scholarly journals Comparison of hyperspectral imaging and fluorescence angiography for the determination of the transection margin in colorectal resections—a comparative study

2020 ◽  
Author(s):  
Boris Jansen-Winkeln ◽  
Isabell Germann ◽  
Hannes Köhler ◽  
Matthias Mehdorn ◽  
Marianne Maktabi ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Hyperspectral Imaging ◽  
Surgical Resection ◽  
Blood Perfusion ◽  
Border Zone ◽  
Fluorescence Angiography ◽  
Central Position ◽  
Link Type ◽  
Resection Line

Abstract Purpose One relevant aspect for anastomotic leakage in colorectal surgery is blood perfusion of both ends of the anastomosis. The clinical evaluation of this issue is limited, but new methods like fluorescence angiography with indocyanine green or non-invasive and contactless hyperspectral imaging have evolved as objective parameters for perfusion evaluation. Methods In this prospective, non-randomized, open-label and two-arm study, fluorescence angiography and hyperspectral imaging were compared in 32 consecutive patients with each other and with the clinical assessment by the surgeon. After preparation of the bowel and determination of the surgical resection line, the tissue was evaluated with hyperspectral imaging for 5 min before and after cutting the marginal artery and assessed by 6 hyperspectral pictures followed by fluorescence angiography with indocyanine green. Results In 30 of 32 patients, the image data could be evaluated and compared. Both methods provided a comparable borderline between well-perfused and poorly perfused tissue (p = 0.704). In 15 cases, the surgical resection line was shifted to the central position due to the imaging. The border zone was sharper in fluorescence angiography and best assessed 31 s after injection. With hyperspectral imaging, the border zone was visualized wider and with more differences between proximal and distal border. Conclusion Hyperspectral imaging and fluorescence angiography provide similar results in determining the perfusion border. Both methods allow a good and safe visualization of the blood perfusion at the central resection margin to create a well-perfused anastomosis. Trial registration This study was registered at Clinicaltrials.gov (NCT04226781) on January 13, 2020.

Surgical Resection of Multiple Small Bowel Neuroendocrine Tumours Using Intraoperative Fluorescence Angiography with Indocyanine Green Dye

2020 ◽  
Vol 51 (2) ◽  
pp. 681-684
Author(s):  
Maria Ana Rafael ◽  
Ricardo Rocha ◽  
Ana Maria Oliveira ◽  
Catarina Graça Rodrigues ◽  
Carla Carneiro ◽  
...  
Keyword(s):  
Small Bowel ◽  
Indocyanine Green ◽  
Surgical Resection ◽  
Neuroendocrine Tumours ◽  
Fluorescence Angiography ◽  
Indocyanine Green Dye ◽  
Intraoperative Fluorescence

Hyperspectral imaging in perfusion and wound diagnostics – methods and algorithms for the determination of tissue parameters

2018 ◽  
Vol 63 (5) ◽  
pp. 547-556 ◽  
Author(s):  
Amadeus Holmer ◽  
Jörg Marotz ◽  
Philip Wahl ◽  
Michael Dau ◽  
Peer W. Kämmerer
Keyword(s):  
Wound Healing ◽  
Hyperspectral Imaging ◽  
Tissue Oxygenation ◽  
Blood Perfusion ◽  
Objective Evaluation ◽  
Key Factor ◽  
Novel Method ◽  
Reliable Methods ◽  
Insight Into

Abstract Blood perfusion is the supply of tissue with blood, and oxygen is a key factor in the field of minor and major wound healing. Reduced perfusion of a wound bed or transplant often causes various complications. Reliable methods for an objective evaluation of perfusion status are still lacking, and insufficient perfusion may remain undiscovered, resulting in chronic processes and failing transplants. Hyperspectral imaging (HSI) represents a novel method with increasing importance for clinical practice. Therefore, methods, software and algorithms for a new HSI system are presented which can be used to observe tissue oxygenation and other parameters that are of importance in supervising healing processes. This could offer an improved insight into wound perfusion allowing timely intervention.

scholarly journals Defining indocyanine green fluorescence to assess anastomotic perfusion during gastrointestinal surgery: systematic review

BJS Open ◽  
2021 ◽  
Vol 5 (2) ◽  
Author(s):  
M D Slooter ◽  
M S E Mansvelders ◽  
P R Bloemen ◽  
S S Gisbertz ◽  
W A Bemelman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Indocyanine Green ◽  
Patient Outcomes ◽  
Gastrointestinal Surgery ◽  
Fluorescence Angiography ◽  
Future Research ◽  
Fluorescence Signal ◽  
Pixel Intensity ◽  
Indocyanine Green Fluorescence ◽  
Quantitative Parameters

Abstract Background The aim of this systematic review was to identify all methods to quantify intraoperative fluorescence angiography (FA) of the gastrointestinal anastomosis, and to find potential thresholds to predict patient outcomes, including anastomotic leakage and necrosis. Methods This systematic review adhered to the PRISMA guidelines. A PubMed and Embase literature search was performed. Articles were included when FA with indocyanine green was performed to assess gastrointestinal perfusion in human or animals, and the fluorescence signal was analysed using quantitative parameters. A parameter was defined as quantitative when a diagnostic numeral threshold for patient outcomes could potentially be produced. Results Some 1317 articles were identified, of which 23 were included. Fourteen studies were done in patients and nine in animals. Eight studies applied FA during upper and 15 during lower gastrointestinal surgery. The quantitative parameters were divided into four categories: time to fluorescence (20 studies); contrast-to-background ratio (3); pixel intensity (2); and numeric classification score (2). The first category was subdivided into manually assessed time (7 studies) and software-derived fluorescence–time curves (13). Cut-off values were derived for manually assessed time (speed in gastric conduit wall) and derivatives of the fluorescence–time curves (Fmax, T1/2, TR and slope) to predict patient outcomes. Conclusion Time to fluorescence seems the most promising category for quantitation of FA. Future research might focus on fluorescence–time curves, as many different parameters can be derived and the fluorescence intensity can be bypassed. However, consensus on study set-up, calibration of fluorescence imaging systems, and validation of software programs is mandatory to allow future data comparison.

scholarly journals Hybrid technique of virtual-assisted lung mapping and systemic indocyanine green injection for extended segmentectomy

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Masahiro Yanagiya ◽  
Noriko Hiyama ◽  
Jun Matsumoto
Keyword(s):  
Indocyanine Green ◽  
Hybrid Approach ◽  
Lung Nodule ◽  
Adenocarcinoma In Situ ◽  
Hybrid Technique ◽  
Medical Checkup ◽  
Resection Line ◽  
Intersegmental Plane ◽  
Computed Tomography Image ◽  
Dye Marking

Abstract Background Various approaches have been used to assist and facilitate segmentectomy with favorable oncological outcomes. We describe a hybrid approach comprising virtual-assisted lung mapping (VAL-MAP), which is a preoperative bronchoscopic dye-marking technique, combined with systemic indocyanine green (ICG) injection. Clinical presentation An asymptomatic 64-year-old man was referred to our department because of a lung nodule detected during his annual medical checkup. The chest computed-tomography image revealed a 16-mm, partly solid, ground-glass nodule in the left segment 4. Because the nodule was hardly palpable and deeply located between the left upper division segment and the left lingular segment, we performed VAL-MAP to facilitate extended left lingulectomy. Five dye markings were undertaken preoperatively. Surgery to remove the nodule was then conducted via complete three-port video-assisted thoracic surgery. The VAL-MAP markings were easily identified intraoperatively and helped locate the nodule. The intersegmental plane was identified by the ICG injection. The resection line was determined based on the intersegmental plane identified by the ICG injection and the site of the nodule suggested by the VAL-MAP markings. Following the resection line, we thoracoscopically achieved extended lingulectomy with sufficient surgical margins. The patient was discharged with no complications. The pathological diagnosis was adenocarcinoma in situ. Conclusion The hybrid technique of VAL-MAP and systemic ICG injection can be useful for accomplishing successful extended segmentectomy.

Determination of starch content in adulterated fresh cheese using hyperspectral imaging

2018 ◽  
Vol 21 ◽  
pp. 14-19 ◽  
Author(s):  
Abel Barreto ◽  
J.P. Cruz-Tirado ◽  
Raúl Siche ◽  
Roberto Quevedo
Keyword(s):  
Hyperspectral Imaging ◽  
Starch Content ◽  
Fresh Cheese

Clearance and Non-Invasive Determination of the Hepatic Extraction of Indocyanine Green in Baboons and Man

1983 ◽  
Vol 64 (2) ◽  
pp. 207-212 ◽  
Author(s):  
S. L. Grainger ◽  
P. W. N. Keeling ◽  
I. M. H. Brown ◽  
J. H. Marigold ◽  
R. P. H. Thompson
Keyword(s):  
Indocyanine Green ◽  
Accurate Determination ◽  
Liver Blood Flow ◽  
Compartment Model ◽  
Hepatic Extraction ◽  
Non Invasive ◽  
Two Compartment Model ◽  
Hepatic Extraction Ratio ◽  
Plasma Disappearance Curve

1. The disposition of an intravenous bolus of indocyanine green (ICG) has been studied in healthy man and baboons using a novel analysis of a two compartment pharmacokinetic model. 2. This analysis enabled the hepatic extraction ratio (ER) of dye to be determined solely from the plasma disappearance curve, and the ER determined did not differ from that measured by hepatic vein catheterization. 3. When compared with clearance measured at steady state, the two compartment model gave a significantly more accurate determination of plasma clearance than did the conventional one compartment model. 4. It is concluded that, in health, liver blood flow may be calculated accurately and noninvasively after a single intravenous injection of ICG.

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