Manuel Barberio1, Eric Felli2, Emilie Seyller2, Fabio Longo2, Manish Chand3, Ines Gockel4, Bernard Geny5, Lee Swanström2, Jacques Marescaux6, Vincent Agnus2, Michele Diana7. 1. IHU-Strasbourg Institute of Image-Guided Surgery, France; Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Germany; EA 3072, Fédération de Médecine Translationnelle de Strasbourg, Medical University of Strasbourg, France. Electronic address: manuel.barberio@ihu-strasbourg.eu. 2. IHU-Strasbourg Institute of Image-Guided Surgery, France. 3. Division of Surgery & Interventional Science, University College London, United Kingdom. 4. Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Germany. 5. EA 3072, Fédération de Médecine Translationnelle de Strasbourg, Medical University of Strasbourg, France. 6. IHU-Strasbourg Institute of Image-Guided Surgery, France; Research Institute against Digestive Cancer (IRCAD), Strasbourg, France. 7. IHU-Strasbourg Institute of Image-Guided Surgery, France; EA 3072, Fédération de Médecine Translationnelle de Strasbourg, Medical University of Strasbourg, France; Research Institute against Digestive Cancer (IRCAD), Strasbourg, France.
Abstract
BACKGROUND: Fluorescence-based enhanced reality is a software that provides quantitative fluorescence angiography by computing the fluorescence intensity time-to-peak after intravenous indocyanine green. Hyperspectral imaging is a contrast-free, optical imaging modality which measures tissue oxygenation. METHODS: In 8 pigs, an ischemic bowel segment created by dividing the arcade branches was imaged using hyperspectral imaging and fluorescence-based enhanced reality. Tissue oxygenation values were acquired through a hyperspectral imaging system. Subsequently, fluorescence angiography was performed using a near-infrared laparoscopic camera after intravenous injection of 0.2 mg/kg of indocyanine green. The time-to-peak fluorescence signal was analyzed through a proprietary software to realize a perfusion map. This was overlaid onto real-time images to obtain fluorescence-based enhanced reality. Simultaneously, 9 adjacent regions of interest were selected and superimposed onto the real-time video, thereby obtaining hyperspectral-based enhanced reality. Fluorescence-based enhanced reality and hyperspectral-based enhanced reality were superimposed allowing a comparison of both imaging modalities. Local capillary lactate levels were sampled at the regions of interest. Two prediction models using the local capillary lactate levels were extrapolated based on both imaging systems. RESULTS: For all regions of interest, the mean local capillary lactate levels were 4.67 ± 4.34 mmol/L, the mean tissue oxygenation was 45.9 ± 18.9%, and the mean time-to-peak was 10 ± 9.4 seconds. Pearson's test between fluorescence-based enhanced reality-time-to-peak and hyperspectral imaging-tissue oxygenation at the corresponding regions of interest gave an R = -0.66 (P < .0001). The hyperspectral imaging lactate prediction model proved more accurate than the fluorescence-based enhanced reality-based model (P < .0001). CONCLUSION: Bowel perfusion was quantified using hyperspectral imaging and fluorescence angiography. Hyperspectral imaging yielded more accurate results than fluorescence angiography. Hyperspectral-based enhanced reality may prove to be a useful, contrast-free intraoperative tool to quantify bowel ischemia.
BACKGROUND: Fluorescence-based enhanced reality is a software that provides quantitative fluorescence angiography by computing the fluorescence intensity time-to-peak after intravenous indocyanine green. Hyperspectral imaging is a contrast-free, optical imaging modality which measures tissue oxygenation. METHODS: In 8 pigs, an ischemic bowel segment created by dividing the arcade branches was imaged using hyperspectral imaging and fluorescence-based enhanced reality. Tissue oxygenation values were acquired through a hyperspectral imaging system. Subsequently, fluorescence angiography was performed using a near-infrared laparoscopic camera after intravenous injection of 0.2 mg/kg of indocyanine green. The time-to-peak fluorescence signal was analyzed through a proprietary software to realize a perfusion map. This was overlaid onto real-time images to obtain fluorescence-based enhanced reality. Simultaneously, 9 adjacent regions of interest were selected and superimposed onto the real-time video, thereby obtaining hyperspectral-based enhanced reality. Fluorescence-based enhanced reality and hyperspectral-based enhanced reality were superimposed allowing a comparison of both imaging modalities. Local capillary lactate levels were sampled at the regions of interest. Two prediction models using the local capillary lactate levels were extrapolated based on both imaging systems. RESULTS: For all regions of interest, the mean local capillary lactate levels were 4.67 ± 4.34 mmol/L, the mean tissue oxygenation was 45.9 ± 18.9%, and the mean time-to-peak was 10 ± 9.4 seconds. Pearson's test between fluorescence-based enhanced reality-time-to-peak and hyperspectral imaging-tissue oxygenation at the corresponding regions of interest gave an R = -0.66 (P < .0001). The hyperspectral imaging lactate prediction model proved more accurate than the fluorescence-based enhanced reality-based model (P < .0001). CONCLUSION: Bowel perfusion was quantified using hyperspectral imaging and fluorescence angiography. Hyperspectral imaging yielded more accurate results than fluorescence angiography. Hyperspectral-based enhanced reality may prove to be a useful, contrast-free intraoperative tool to quantify bowel ischemia.
Authors: A Pfahl; G K Radmacher; H Köhler; M Maktabi; T Neumuth; A Melzer; I Gockel; C Chalopin; B Jansen-Winkeln Journal: Biomed Opt Express Date: 2022-04-29 Impact factor: 3.562
Authors: Alexander Studier-Fischer; Silvia Seidlitz; Jan Sellner; Berkin Özdemir; Manuel Wiesenfarth; Leonardo Ayala; Jan Odenthal; Samuel Knödler; Karl Friedrich Kowalewski; Caelan Max Haney; Isabella Camplisson; Maximilian Dietrich; Karsten Schmidt; Gabriel Alexander Salg; Hannes Götz Kenngott; Tim Julian Adler; Nicholas Schreck; Annette Kopp-Schneider; Klaus Maier-Hein; Lena Maier-Hein; Beat Peter Müller-Stich; Felix Nickel Journal: Sci Rep Date: 2022-06-30 Impact factor: 4.996
Authors: Antonio D'Urso; Vincent Agnus; Manuel Barberio; Barbara Seeliger; Francesco Marchegiani; Anne-Laure Charles; Bernard Geny; Jacques Marescaux; Didier Mutter; Michele Diana Journal: Surg Endosc Date: 2020-08-27 Impact factor: 4.584
Authors: Boris Jansen-Winkeln; Manuel Barberio; Claire Chalopin; Katrin Schierle; Michele Diana; Hannes Köhler; Ines Gockel; Marianne Maktabi Journal: Cancers (Basel) Date: 2021-02-25 Impact factor: 6.575