Preliminary experience with a novel intraoperative fluorescence imaging technique to evaluate the patency of bypass grafts in total arterial revascularization

Taggart, David P.; Choudhary, Bharat; Anastasiadis, Kyriakos; Abu‐Omar, Yasir; Balacumaraswami, Lognathen; Pigott, David

doi:10.1016/s0003-4975(02)04669-6

Cited by 154 publications

(99 citation statements)

References 12 publications

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“…15,16,21 Intravenously injected ICG binds to serum proteins and fluoresces in near-infrared light. The protein-bound ICG is excreted into the bile juice through hepatocytes.…”

Section: Discussionmentioning

confidence: 99%

Real‐time detection of hepatic micrometastases from pancreatic cancer by intraoperative fluorescence imaging

Yokoyama

Otani

Hashidate

et al. 2011

Cancer

105

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BACKGROUND: Recently, a highly sensitive fluorescent imaging technique was developed for the real-time identification of hepatic tumors. The authors applied this procedure for the intraoperative detection of radiographically occult hepatic micrometastases from pancreatic cancer. METHODS: Forty-nine consecutive patients with pancreatic cancer who underwent surgical intervention were examined. Preoperative clinical images had not revealed any hepatic metastases. On the day before surgery, indocyanine green was injected intravenously. During the operation, the liver was observed with a near-infrared camera system, and abnormal fluorescent foci were examined by frozen-section histology. The patients with hepatic micrometastases were judged to have unresectable disease and underwent only palliative surgery followed by systemic chemotherapy using gemcitabine. RESULTS: Abnormal hepatic fluorescence at least 1.5 mm in greatest dimension without any apparent tumor was observed in 13 patients. Among them, histologic examination confirmed micrometastases in 8 of 49 patients (16%). All patients with hepatic micrometastases had clinical T3 or T4 disease and high serum CA19-9 levels (P ¼ .042). On follow-up computed tomography images that were obtained within 6 months after surgery, the patients with hepatic micrometastases manifested hepatic overt metastases (7 of 8 patients; 88%) more frequently than the patients without hepatic micrometastases (4 of 41 patients; 10%; P < .001). Regardless of histologic confirmation, the positive predictive value of abnormal fluorescence for the manifestation of hepatic relapse within 6 months was 77% (10 of 13 patients), and the negative predictive value was 97% (35 of 36 patients). CONCLUSIONS: Indocyanine green-fluorescent imaging can detect hepatic micrometastases of pancreatic cancer during surgery. The hepatic micrometastases seem to have an adverse clinical impact identical to that of evident distant metastases. Cancer 2012;118:2813-

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“…15,16,21 Intravenously injected ICG binds to serum proteins and fluoresces in near-infrared light. The protein-bound ICG is excreted into the bile juice through hepatocytes.…”

Section: Discussionmentioning

confidence: 99%

Real‐time detection of hepatic micrometastases from pancreatic cancer by intraoperative fluorescence imaging

Yokoyama

Otani

Hashidate

et al. 2011

Cancer

105

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“…Potential advantages of A15 as a clinical thrombosis imaging agent include its ability to covalently bind to fibrin, permitting biological amplification of the thrombus signal; its ability to detect biologically "active" thrombi 7,8 that may be more amenable to medical treatment; and its small size, permitting rapid thrombus enhancement. From a clinical imaging standpoint, NIRF intraoperative 19 and tomographic optical imaging 20 systems are under development for patient use and, in conjunction with A15, could detect recent cerebral, intracardiac, peripheral arterial, and pulmonary thromboemboli. In addition, this agent could be used with a clinical coronary catheter NIRF imaging system to detect biologically acute thrombi on atherosclerotic lesions.…”

Section: Discussionmentioning

confidence: 99%

Molecular Imaging of Factor XIIIa Activity in Thrombosis Using a Novel, Near-Infrared Fluorescent Contrast Agent That Covalently Links to Thrombi

et al. 2004

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Background-Activated factor XIII (FXIIIa) mediates fibrinolytic resistance and is a hallmark of newly formed thrombi.In vivo imaging of FXIIIa activity could further elucidate the role of this molecule in thrombosis and other biological processes and aid in the clinical detection of acute thrombi. Methods and Results-An FXIIIa-sensitive near-infrared fluorescence imaging agent (A15) was engineered by conjugating a near-infrared fluorochrome to a peptide ligand derived from the amino terminus of ␣ 2 -antiplasmin. To evaluate the molecular specificity of A15 for FXIIIa, a control agent (C15) was also synthesized by modifying a single key glutamine residue in A15. Fluorescence imaging experiments with A15 demonstrated stronger thrombosis enhancement in human plasma clots in vitro (PϽ0.001 versus C15 clots and other controls). A15 was found to be highly specific for the active site of FXIIIa and was covalently bound to fibrin. In vivo murine experiments with A15 demonstrated significant signal enhancement in acute intravascular thrombi (PϽ0.05 versus C15 group). Minimal A15 enhancement was seen in older aged thrombi (Ͼ24 hours), consistent with an expected decline of FXIIIa activity over time. Imaging results were confirmed on correlative histopathology and fluorescence microscopy. Conclusions-A15 is a novel optical imaging agent that is specifically crosslinked to fibrin by FXIIIa, permitting detection of FXIIIa activity in experimental thrombi in vivo. This agent should permit assessment of FXIIIa activity in a broad range of biological processes and could aid in the clinical diagnosis of acute thrombi.

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“…Likewise, ICG-AG has been commonly used for evaluating graft patency. Many reports in literature demonstrated the effectiveness of ICG-AG for CABG [1][2][3][4][5]. In Japan, the SPY system and HEMS have been used for CABG; however, quantitative analysis has not been a popular method because a better analysis software program is not yet available.…”

Section: Discussionmentioning

confidence: 99%

“…Indocyanine green angiography (ICG-AG) is used to assess grafts for coronary artery bypass grafting (CABG) [1][2][3][4]. Previously, we developed a prototype color ICG-AG system, the HyperEye Medical System (HEMS; Mizuho IKAKOGYO Inc., Tokyo, Japan), and have used it with TTFM (VeriQ; Medistim, Oslo, Norway) for intraoperative graft evaluation since 2007 [5,6].…”

Section: Introductionmentioning

confidence: 99%

New Quantitative Analysis Method Using HyperEye Medical System Image for Coronary Artery Bypass Grafting

Takemi¹,

Orihashi²,

Nishimori³

et al. 2017

Angiol

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Purpose: The current evaluation by indocyanine green angiography in coronary artery bypass patients has been performed by qualitative analysis. We devised an original quantitative analysis method using Image J.Methods: Indocyanine green angiography movie was converted to spatiotemporal images. Using the spatiotemporal image, an indocyanine green fluorescence intensity curve was drawn and converted to a firstderivative (acceleration) curve. Indocyanine green angiography evaluations were classified into four types. We collected the peak indocyanine green fluorescence intensity value (peak-I) and both time interval and ratio of maximum indocyanine green acceleration value (max dI/dt) between the mid and distal portions of the graft. Results:In 61 left internal thoracic artery grafts, 49 were patent and 12 were abnormal on CAG. There were significant differences between peak-I at the mid portion of the graft (221.47 ± 39.33 vs. 184.82 ± 40.15 gray scale) and time delay with max dI/dt (0.45 ± 1.28 vs. −1.00 ± 1.25 s), but there was no significant difference in the ratio of max dI/dt between patent and abnormal grafts. Conclusions:The spatiotemporal image method may become a model of the analysis software and the time interval of max dI/dt may become a predictor for future graft failure.

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Preliminary experience with a novel intraoperative fluorescence imaging technique to evaluate the patency of bypass grafts in total arterial revascularization

Cited by 154 publications

References 12 publications

Real‐time detection of hepatic micrometastases from pancreatic cancer by intraoperative fluorescence imaging

Real‐time detection of hepatic micrometastases from pancreatic cancer by intraoperative fluorescence imaging

Molecular Imaging of Factor XIIIa Activity in Thrombosis Using a Novel, Near-Infrared Fluorescent Contrast Agent That Covalently Links to Thrombi

New Quantitative Analysis Method Using HyperEye Medical System Image for Coronary Artery Bypass Grafting

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