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The "smart needle" in use during neurosurgery. Photo: Sir Charles Gairdner Hospital, Australia

Researchers have developed a hair-thin needle with a tiny camera and a warning system to more safely navigate during brain surgery, according to a feasibility study published in Science Advances Wednesday.

Why it matters: Current use of MRI imaging to assist with brain needle surgeries does not have the resolution to detect small blood vessels, making the risk higher that the neurosurgeon could cause a brain bleed when conducting a biopsy. This new needle — tested successfully so far on 11 patients — shows up to 98% accuracy in detecting those blood vessels. Brain bleeds can cause complications, which can be fatal.

How it works: Study author Robert McLaughlin tells Axios that the team developed the probe, which consists of an optical fiber that's roughly the thickness of a human hair, with a tiny lens fabricated at the end. It's integrated into the biopsy needle, which is just 2 millimeters in diameter.

  • The probe shines a light down the fiber and reflects images from the tissue and flowing blood via a technique called optical coherence tomography, often used for high-resolution medical imaging.
  • The team developed a smart image processing algorithm to automatically detect blood vessels as small as 110 micrometers (μm) near the needle.
  • As the needle is inserted, it shows the image on a computer screen, which will highlight in red when it senses a blood vessel near the needle.
  • "In practice, if there is a blood vessel there, then the neurosurgeon can simply rotate the needle (and the hole) or move forward a little," says McLaughlin, who's the chair of biophotonics at the University of Adelaide's Center for Nanoscale Biophotonics.

The results: They tested the "smart needle" in 11 surgeries, which had no complications resulting from their probe, McLaughlin says.

  • The needle detected blood vessels with a sensitivity of 91.3% and a specificity of 97.7% in blood vessels wider than 500 μm.
  • It achieved the same detections with a sensitivity of 86.2% and a specificity of 86.4% in all blood vessels, including those at the minimum diameter of 110 μm.
  • The team also tested the device’s deep vessel detection capabilities in 3 patients with deep tumors from glioblastoma, an often deadly form of brain cancer.
  • McLaughlin says they believe it could be used for deep brain stimulation for disorders such as Parkinson's disease.

Outside perspective: Brian Wilson, head of a research lab at the University of Toronto and the Princess Margaret Cancer Center who was not involved in the new study, tells Axios that "these values for sensitivity and specificity are excellent and would certainly be sufficient to justify deploying the technology in the clinic."

"It would make procedures such as deep-brain stimulation and brain tumor biopsy less risky for the patient. For example, in obtaining tissue in the brain to confirm, diagnose and stage tumors (which is important so that the best treatment can be given), there is a real risk of cutting a significant blood vessel, causing complications and sometimes even being fatal."
— Brian Wilson

What's next: The researchers hope to undertake a larger trial with patients who undergo brain biopsies, and are looking for a medical device manufacturer to help bring it to market.

Go deeper

5 hours ago - Politics & Policy

Scoop: Sources say Beto plans Texas comeback in governor’s race

Former U.S. Rep. Beto O'Rourke speaks during the Georgetown to Austin March for Democracy rally on July 31, 2021, in Austin, Texas. Photo: Brandon Bell/Getty Images

Former Rep. Beto O’Rourke is preparing to run for governor of Texas in 2022, with an announcement expected later this year, Texas political operatives tell Axios.

Why it matters: O'Rourke's entry would give Democrats a high-profile candidate with a national fundraising network to challenge Republican Gov. Greg Abbott — and give O’Rourke, a former three-term congressman from El Paso and 2020 presidential candidate and voting rights activist, a path to a political comeback.

Texas doctor says he performed an abortion in violation of state law

Pro-choice protesters march down Congress Avenue and back to the Texas state capitol in Austin, Texas, in July 2021. Photo: Erich Schlegel/Getty Images

A Texas doctor disclosed in an op-ed in the Washington Post on Saturday that he has performed an abortion in violation of the state's restrictive new abortion law, which effectively bans the procedure after six weeks.

Why it matters: Alan Braid's op-ed is a direct disclosure that will very likely result in legal action, thereby setting it up as a potential test case for how the abortion ban will be litigated, notes the New York Times.

Mike Allen, author of AM
6 hours ago - Technology

Axios interview: Facebook to try for more transparency

Nick Clegg last year. Photo: Matthew Sobocinski/USA Today via Reuters

Nick Clegg, Facebook's vice president of global affairs, tells me the company will try to provide more data to outside researchers to scrutinize the health of activity on Facebook and Instagram, following The Wall Street Journal's brutal look at internal documents.

Driving the news: Clegg didn't say that in his public response to the series. So I called him to push for what Facebook will actually do differently given the new dangers raised by The Journal.