Analysis of in vivo optical coherence tomography images of human peripheral nerves using texture analysis

In this work we demonstrate optical coherence tomography (OCT) to support peripheral nerve surgery which provides superior resolution than intraoperative sonography. For that purpose, a handheld probe covered with a sterile foil was utilized. In total 34 patients were measured with the OCT device during surgery. In this study eight different peripheral nerves have been accessed at various positions of the human body. It could be observed that near-surface nerves provided the best contrast. In the acquired images it was possible to identify single fascicles within the volumetric images of the peripheral nerves. However, due to the use of a sterile foil, the sensitivity was decreased compared to ex vivo results. In order to highlight different areas within a nerve, e.g. the perineurium, texture analysis was performed. Thus, chronic nerve compression with an enhanced amount of connective tissue can be precisely located. We are confident that in the future this methodology can provide high resolution images of a peripheral nerve’s microstructure in real time, which leads to multiple possible applications, e.g. the revealing of scar tissue or the direct optical biopsy without the need of a pathological analysis.