Quantification of fluorescence angiography in a porcine model

Nerup, Nikolaj; Andersen, Helene Schou; Ambrus, Rikard; Strandby, Rune Broni; Svendsen, Morten Bo Søndergaard; Madsen, Mads H. Aa.; Svendsen, Lars Bo; Achiam, Michael Patrick

doi:10.1007/s00423-016-1531-z

Cited by 45 publications

(54 citation statements)

References 30 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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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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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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confidence: 99%

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

et al. 2021

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“…In a porcine model, Nerup et al . reported that the regional blood perfusion of the stomach was significantly associated with both Slope and Fmax 36 . In a small bowel strangulation model, Matsui et al .…”

Section: Discussionmentioning

confidence: 98%

Enhanced anastomotic healing by Daikenchuto (TJ-100) in rats

Wada

Kawada

Hirai

et al. 2018

Sci Rep

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Daikenchuto (DKT), a traditional Japanese medicine, is widely used to treat various gastrointestinal disorders. This study aimed to investigate whether DKT could promote the anastomotic healing in a rat model. Pedicled colonic segments were made in left colon by ligation of the feeding arteries, and then intestinal continuity was restored. Colonic blood flow was analyzed by using ICG fluorescence imaging: Fmax, Tmax, T1/2, and Slope were calculated. Anastomotic leakage (AL) was found in 6 of 19 rats (31.6%) in the control group, whereas in 1 of 16 rats (6.2%) in the DKT group. The Fmax and Slope of DKT group were significantly higher than those of control group. DKT could promote the anastomotic healing, with the higher bursting pressure on postoperative day (POD) 2 and 5, the larger granulation thickness on POD 5, and neoangiogenesis on POD 5. Histological examination showed DKT exhibited a decreased inflammatory cell infiltration, enhanced fibroblast infiltration, and enhanced collagen density on POD 5. In the DKT group, the levels of TGFβ1 on POD 2 and VEGFα on POD5 were significantly higher, whereas the level of TNFα on POD 2 was significantly lower. Therefore, DKT could be effective for the prevention of AL following colorectal surgery.

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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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Quantification of fluorescence angiography in a porcine model

Abstract: Perfusion assessment with quantitative indocyanine green fluorescence angiography is not only feasible but easy to perform with commercially available equipment and readily accessible software.

Cited by 45 publications

References 30 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

Enhanced anastomotic healing by Daikenchuto (TJ-100) in rats

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

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