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BioMed Research International
Volume 2016 (2016), Article ID 6183218, 8 pages
Research Article

Automatic Tissue Differentiation Based on Confocal Endomicroscopic Images for Intraoperative Guidance in Neurosurgery

1Siemens Healthcare, Technology Center, Princeton, NJ 08540, USA
2Siemens Corporate Technology, 81739 Munich, Germany
3Department of Neurosurgery, Hospital Merheim, Cologne Medical Center, 51109 Cologne, Germany
4Department of Neurosurgery, Heinrich Heine University Düsseldorf, 40255 Düsseldorf, Germany

Received 26 November 2015; Revised 15 January 2016; Accepted 18 January 2016

Academic Editor: Lin Hua

Copyright © 2016 Ali Kamen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Diagnosis of tumor and definition of tumor borders intraoperatively using fast histopathology is often not sufficiently informative primarily due to tissue architecture alteration during sample preparation step. Confocal laser microscopy (CLE) provides microscopic information of tissue in real-time on cellular and subcellular levels, where tissue characterization is possible. One major challenge is to categorize these images reliably during the surgery as quickly as possible. To address this, we propose an automated tissue differentiation algorithm based on the machine learning concept. During a training phase, a large number of image frames with known tissue types are analyzed and the most discriminant image-based signatures for various tissue types are identified. During the procedure, the algorithm uses the learnt image features to assign a proper tissue type to the acquired image frame. We have verified this method on the example of two types of brain tumors: glioblastoma and meningioma. The algorithm was trained using 117 image sequences containing over 27 thousand images captured from more than 20 patients. We achieved an average cross validation accuracy of better than 83%. We believe this algorithm could be a useful component to an intraoperative pathology system for guiding the resection procedure based on cellular level information.