A Novel Diagnostic Method for Evaluation of Vascular Lesions in the Digestive Tract Using Infrared Fluorescence Endoscopy

Okamoto, Koichi; Muguruma, Naoki; Kimura, Tooru; Yano, Hiromi; Imoto, Yoshitaka; Takagawa, Mayuko; Kaji, Masako; Aoki, Rika; Sato, Yoshitaka; Okamura, Seisuke; Kusaka, Yoshiaki; Ito, Susumu

doi:10.1055/s-2004-826102

Cited by 20 publications

(16 citation statements)

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“…In addition, Sekijima et al [27] introduced ICG fluorescence for organ transplantation. However, detection of the microcirculation in gastrointestinal organs has not been studied much so far [28, 29]. …”

Section: Discussionmentioning

confidence: 99%

Usefulness of blood supply visualization by indocyanine green fluorescence for reconstruction during esophagectomy

et al. 2011

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BackgroundAdequate blood supply for the reconstructed organ is important for safe esophagogastric anastomosis during esophagectomy. Recently, indocyanine green (ICG) has been used for visualization of the blood supply when anastomosis is performed in vascular surgery. To visualize the blood supply for reconstruction, we employed ICG fluorescence during esophagectomy.MethodsFrom August 2008, 40 patients received cervical or thoracic esophagectomy. They consisted of 33 patients having esophagectomy for thoracic esophageal cancer, 3 being treated for cervical esophageal cancer, and 4 with double cancer of the thoracic and cervical regions. Before and after pulling up the reconstructed organ, 2.5 mg of ICG was injected as a bolus. Then ICG fluorescence was detected by a camera and recorded.ResultsICG fluorescence was easily detected in all patients at 1 min after injection. The vascular network was well visualized in the gastric wall, colonic grafts, and free jejunal grafts. In five patients, we also performed anastomosis between the short gastric vein and the external cervical vein or superficial cervical vein. The intraoperative and postoperative course of all patients was uneventful apart from three anastomotic leakages.ConclusionsICG fluorescence can be employed to evaluate the blood supply to reconstructed organs and can be useful in selecting the patients who do not need additional vessel anastomosis. However, anastomotic leakage was not reduced, so the microcirculation detected by ICG fluorescence did not necessarily provide appropriate blood supply for a viable anastomosis.

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Section: Discussionmentioning

confidence: 99%

Usefulness of blood supply visualization by indocyanine green fluorescence for reconstruction during esophagectomy

et al. 2011

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“…Intravenous injection of the fluorophore was done in all included studies visualizing the vascularity of the tissue of interest. Six of the seven studies investigated the diagnostic value of fluorescence endoscopy in patients with previously diagnosed adenomas, neoplasms, or cancer ( n = 170)[ 12 , 15 , 21 ], and one study investigated the use in detecting esophageal varices ( n = 20)[ 22 - 25 ].…”

Section: Resultsmentioning

confidence: 99%

Fluorescence guided intraluminal endoscopy in the gastrointestinal tract: A systematic review

Mortensen

Nerup

Thorsteinsson

et al. 2020

WJGE

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BACKGROUND Conventional endoscopy is based on full spectrum white light. However, different studies have investigated the use of fluorescence based endoscopy systems where the white light has been supplemented by infrared light and the use of relevant fluorophores. Fluorescence endoscopy utilizes the fluorescence emitted from a fluorophore, visualizing what is not visible to the naked eye. AIM To explore the feasibility of fluorescence endoscopy and evaluate its use in diagnosing and evaluating gastrointestinal disease. METHODS We followed the PRISMA guidelines for this systematic review. The research covered five databases; PubMed, Scopus, Web of Science, Embase, and the Cochrane Collection, including only studies in English and Scandinavian languages. Authors screened title and abstract for inclusion, subsequently full-text for inclusion according to eligibility criteria listed in the protocol. The risk of bias was assessed for all studies according to the Newcastle-Ottawa Scale. The authors extracted the data and reported the results in both text and tables. RESULTS We included seven studies in the systematic review after screening a total of 2769 papers. The most prominent fluorophore was indocyanine green ( n = 6), and whereas one study ( n = 1) used Bevacizumab 800-CW. Three studies investigated fluorescence endoscopy in detecting varices, adenomas in patients with familial adenomatous polyposis and neoplasms in the gastrointestinal tract. Four studies evaluated the usefulness of fluorescence endoscopy in assessing tumor invasion. Three of the four studies reported an exceptional diagnostic accuracy (93%, 89% and 88%) in assessing tumor invasion, thus representing better visualization and more correct diagnosis by fluorescence endoscopy compared with the conventional endoscopy. The relationship between the endoscopic findings, tumor invasion, and tumor vascularity was evaluated in two studies showing a significant correlation ( d P < 0.05 and b P < 0.01). CONCLUSION The use of fluorescence endoscopy is a promising method adding diagnostic value in the detection of neoplasia, adenomas, and assessment of tumor invasion within the gastrointestinal tract. More studies are needed to utilize the feasibility of fluorescence endoscopy compared with other endoscopic methods.

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“…Evaluate vascular anatomy [60-65], assess graft patency and perfusion [66-70], evaluate vascular lesions [71, 72]…”

Section: Figmentioning

confidence: 99%

Fluorescence Imaging in Surgery

Orosco

Tsien

Nguyen

2013

IEEE Rev. Biomed. Eng.

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Although the modern surgical era is highlighted by multiple technological advances and innovations, one area that has remained constant is the dependence of the surgeon's vision on white-light reflectance. This renders different body tissues in a limited palette of various shades of pink and red, thereby limiting the visual contrast available to the operating surgeon. Healthy tissue, anatomic variations, and diseased states are seen as slight discolorations relative to each other and differences are inherently limited in dynamic range. In the upcoming years, surgery will undergo a paradigm shift with the use of targeted fluorescence imaging probes aimed at augmenting the surgical armamentarium by expanding the “visible” spectrum available to surgeons. Such fluorescent “smart probes” will provide real-time, intraoperative, pseudo-color, high-contrast delineation of both normal and pathologic tissues. Fluorescent surgical molecular guidance promises another major leap forward to improve patient safety and clinical outcomes, and to reduce overall healthcare costs. This review provides an overview of current and future surgical applications of fluorescence imaging in diseased and nondiseased tissues and focus on the innovative fields of image processing and instrumentation.

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A Novel Diagnostic Method for Evaluation of Vascular Lesions in the Digestive Tract Using Infrared Fluorescence Endoscopy

Cited by 20 publications

References 10 publications

Usefulness of blood supply visualization by indocyanine green fluorescence for reconstruction during esophagectomy

Usefulness of blood supply visualization by indocyanine green fluorescence for reconstruction during esophagectomy

Fluorescence guided intraluminal endoscopy in the gastrointestinal tract: A systematic review

Fluorescence Imaging in Surgery

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