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INNOSC Theranostics and
Pharmacological Sciences Theranostics in neurosurgery

Figure 3. Intraoperative consultation pipeline for histological diagnosis in tumor resection.

study involving SRH and multiple forms of neoplasms, but neurosurgeons, which still shows a significant benefit
[68]
few other studies have additionally assessed this. of utilization . Overall, these recent advances suggest
that machine learning within neurosurgery could play a
4.3. Confocal laser endomicroscopy (CLE) significant role in theranostics and IOC.
In a study by Izadyyazdanabadi et al., CLE was assessed
as a mode of imaging, similarly paired to DCNN . The 5. Electrical stimulation in CP
[68]
architecture of CLE involves a pen-sized device operated CP is a group of neurological disorders that affect muscle
by the surgeon during a procedure requiring fluoroscopy tone, movement, and coordination; it is the most common
for image generation . This process occurs in real-time cause of motor disability in children . Historically, the
[63]
[72]
at a speed of 0.8 – 1.2 frames/s, as the surgeon navigates diagnosis, prognosis, and management of CP have been
the nervous system. Further, these images can be adjusted challenging; however, with recent advances in technology,
in both depths without requiring resection, which is different treatments are becoming increasingly available.
also controlled by the surgeon. There are two relevant One such paradigm of treatment is through the use of
disadvantages to using this imaging modality. First, as with electrical stimulation, which has emerged as a particularly
any fluorophore dependency, there is a possibility of ROS effective mode of therapy for patients with CP, mirroring the
production and damage to cellular structures [69,70] . Second, success seen with other neuromuscular conditions. Within
pertaining to CLE, the rapid generation of images creates a the scope of electrical stimulation, there are a few types that
barrier in itself, as the interpretation and diagnosis of such have predominated academic and clinical interest over the
images is a demanding task. Another limitation of CLE past decade, such as functional electrical stimulation (FES)
is its design – the motion in addition to blood flow and and transcranial direct current stimulation (tDCS); both
indiscernible tissue features ultimately produces images have shown efficacy in improving muscle function and
that are impractical for diagnosis. These images were movement. Along the theme of theranostic application,
described by Izadyyazdanabadi et al. as non-useful and a notable benefit of utilizing electrical stimulation is its
occurred in nearly half of the 20,000 images generated in an direct connection to the standard metric and methods
in vivo application of CLE for intracranial neoplasms . The used diagnostically to uncover and track the progression
[71]
DCNN model applied by Izadyyazdanabadi et al. displayed of neurological diseases, such as CP. This is congruent
a tumoral diagnostic accuracy of 85% in comparison to a with the current drive within research to develop real-time
75% and 67% accuracy, based on interpretations by two biofeedback systems that can help patients during therapy,

Volume 6 Issue 2 (2023) 7 https://doi.org/10.36922/itps.417