlighting its recent technological improvements that make laser surgery easier and more reliable.
  • Ten brain and spinal tumor cases were treated using the CO laser alongside traditional surgical tools, demonstrating effective tumor removal while preserving surrounding neurovascular structures.
  • The results suggest the SmartXide CO laser system is a safe and cost-effective option for neurosurgical procedures, offering simultaneous cutting, ablating, and coagulating capabilities with minimal thermal damage.
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We present a novel hyperspectral imaging (HSI) system using visible and near-infrared (NIR) light on the exposed cerebral cortex of animals, to monitor and quantify changes in the oxygenation of haemoglobin and in cellular metabolism via measurement of the redox states of cytochrome-c-oxidase (CCO). The system, named hNIR, is based on spectral scanning illumination at 11 bands (600, 630, 665, 784, 800, 818, 835, 851, 868, 881 and 894 nm), using a supercontinuum laser coupled with a rotating Pellin-Broca prism. Image reconstruction is performed with the aid of a Monte Carlo framework for photon pathlength estimation and post-processing correction of partial volume effects.

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Article Synopsis
  • Post-hemorrhagic hydrocephalus (PHH) is a serious condition in premature infants, often following intraventricular hemorrhage (IVH), but its causes and prevention are still debated.
  • A study analyzed 180 preterm patients under 28 weeks from 1999 to 2014 who experienced IVH, revealing differing outcomes based on the severity of IVH and the presence of thrombocytopenia.
  • The findings suggest that lower levels of thrombocytes may help prevent PHH, leading the researchers to propose further controlled trials on antiplatelet drugs as a preventive measure in high-risk infants.
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Significance: We present a Monte Carlo (MC) computational framework that simulates near-infrared (NIR) hyperspectral imaging (HSI) aimed at assisting quantification of the in vivo hemodynamic and metabolic states of the exposed cerebral cortex in small animal experiments. This can be done by targeting the NIR spectral signatures of oxygenated (HbO2) and deoxygenated (HHb) hemoglobin for hemodynamics as well as the oxidative state of cytochrome-c-oxidase (oxCCO) for measuring tissue metabolism.

Aim: The aim of this work is to investigate the performances of HSI for this specific application as well as to assess key factors for the future design and operation of a benchtop system.

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Hyperspectral imaging (HSI) systems have the potential to retrieve in vivo hemodynamic and metabolic signals from the exposed cerebral cortex. The use of multiple narrow wavelength bands in the near infrared (NIR) range theoretically allows not only to image brain tissue oxygenation and hemodynamics via mapping of hemoglobin concentration changes, but also to directly quantify cerebral metabolism via measurement of the redox states of mitochondrial cytochrome-c-oxidase (CCO). The aim of this study is to assess the possibility of performing hyperspectral imaging of in vivo cerebral oxyhemoglobin (HbO), deoxyhemoglobin (HHb) and oxidized CCO (oxCCO) using commercially available HSI devices.

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Hyperspectral imaging (HSI) technologies have been used extensively in medical research, targeting various biological phenomena and multiple tissue types. Their high spectral resolution over a wide range of wavelengths enables acquisition of spatial information corresponding to different light-interacting biological compounds. This review focuses on the application of HSI to monitor brain tissue metabolism and hemodynamics in life sciences.

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