Label-free intraoperative imaging of hemodynamics using deep learning

Intraoperative visualization of hemodynamics is crucial for accurate diagnosis and informed surgical decision-making. In neurosurgery, indocyanine green fluorescence imaging (ICG-FI) is the gold standard for assessing blood flow and identifying vascular structures. However, it is limited by time-consuming data acquisition, mandatory waiting periods, potential allergic reactions, and operational complexities. Label-free alternatives, such as laser speckle contrast imaging (LSCI) and white light imaging (WLI), offer real-time vascular assessment but cannot resolve arterial-venous differentiation or blood flow direction determination. To address these challenges, we present a label-free cross-modal generation framework to synthesize mean transition time (MTT) maps from LSCI and WLI. MTT maps encode local hemodynamics, enabling artery-vein differentiation and flow direction inference. Experimental validation in rat brains demonstrates that the proposed method presents clear vasculature delineation, accurate artery-vein differentiation, and reliable blood flow direction decoding, while reducing total imaging time by 95.8% compared to conventional ICG protocols. This approach offers a fast, efficient, and contrast-free solution for continuous intraoperative surgical guidance.