STRATUM is a Horizon Europe multi-partner project developing a clinically validated, real-time 3D decision support tool for brain tumour surgery. The system integrates Hyperspectral Imaging (HSI), AI-based multimodal data fusion, and heterogeneous High-Performance Computing (HPC) architectures combining Graphics Processing Units (GPUs), Field-Programmable Gate Arrays (FPGAs), and Processing-In-Memory (PIM) technologies. A touchless augmented reality interface facilitates safe and intuitive intraoperative interaction. The distinguishing characteristic of STRATUM is its end-to-end co-designed approach, which integrates advanced computing, state-of-the-art imaging and clinical expertise into a unified Point-of-Care (PoC) platform. Utilising a structured co-creation methodology involving surgeons, engineers, and social scientists, the project ensures usability, safety and regulatory compliance from its early design stages to its clinical validation. The usability of STRATUM will be tested in three hospitals located in different European regions with diverse conditions and regulations. This will allow to collect advice and remarks from surgical staff in a continuous co-creation and co-tuning protocol. Beyond its clinical objectives, STRATUM contributes to the advancement of heterogeneous computing for real-time diagnostics, AI acceleration in critical medical environments and energy-efficient system integration. Furthermore, it delivers open datasets, validated AI pipelines, and performance benchmarks with a view to fostering future research and industrial innovation in digital surgery. The STRATUM project establishes a replicable model for intelligent, human-centred computing integrating microelectronics, AI and medicine.The paper presents an overview of the project in terms of aims, concepts and technologies and the description of the state of the work when approaching the end of the second of the five years planned. Specifically, the outcomes of the steps related to the collaboration with surgeons and medical staff (co-creation process) and the intelligent Graphical User Interface (GUI) development will be described. The latter allows for contactless interaction of the surgeon with several functions that have already been developed in the system.

Integrated digital diagnostics can support complex surgical procedures in many anatomical sites, brain tumour surgery being the most complex. STRATUM is a 5-year Horizon Europe funded project with the goal of developing an innovative 3D decision support tool for brain tumour surgeries, based on real-time multimodal data processing using artificial intelligence algorithms. The proposed tool is envisioned as an energy-efficient Point-of-Care computing system to be integrated within neurosurgical workflows to aid surgeons to make informed, efficient, and accurate decisions during surgical procedures. The expected long-term impact of STRATUM is to reduce the duration of surgical procedures, thus decreasing patients' risks, but also optimising the resources of European health care systems.

The purpose of this paper is to outline the advances in hyperspectral (HS) image fusion for intraoperative delineation of brain tumor tissue. HS images were acquired using an intraoperative acquisition system based on two push-broom HS cameras, one covering the visible and near-infrared (VNIR) [400–1000 nm] and the other the near-infrared (NIR) [900–1700 nm] spectral range. A dataset of a wide range of in-vivo brain cancer acquired during neurosurgical procedures with both HS cameras was used to compare the performance results of using the VNIR and NIR data, independently and combining the VNIR-NIR data. Classification maps obtained using the fused VNIR-NIR images provide more accurate classification, removing false positives that appear when the VNIR and NIR images are processed independently.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse reaction produced by chemotherapy drugs used to treat cancer. A few of the most common symptoms are pain, discomfort, tingling, numbness, and weakness in the hands, feet, and other parts of the body. The use of ozone therapy (O3T) is a novel therapy which aims to reduce these side effects. This study focuses on the visualization of oxygen saturation (StO2) in the extremities in a non-contact fashion employing hyperspectral (HS) imaging (HSI) with the goal of using HSI as a predictive value in the objective assessment of pain after ozone therapy application. A customized acquisition system composed of an HS camera (covering the 470–900 nm spectral range) and a halogen illumination system was developed to capture images of the extremities in a non-contact approach. An experimental clinical procedure was established to measure the evolution of StO2in hands and feet using a mathematical model based on information related to two wavelengths (660 and 880 nm). The preliminary results show that, in general, when analyzing the extremities of all unified patients, StO2slightly improves but significatively in the peripheral tissues after ozone therapy (O3T). HS technology allows the estimation of StO2values and allows the quantification of the effect of O3T.

Oxygen saturation (StO2) measurement allows to detect different clinical conditions related with the low oxygenation of tissues or is used to monitor the quality and safety of organ transplantation. This study is focused on the visualization and measurement of StO2using hyperspectral imaging (HSI) through non-contact skin captures, targeting a potential real-time monitoring application. A customized acquisition system composed by a hyperspectral camera (covering the 470-900 nm spectral range) and a thermal camera was developed to capture images of hands in a non-contact fashion. An experimental procedure was established to measure the evolution of StO2in healthy hands where a compression of the index finger or brachial artery were performed. StO2measurements were performed in normal, compression, and reperfusion states. Two mathematical models with different sets of wavelengths were evaluated. The results show the proposed models, which employed two wavelengths (660 and 880 nm), obtain reliable StO2values, providing a potential non-contact imaging tool for StO2measurement.