Abstract
Intraoperative blood flow measurement is an effective way to assess the quality of bypass surgery. Flow quantification from indocyanine green (ICG) angiography promises to be an easy, contact-free method. It shows deviations compared to a reference. These are given as factor k, which depends on the vessel diameter d. The radiation transport within the vessel while recording the ICG passage might cause this. It is analyzed in silico to disclose its impact on k (d). A Fluorescence Monte Carlo Multi Cylinder (FMCMC) model was developed as a static model, assuming homogeneous concentration of ICG. In contrast to published approaches utilizing a Monte Carlo Multi Layer (MCML) model assuming the deepest penetration location within a photon packet’s path to be the fluorescence location, the events are modeled. Fluorescence event modeling, Multi Cylinder geometry and a homogeneous illumination as well as combinations of these were implemented in separate aspect models. Resulting k (d) were compared to k (d) from MCML. Deviations in k (d) derived from FMCMC and MCML in each aspect model were present. The Root Mean Square Error ranges from 6,8% to 36 %, k (d) also varied comparing the aspect models to each other. The model geometry, the modeled fluorescence location and illumination mode show a clear impact on simulated k (d). Therefore, our study shows that simplifications of previous studies are invalid. The developed FMCMC model considers the named aspects, allowing the analysis of radiation transport in ICG angiography. The FMCMC model assumes a homogeneous concentration of ICG which is not true in clinical cases. Obtaining the heterogeneous distribution of ICG is possible via fluid flow models. Coupling the fluid flow model and the developed radiation transport model as well as including a detailed camera optic is the task for future work.
Inter- and intra-rater reliability of blood and cerebrospinal fluid flow quantification by phase-contrast MRI
