Feasibility and comparison of laparoscopic laser speckle contrast imaging to near-infrared display of indocyanine green in intraoperative tissue blood flow/tissue perfusion in preclinical porcine models

Nwaiwu, Chibueze A.; Buharin, Vasiliy E.; Mach, Anderson; Grandl, Robin; King, Matthew L.; Dechert, Alyson F.; O'Shea, Liam; Schwaitzberg, Steven D.; Kim, Peter C.W.

doi:10.1007/s00464-022-09583-2

Cited by 9 publications

(14 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The light from sensor is then sent to a light engine which then provides near infrared illumination allowing for either ICG-FA or LSCI processing. The images from white light camera and the infrared camera are then combined using proprietary ActivSight LSCI algorithms [17] to create an overlay that shows augmented surgical video [1] . The module provides two different modes of data augmentation -i) ICG fluorescence angiography ii) LSCI generated perfusion color heatmap.…”

Section: Combining Laser Speckle Contrast Imaging (Lsci) and Icg -Fa ...mentioning

confidence: 99%

Real-time Quantification of Bowel Perfusion using Laparoscopic Laser Speckle Contrast Imaging (LSCI) in a Porcine Model

Mehrotra

Liu

Nwaiwu

et al. 2023

Preprint

View full text Add to dashboard Cite

Background/Purpose Real-time quantification of tissue perfusion can improve intraoperative surgical decision making. Here we demonstrate the utility of Laser Speckle Contrast Imaging as an intra-operative tool that quantifies real-time regional differences in intestinal perfusion and distinguishes ischemic changes resulting from arterial/venous obstruction.Methods Porcine models (n = 3) consisted of selectively devascularized small bowel loops that were used to measure the perfusion responses under conditions of control/no vascular occlusion, arterial inflow occlusion, and venous outflow occlusion using laser speckle imaging and indocyanine green fluoroscopy. Laser Speckle was also used to assess perfusion differences between small bowel antimesenteric-antimesenteric and mesenteric-mesenteric anastomoses. Perfusion quantification was measured in relative perfusion units calculated from the laser speckle perfusion heatmap.Results Laser Speckle distinguished between visually identified perfused, watershed, and ischemic intestinal segments with both color heatmap and quantification (p < .00001). It detected a continuous gradient of relative intestinal perfusion as a function of distance from the stapled ischemic bowel edge. Strong positive linear correlation between relative perfusion units and changes in mean arterial pressure resulting from both arterial (R2 = .96/.79) and venous pressure changes (R2 = .86/.96) was observed. Furthermore, Laser Speckle showed that the antimesenteric anastomosis had a higher perfusion than mesenteric anastomosis (p < 0.01).Conclusions Laser Speckle Contrast Imaging provides objective, quantifiable tissue perfusion information in both color heatmap and relative numerical units. Laser Speckle can detect spatial/temporal differences in perfusion between antimesenteric and mesenteric borders of a bowel segment and precisely detect perfusion changes induced by progressive arterial/venous occlusions in real-time.

show abstract

Section: Combining Laser Speckle Contrast Imaging (Lsci) and Icg -Fa ...mentioning

confidence: 99%

Real-time Quantification of Bowel Perfusion using Laparoscopic Laser Speckle Contrast Imaging (LSCI) in a Porcine Model

Mehrotra

Liu

Nwaiwu

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Another problem with the intensity parameter is that it can cause overestimation of tissue perfusion. Fluorescence intensity in the perfusion area usually peaks within 60 s after ICG administration and then reaches a plateau ( Figure 2 ); however, over time, capillary diffusion may cause fluorescence to be observed even in ischemic areas [ 78 ].…”

Section: Quantitative Assessment Of Colon Perfusion Using Icg-fluores...mentioning

confidence: 99%

“…Novel technologies may overcome these problems in the future. For instance, laser speckle contrast imaging (LSCI), which specifically displays real-time blood flow and tissue perfusion by detecting the movement of objects such as red blood cells using coherent laser light, has advantages over ICG-FA: it facilitates repeat assessments, precludes the administration of additional drugs, and involves no latency from dye injection to perfusion [ 78 ]. In a study by Liu et al, LSCI showed high concordance with ICG-FA in the assessment of intestinal perfusion in human participants, and was associated with high surgical convenience [ 83 ].…”

Section: Future Perspectivesmentioning

confidence: 99%

A Narrative Review of the Usefulness of Indocyanine Green Fluorescence Angiography for Perfusion Assessment in Colorectal Surgery

Iwamoto

Kawamura

2022

Cancers

View full text Add to dashboard Cite

Anastomotic leakage is one of the most dreaded complications of colorectal surgery and is strongly associated with tissue perfusion. Indocyanine green fluorescence angiography (ICG-FA) using indocyanine green and near-infrared systems is an innovative technique that allows the visualization of anastomotic perfusion. Based on this information on tissue perfusion status, surgeons will be able to clearly identify colorectal segments with good blood flow for safer colorectal anastomosis. The results of several clinical trials indicate that ICG-FA may reduce the risk of AL in colorectal resection; however, the level of evidence is not high, as several other studies have failed to demonstrate a reduction in the risk of AL. Several large-scale RCTs are currently underway, and their results will determine whether ICG-FA is, indeed, useful. The major limitation of the current ICG-FA evaluation method, however, is that it is subjective and based on visual assessment by the surgeon. To complement this, the utility of objective evaluation methods for fluorescence using quantitative parameters is being investigated. Promising results have been reported from several clinical trials, but all trials are preliminary owing to their small sample size and lack of standardized protocols for quantitative evaluation. Therefore, appropriately standardized, high-quality, large-scale studies are warranted.

show abstract

“…Laser speckle contrast imaging (LSCI), a powerful and low-cost modality allowing for structural and functional imaging of blood vessels using non-contact and real-time measurement (Senarathna et al 2013), is successfully applied in clinical (Miller et al 2022), biomedical (Tamplin et al 2022), and nonmedical fields (Vaz et al 2017, van Welzen et al 2022. Compared to several techniques and biomarkers for assessing tumor status, such as magnetic resonance imaging (MRI) (Thoeny and Ross 2010), ultrasound (Abma et al 2019), positron emission tomography (Jochumsen et al 2019), and indocyanine green fluorescence (Nwaiwu et al 2023), LSCI has unique advantages in real-time, full-field blood flow maps without contrast agents or radiation exposure, which can be beneficial for continuous monitoring of tumor perfusion and vascularization , Miller et al 2022. However, LSCI is best suited for superficial tumors due to its limited depth of penetration (Briers et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Robust vessel segmentation in laser speckle contrast images based on semi-weakly supervised learning

Yang,

Chang,

Yuan

et al. 2023

Phys. Med. Biol.

View full text Add to dashboard Cite

Objective. The goal of this study is to develop a robust semi-weakly supervised learning strategy for vessel segmentation in laser speckle contrast imaging (LSCI), addressing the challenges associated with the low signal-to-noise ratio, small vessel size, and irregular vascular aberration in diseased regions, while improving the performance and robustness of the segmentation method. Approach. For the training dataset, the healthy vascular images denoted as normal-vessel samples were manually labeled, while the diseased LSCI images involving tumor or embolism were denoted as abnormal-vessel samples and annotated as pseudo labels by the traditional semantic segmentation methods. In the training phase, the pseudo labels were constantly updated to improve the segmentation accuracy based on DeepLabv3+. Objective evaluation was conducted on the normal-vessel test set, while subjective evaluation was performed on the abnormal-vessel test set. Main results. The proposed method achieved an IOU of 0.8671, a Dice of 0.9288, and a mean relative percentage difference (mRPD) with supervised learning of 0.5% in the objective evaluation. In the subjective evaluation, our method significantly outperformed other methods in main vessel segmentation, tiny vessel segmentation, and blood vessel connection. Additionally, our method exhibited robustness when abnormal-vessel style noise was added to normal-vessel samples using a style translation network. Significance. The proposed semi-weakly supervised learning strategy demonstrates high efficiency and excellent robustness for vascular segmentation in LSCI, providing a potential tool for assessing the morphological and structural features of vessels in clinical applications.

show abstract

Feasibility and comparison of laparoscopic laser speckle contrast imaging to near-infrared display of indocyanine green in intraoperative tissue blood flow/tissue perfusion in preclinical porcine models

Cited by 9 publications

References 35 publications

Real-time Quantification of Bowel Perfusion using Laparoscopic Laser Speckle Contrast Imaging (LSCI) in a Porcine Model

Real-time Quantification of Bowel Perfusion using Laparoscopic Laser Speckle Contrast Imaging (LSCI) in a Porcine Model

A Narrative Review of the Usefulness of Indocyanine Green Fluorescence Angiography for Perfusion Assessment in Colorectal Surgery

Robust vessel segmentation in laser speckle contrast images based on semi-weakly supervised learning

Contact Info

Product

Resources

About