Considerations for Intraoperative Laser Speckle Contrast Imaging for Vessel Flow Visualization

Laser speckle contrast imaging (LSCI) has emerged as a promising non-invasive optical technique for assessing blood flow dynamics in clinical settings, including neurosurgery. This study aimed to illustrate the challenges and limitations associated with intraoperative LSCI-based blood flow assessment. A custom microscope-integrated LSCI device was utilized in 20 neurosurgical procedures, providing real-time high-resolution imaging. Two clinical observations were reported, highlighting the impact of static scattering and limited penetration depth on LSCI measurements. Calcified vessel walls affected the speckle contrast values, emphasizing the importance of precise thresholding for meaningful blood flow visualization and intraoperative display. Furthermore, LSCI demonstrated limited capability in assessing blood flow within thick vessels such as the carotid artery. The results shed light on the potential applications and limitations of LSCI in surgical interventions, emphasizing the need for further research. Overall, LSCI shows promise as a valuable tool for evaluating tissue perfusion and vessel flow, but careful consideration of its limitations is crucial for successful implementation in clinical practice.