Can sidestream dark field (SDF) imaging identify subtle microvascular changes of the bowel during colorectal surgery?

Bruin, A. F. J. de; Tavy, A. L. M.; Sloot, K. van der; Smits, Anke B.; İnce, Can; Boerma, E. Christiaan; Noordzij, Peter G.; Boerma, Djamila; Iterson, Mat van

doi:10.1007/s10151-018-1872-4

Cited by 14 publications

(11 citation statements)

References 32 publications

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“…SDF imaging can track the movement of individual RBCs enabling quantitative blood flow measurements and the detection of subtle microvascular changes. 17 – 19 SDF imaging is a contact method with a relatively small FOV of

. The device has a total magnification of

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Section: Methodsmentioning

confidence: 99%

Real-time visualization of renal microperfusion using laser speckle contrast imaging

et al. 2021

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. Significance: Intraoperative parameters of renal cortical microperfusion (RCM) have been associated with postoperative ischemia/reperfusion injury. Laser speckle contrast imaging (LSCI) could provide valuable information in this regard with the advantage over the current standard of care of being a non-contact and full-field imaging technique. Aim: Our study aims to validate the use of LSCI for the visualization of RCM on ex vivo perfused human-sized porcine kidneys in various models of hemodynamic changes. Approach: A comparison was made between three renal perfusion measures: LSCI, the total arterial renal blood flow (RBF), and sidestream dark-field (SDF) imaging in different settings of ischemia/reperfusion. Results: LSCI showed a good correlation with RBF for the reperfusion experiment ( ; ) and short- and long-lasting local ischemia ( ; and ; , respectively). The correlation decreased for low flow situations due to RBF redistribution. The correlation between LSCI and SDF ( ; ) showed superiority over RBF ( ; ). Conclusions: LSCI is capable of imaging RCM with high spatial and temporal resolutions. It can instantaneously detect local perfusion deficits, which is not possible with the current standard of care. Further development of LSCI in transplant surgery could help with clinical decision making.

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. The device has a total magnification of

.…”

Section: Methodsmentioning

confidence: 99%

Real-time visualization of renal microperfusion using laser speckle contrast imaging

et al. 2021

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“…In vivo , HSI can detect alterations at the early stages of NMP. While intra-operative haemodynamic monitoring has been limited to systemic measurements, a more organ-specific approach reflecting local oxygen delivery and microcirculatory perfusion has gained interest ( 38 – 40 ). In the field of hepatobiliary surgery, different imaging techniques were tested in order to evaluate liver parenchymal perfusion ( 41 , 42 ).…”

Section: Discussionmentioning

confidence: 99%

Hyperspectral Imaging as a Tool for Viability Assessment During Normothermic Machine Perfusion of Human Livers: A Proof of Concept Pilot Study

Fodor¹,

Lanser²,

Hofmann³

et al. 2022

Transpl Int

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Normothermic machine perfusion (NMP) allows for ex vivo viability and functional assessment prior to liver transplantation (LT). Hyperspectral imaging represents a suitable, non-invasive method to evaluate tissue morphology and organ perfusion during NMP. Liver allografts were subjected to NMP prior to LT. Serial image acquisition of oxygen saturation levels (StO2), organ hemoglobin (THI), near-infrared perfusion (NIR) and tissue water indices (TWI) through hyperspectral imaging was performed during static cold storage, at 1h, 6h, 12h and at the end of NMP. The readouts were correlated with perfusate parameters at equivalent time points. Twenty-one deceased donor livers were included in the study. Seven (33.0%) were discarded due to poor organ function during NMP. StO2 (p < 0.001), THI (p < 0.001) and NIR (p = 0.002) significantly augmented, from static cold storage (pre-NMP) to NMP end, while TWI dropped (p = 0.005) during the observational period. At 12–24h, a significantly higher hemoglobin concentration (THI) in the superficial tissue layers was seen in discarded, compared to transplanted livers (p = 0.036). Lactate values at 12h NMP correlated negatively with NIR perfusion index between 12 and 24h NMP and with the delta NIR perfusion index between 1 and 24h (rs = −0.883, p = 0.008 for both). Furthermore, NIR and TWI correlated with lactate clearance and pH. This study provides first evidence of feasibility of hyperspectral imaging as a potentially helpful contact-free organ viability assessment tool during liver NMP.

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“…This makes it possible to assess perfusion, diffusion distances and heterogeneity of flow. In addition to distinguishing between flow and no flow, HVM is also able to detect a gradual decline in microperfusion [8]. However, microcirculation parameters, as determined with HVM, have not yet been coupled to AL.…”

Section: Discussionmentioning

confidence: 99%

Detection of inadequate anastomotic perfusion with handheld vital microscopy in two patients during colorectal surgery

Tavy

Bruin

Iterson

et al. 2020

Clin J Gastroenterol

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Introduction Anastomotic leakage is one of the most feared complications after gastrointestinal surgery. Assessment of anastomotic viability during surgery remains challenging. Sufficient bowel tissue perfusion is a requisite for anastomotic healing. Handheld vital microscopy (HVM) is a non-invasive technique that can directly visualize the intestinal microcirculation during surgery. Presentation of two cases Two patients underwent elective laparoscopic colorectal surgery. During surgery HVM was used to assess bowel perfusion prior to creation of a primary anastomosis. Although the bowel macroscopically appeared to be well perfused, HVM showed a severely compromised microcirculation. The colon was re-internalized and during the following minutes cyanosis of the bowel occurred which was visually determined by the surgeon. After dissection towards cranially, a new site for the primary anastomosis was chosen. The postoperative period was uncomplicated. Discussion Sufficient bowel tissue perfusion is often mentioned as key in the pathophysiology of anastomotic leakage. HVM is a technique that could potentially aid surgeons in the assessment of microcirculatory perfusion of the bowel during surgery. Conclusion We report two cases undergoing colorectal surgery in which HVM showed merit in detecting compromised bowel perfusion before creation of a primary anastomosis.

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Can sidestream dark field (SDF) imaging identify subtle microvascular changes of the bowel during colorectal surgery?

Cited by 14 publications

References 32 publications

Real-time visualization of renal microperfusion using laser speckle contrast imaging

Real-time visualization of renal microperfusion using laser speckle contrast imaging

Hyperspectral Imaging as a Tool for Viability Assessment During Normothermic Machine Perfusion of Human Livers: A Proof of Concept Pilot Study

Detection of inadequate anastomotic perfusion with handheld vital microscopy in two patients during colorectal surgery

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