Spectral imaging enables contrast agent–free real-time ischemia monitoring in laparoscopic surgery

Abstract

Laparoscopic surgery has evolved as a key technique for cancer diagnosis and therapy. While characterization of the tissue perfusion is crucial in various procedures, such as partial nephrectomy, doing so by means of visual inspection remains highly challenging. We developed a laparoscopic real-time multispectral imaging system featuring a compact and lightweight multispectral camera and the possibility to complement the conventional surgical view of the patient with functional information at a video rate of 25 Hz. To enable contrast agent–free ischemia monitoring during laparoscopic partial nephrectomy, we phrase the problem of ischemia detection as an out-of-distribution detection problem that does not rely on data from any other patient and uses an ensemble of invertible neural networks at its core. An in-human trial demonstrates the feasibility of our approach and highlights the potential of spectral imaging combined with advanced deep learning–based analysis tools for fast, efficient, reliable, and safe functional laparoscopic imaging.

Switchable LED-based laparoscopic multispectral system for rapid high-resolution perfusion imaging

“…Light source requirements such as available spectrum, long-term stability, switching behavior, or synchronization with the image sensor were fulfilled. Although comparable filter wheel 4 and snapshot 17 systems respectively reach higher spectral resolutions (FWHM: 10-25 nm versus 12 to 75 nm) and temporal resolutions (frame rate: 25 fps versus 20 fps), the presented MSI system benefits from a broader spectral range beyond the visible range and carries the potential for further applications like tissue discrimination.…”

“…MSI has therefore been evaluated qualitatively. 4 , 17 In-vivo animal studies in which bowel tissue oxygenation is selectively reduced or in which tissue perfusion is imaged by fluorescence angiography should be performed in the future to investigate the added value and accuracy of MSI perfusion monitoring.…”

Lightfield hyperspectral imaging in neuro-oncology surgery: an IDEAL 0 and 1 study

“…Mosaic snapshot HSI sensor combined with fast implementation of appropriate post-processing steps allows for real-time hyperspectral imaging which in turn enables non-invasive analysis of tissues to provide physiologically relevant parameters (e.g., tissue oxygenation) with the potential to provide surgical guidance (Ayala et al, 2021 ; Ebner et al, 2021 ). Building on these foundations, hyperspectral imaging systems capable of acquiring tissue spectral information whilst integrating seamlessly in to the surgical theater workflow have been demonstrated (Ebner et al, 2021 ; Ayala et al, 2023 ). However, mosaic snapshot HSI remains limited to acquiring a relatively small number of spectral bands in a relatively confined range of the optical spectrum.…”

A rapid multispectral endoscopic imaging system for in vivo assessment of the morphological and physiological characteristics of mouse intestines

“…As a practical biomedical application, multispectral imaging is usually incorporated with endoscopy for the detection of cancer in many different parts of the human body, especially for hollow organs. 15–17 In this work, a continuous scanning method of a six-channel illumination filter with parallel image detection based on a standard color CCD camera was used. After acquiring the reflected spectral images and reconstructing the multispectral images, the system further provided the morphology and blood supply from exposed in vivo animal organs.…”