Jürgen Beck

Lukas D. J. Fiederer, Hisham Alwanni, Martin Völker et al.

Fully immersive virtual reality (VR) has the potential to improve neurosurgical planning. For example, it may offer 3D visualizations of relevant anatomical structures with complex shapes, such as blood vessels and tumors. However, there is a lack of research tools specifically tailored for this area. We present a research framework for VR neurosurgery based on open-source tools and preliminary evaluation results. We showcase the potential of such a framework using clinical data of two patients and research data of one subject. As a first step toward practical evaluations, two certified senior neurosurgeons positively assessed the usefulness of the VR visualizations using head-mounted displays. The methods and findings described in our study thus provide a foundation for research and development aiming at versatile and user-friendly VR tools for improving neurosurgical planning and training.

Xinhai Hou, Akhil Kondepudi, Cheng Jiang et al.

The importance of rapid and accurate histologic analysis of surgical tissue in the operating room has been recognized for over a century. Our standard-of-care intraoperative pathology workflow is based on light microscopy and H\&E histology, which is slow, resource-intensive, and lacks real-time digital imaging capabilities. Here, we present an emerging and innovative method for intraoperative histologic analysis, called Intelligent Histology, that integrates artificial intelligence (AI) with stimulated Raman histology (SRH). SRH is a rapid, label-free, digital imaging method for real-time microscopic tumor tissue analysis. SRH generates high-resolution digital images of surgical specimens within seconds, enabling AI-driven tumor histologic analysis, molecular classification, and tumor infiltration detection. We review the scientific background, clinical translation, and future applications of intelligent histology in tumor neurosurgery. We focus on the major scientific and clinical studies that have demonstrated the transformative potential of intelligent histology across multiple neurosurgical specialties, including neurosurgical oncology, skull base, spine oncology, pediatric tumors, and periperal nerve tumors. Future directions include the development of AI foundation models through multi-institutional datasets, incorporating clinical and radiologic data for multimodal learning, and predicting patient outcomes. Intelligent histology represents a transformative intraoperative workflow that can reinvent real-time tumor analysis for 21st century neurosurgery.