Laser speckle contrast imaging and quantitative fluorescence angiography for perfusion assessment

Rønn, Jonas Hedelund; Nerup, Nikolaj; Strandby, Rune Broni; Svendsen, Morten Bo Søndergaard; Ambrus, Rikard; Svendsen, Lars Bo; Achiam, Michael Patrick

doi:10.1007/s00423-019-01789-8

Cited by 40 publications

(37 citation statements)

References 42 publications

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“…Ventilation was paused for 10-20 s after injection of ICG to avoid respiratory movement artifacts during the quantification. For quantification, we used previously validated software (q-ICG) [13][14][15][16][17], and a picture of a color-coded output (beta-version of the present system [20]) representing relative perfusion of the segments (Fig. 1).…”

Section: Perfusion Assessmentmentioning

confidence: 99%

“…Recently, quantitative analysis of ICG-FA (q-ICG) has been introduced to limit the observer bias and reduce reproducibility problems when normal non-quantitative visual ICG-FA is performed. We have previously described our quantification software's validation, reliability, and reproducibility (q-ICG) in a series of animal studies in both normal, increased, and reduced perfusion [13][14][15][16][17].…”

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Quantitative fluorescence angiography aids novice and experienced surgeons in performing intestinal resection in well-perfused tissue

et al. 2021

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Background Anastomotic leakage (AL) after gastrointestinal resection is a devastating complication with huge consequences for the patient. As AL is associated with poor blood supply, tools for objective assessment of perfusion are in high demand. Indocyanine green angiography (ICG-FA) and quantitative analysis of ICG-FA (q-ICG) seem promising. This study aimed to investigate whether ICG-FA and q-ICG could improve perfusion assessment performed by surgeons of different experience levels. Methods Thirteen small bowel segments with a varying degree of devascularization, including two healthy sham segments, were constructed in a porcine model. We recruited students, residents, and surgeons to perform perfusion assessment of the segments in white light (WL), with ICG-FA, and after q-ICG, all blinded to the degree of devascularization. Results Forty-five participants fulfilled the study (18 novices, 12 intermediates, and 15 experienced). ICG and q-ICG helped the novices correctly detect the healthy bowel segments to experienced surgeons’ level. ICG and q-ICG also helped novice surgeons to perform safer resections in healthy tissue compared with normal WL. The relative risk (RR) of leaving ischemic tissue in WL and ICG compared with q-ICG, even for experienced surgeons was substantial, intermediates (RR = 8.9, CI95% [4.0;20] and RR = 6.2, CI95% [2.7;14.1]), and experienced (RR = 4.7, CI95% [2.6;8.7] and RR = 4.0, CI95% [2.1;7.5]). Conclusion Q-ICG seems to guide surgeons, regardless of experience level, to safely perform resection in healthy tissue, compared with standard WL. Future research should focus on this novel tool’s clinical impact.

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Section: Perfusion Assessmentmentioning

confidence: 99%

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Quantitative fluorescence angiography aids novice and experienced surgeons in performing intestinal resection in well-perfused tissue

et al. 2021

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“…The authors described the diversity in perfusion parameters and methodology in the field of gastrointestinal surgery, concluding that the application of ICG-NIRF imaging in this field requires standardization before implementation in a clinical setting. A potential means of achieving standardization is by the process of normalization, a mathematical means of correcting for fluctuations in fluorescence intensity, as yet only described in animal studies with promising results [ 67 , 68 , 69 ].…”

Section: Discussionmentioning

confidence: 99%

Perfusion Parameters in Near-Infrared Fluorescence Imaging with Indocyanine Green: A Systematic Review of the Literature

Goncalves

Hoven

Schaik

et al. 2021

Life

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(1) Background: Near-infrared fluorescence imaging is a technique capable of assessing tissue perfusion and has been adopted in various fields including plastic surgery, vascular surgery, coronary arterial disease, and gastrointestinal surgery. While the usefulness of this technique has been broadly explored, there is a large variety in the calculation of perfusion parameters. In this systematic review, we aim to provide a detailed overview of current perfusion parameters, and determine the perfusion parameters with the most potential for application in near-infrared fluorescence imaging. (2) Methods: A comprehensive search of the literature was performed in Pubmed, Embase, Medline, and Cochrane Review. We included all clinical studies referencing near-infrared perfusion parameters. (3) Results: A total of 1511 articles were found, of which, 113 were suitable for review, with a final selection of 59 articles. Near-infrared fluorescence imaging parameters are heterogeneous in their correlation to perfusion. Time-related parameters appear superior to absolute intensity parameters in a clinical setting. (4) Conclusions: This literature review demonstrates the variety of parameters selected for the quantification of perfusion in near-infrared fluorescence imaging.

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“…In the studies included in this review, the fluorescent signal was judged qualitative, meaning visually subjectively, except for one study which quantified the fluorescent signal ex vivo [ 15 ]. In a series of animal studies[ 43 - 45 ], a new method named quantitative-ICG for quantification of perfusion using ICG fluorescence was presented and validated. The quantification of the fluorescent signal will add an important factor to all technologies using fluorescence as a diagnostic marker.…”

Section: Discussionmentioning

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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Laser speckle contrast imaging and quantitative fluorescence angiography for perfusion assessment

Cited by 40 publications

References 42 publications

Quantitative fluorescence angiography aids novice and experienced surgeons in performing intestinal resection in well-perfused tissue

Quantitative fluorescence angiography aids novice and experienced surgeons in performing intestinal resection in well-perfused tissue

Perfusion Parameters in Near-Infrared Fluorescence Imaging with Indocyanine Green: A Systematic Review of the Literature

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

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