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Peul RC, Kharbanda RK, Koning S, Kruiswijk MW, Tange FP, van den Hoven P, Vahrmeijer AL, Klautz RJ, Hamming JF, Hjortnaes J, van der Vorst JR. Intraoperative assessment of myocardial perfusion using near-infrared fluorescence and indocyanine green: A literature review. JTCVS Tech 2025; 30:81-93. [PMID: 40242100 PMCID: PMC11998401 DOI: 10.1016/j.xjtc.2025.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2024] [Revised: 12/05/2024] [Accepted: 12/20/2024] [Indexed: 04/18/2025] Open
Abstract
Background Coronary artery bypass grafting (CABG) is among the most commonly performed major surgical procedures worldwide. While flow measurements help assess graft patency during surgery, there are limited tools available for surgeons to objectively evaluate myocardial perfusion after graft placement. Near-infrared fluorescence (NIRF) imaging shows promise in this area, offering real-time visualization of flow and perfusion without the need for radiation or nephrotoxic contrast agents. This review summarizes current knowledge of and developments in myocardial perfusion assessment via NIRF imaging, emphasizing the potential benefits of adding quantification to enhance this technique. Methods PubMed was searched for articles describing the use of NIRF imaging for myocardial perfusion assessment. Articles were subsequently analyzed based on study objectives, subjects, and quantification capabilities. Limitations, future directions, and comparisons with other techniques were examined to recognize patterns and describe the chronological developments in NIRF imaging for myocardial perfusion assessment. Results Twenty-eight articles were included, 11 of which explored quantification. Only 5 of these articles included patients. Aims and techniques varied significantly among studies. Compared to the abundance of qualitative assessments, quantified NIRF imaging in patients remains limited. Conclusions This literature review highlights that NIRF imaging has been broadly researched qualitatively, showing promise for guiding CABG surgery through visualization of graft flow. However, the critical step of incorporating quantification to accurately assess myocardial perfusion remains insufficiently explored. To optimize decision making during CABG surgery, future studies must focus on intraoperative application of quantified NIRF imaging in cardiovascular patients.
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Affiliation(s)
- Roderick C. Peul
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Rohit K. Kharbanda
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Stefan Koning
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Mo W. Kruiswijk
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Floris P. Tange
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Pim van den Hoven
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Robert J.M. Klautz
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam-Zuidoost, The Netherlands
| | - Jaap F. Hamming
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Jesper Hjortnaes
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
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Spadaccio C, Nenna A, Corrado D, Glenn C, Panza A, Vester R, Laskawski G, Rose D, Louis L. Use of Indocyanine Green (ICG) to Assess Myocardial Perfusion and Territorial Distribution of Vein Grafts Implanted on Coronary Arteries in an Ex-vivo Porcine Model. A Potential Adjunct to Assist Revascularization Strategies and Training in Coronary Artery Bypass Grafting. Rev Cardiovasc Med 2025; 26:25778. [PMID: 39867206 PMCID: PMC11759963 DOI: 10.31083/rcm25778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Revised: 11/04/2024] [Accepted: 11/14/2024] [Indexed: 01/28/2025] Open
Abstract
Background The fluorescent dye indocyanine green (ICG) has been used to identify anatomical structures intraoperatively in coronary artery bypass grafting (CABG). This study aimed to evaluate the feasibility of using ICG to assess graft patency and territorial distribution of myocardial reperfusion during CABG. Methods Porcine arrested hearts (n = 18) were used to evaluate territorial distribution of native coronary arteries and of a coronary bypass constructed with porcine saphenous vein graft (SVG) using ICG. Coronary ostia were dissected and selectively cannulated for ICG injection. Sequential fluorescence was assessed in the epicardial coronary arteries, myocardium and coronary veins using an infrared-sensitive charge-coupled device (CCD) camera system. In a separate set of experiments, SVG was used for anastomosis in end-to-side fashion to a terminal obtuse marginal (OM) branch. This approach was used to avoid bias in the assessment of territorial distribution. The anastomosis was injected with ICG; graft patency and territorial distribution was assessed using an infrared-sensitive CCD camera system from 30 cm above the field, as previously described. Native circulation and SVG grafts were assessed using real-time video recording and fluorescence intensity mapping that was averaged into a graded scoring system. The heart was divided into functional regions: anterior wall, lateral wall, inferior wall and right ventricle. All experiments were performed in triplicates. Results After ICG injection into the individual coronary ostia, perfusion of the native coronary artery was visible. Portions of the vessels embedded into the epicardial fat could be easily visualized on the surface of the heart and the dissection facilitated via fluorescence guidance. The territorial distribution reflected the expected regional perfusion. The SVG graft was anastomosed to an OM branch. ICG visualization allowed for assessment of graft patency excluding potential technical anastomosis problems or graft twisting or dissection. The myocardial perfusion observed in real-time confirmed regional distribution to the entire lateral wall and minimally to the inferior wall. These findings were confirmed in all the specimens used in the study. Conclusions Besides assisting the identification of intramyocardial vessels, ICG can provide information on the native coronary circulation status and the territorial distribution of the perfusion before and after grafting. It enables visualization of collaterals and the territory of distribution subtended by a graft offering real-time assessment and guidance on the grafting strategy.
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Affiliation(s)
- Cristiano Spadaccio
- Cardiac Surgery, University of Cincinnati Medical Center, Cincinnati, OH 45202, USA
| | - Antonio Nenna
- Cardiac Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Diletta Corrado
- Cardiac Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Carter Glenn
- Cardiac Surgery, University of Cincinnati Medical Center, Cincinnati, OH 45202, USA
| | - Antonio Panza
- Cardiac Surgery, University of Cincinnati Medical Center, Cincinnati, OH 45202, USA
| | - Russell Vester
- Cardiac Surgery, University of Cincinnati Medical Center, Cincinnati, OH 45202, USA
| | - Grzegorz Laskawski
- Cardiac Surgery, Blackpool Teaching Hospital - Lancashire Cardiac Center, FY3 8NP Blackpool, UK
| | - David Rose
- Cardiac Surgery, Blackpool Teaching Hospital - Lancashire Cardiac Center, FY3 8NP Blackpool, UK
| | - Louis Louis
- Cardiac Surgery, University of Cincinnati Medical Center, Cincinnati, OH 45202, USA
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Verma N, Setia A, Mehata AK, Randhave N, Badgujar P, Malik AK, Muthu MS. Recent Advancement of Indocyanine Green Based Nanotheranostics for Imaging and Therapy of Coronary Atherosclerosis. Mol Pharm 2024; 21:4804-4826. [PMID: 39225111 DOI: 10.1021/acs.molpharmaceut.4c00495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Atherosclerosis is a vascular intima condition in which any part of the circulatory system is affected, including the aorta and coronary arteries. Indocyanine green (ICG), a theranostic compound approved by the FDA, has shown promise in the treatment of coronary atherosclerosis after incorporation into nanoplatforms. By integration of ICG with targeting agents such as peptides or antibodies, it is feasible to increase its concentration in damaged arteries, hence increasing atherosclerosis detection. Nanotheranostics offers cutting-edge techniques for the clinical diagnosis and therapy of atherosclerotic plaques. Combining the optical properties of ICG with those of nanocarriers enables the improved imaging of atherosclerotic plaques and targeted therapeutic interventions. Several ICG-based nanotheranostics platforms have been developed such as polymeric nanoparticles, iron oxide nanoparticles, biomimetic systems, liposomes, peptide-based systems, etc. Theranostics for atherosclerosis diagnosis use magnetic resonance imaging (MRI), computed tomography (CT), near-infrared fluorescence (NIRF) imaging, photoacoustic/ultrasound imaging, positron emission tomography (PET), and single photon emission computed tomography (SPECT) imaging techniques. In addition to imaging, there is growing interest in employing ICG to treat atherosclerosis. In this review, we provide a conceptual explanation of ICG-based nanotheranostics for the imaging and therapy of coronary atherosclerosis. Moreover, advancements in imaging modalities such as MRI, CT, PET, SPECT, and ultrasound/photoacoustic have been discussed. Furthermore, we highlight the applications of ICG for coronary atherosclerosis.
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Affiliation(s)
- Nidhi Verma
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Aseem Setia
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Abhishesh Kumar Mehata
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Nandini Randhave
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Paresh Badgujar
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Ankit Kumar Malik
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Madaswamy S Muthu
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
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von Kroge P, Russ D, Wagner J, Grotelüschen R, Reeh M, Izbicki JR, Mann O, Wipper SH, Duprée A. Quantification of gastric tube perfusion following esophagectomy using fluorescence imaging with indocyanine green. Langenbecks Arch Surg 2022; 407:2693-2701. [PMID: 35581393 DOI: 10.1007/s00423-022-02546-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 05/09/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Anastomotic leakage (AL) remains a prevalent and life-threatening complication after esophagectomy. Gastric tube perfusion assessment using indocyanine green fluorescence imaging (ICG-FI) has been published in several studies and appears to be a promising tool to reduce AL rates by changing the surgical approach, namely by an intraoperative evaluation of the anastomosis localization. METHODS In this study, gastric tube perfusion was quantified by using ICG-FI in 20 high-risk patients undergoing esophagectomy. From a time-dependent fluorescence intensity curve, the following three parameters were evaluated: slope of fluorescence intensity (SFI), background subtracted peak fluorescence intensity (BSFI), and time to slope (TTS). RESULTS The values between pyloric region and tip showed a similar downward trend and SFI and BSFI significantly correlated with the distance to the pyloric region. SFI and BSFI were significantly decreased at the tip of the gastric tube. The placement of anastomosis in an area with homogenous fluorescence pattern was correlated with no AL in 92.9% of cases. An inhomogeneous fluorescence pattern at anastomotic site was a risk factor for the occurrence of an AL (p < 0.05). Reduction of perfusion up to 32% using SFI and up to 23% using BSFI was not associated with AL. CONCLUSION ICG-FI can be used to quantify the gastric tube perfusion by calculating SFI, BSFI, and TTS. The anastomosis should be created in areas with homogeneous fluorescence pattern. A reduction in blood flow of up to 32% can be accepted without causing an increased rate of insufficiency.
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Affiliation(s)
- Philipp von Kroge
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Detlef Russ
- Department for the Development of Applications, Institute for Laser Technology, University Ulm, Ulm, Germany
| | - Jonas Wagner
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rainer Grotelüschen
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Reeh
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jakob R Izbicki
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Oliver Mann
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sabine H Wipper
- Department of Vascular Surgery, University Medical Center Innsbruck, Innsbruck, Austria
| | - Anna Duprée
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia. PLoS One 2021; 16:e0254144. [PMID: 34283875 PMCID: PMC8291700 DOI: 10.1371/journal.pone.0254144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/18/2021] [Indexed: 11/19/2022] Open
Abstract
Background Mesenteric ischemia is a severe and potentially lethal event. Assessment of intestine perfusion is eminently depending on the skills, and the experience of the surgeon. Thus, the therapy is biased by the right evaluation. Aim of this study is to determine the applicability, and the usefulness of fluorescent-imaging (FI) with indocyanine green (ICG) in a porcine model of mesenteric ischemia. Second end-point is the verification of a visual and quantitative assessment tool of the intestinal perfusion. Methods In 18 pigs (54,2 ±2,9kg) an occlusion of a side-branch of the mesenteric artery was performed for 3 (group I, n = 7), 6 (group II, n = 7), and 10 hours (group III, n = 4). After reperfusion a 60 minutes observation period was carried out. 3 regions of interest were defined: ischemic bowel (D1), transitional zone (D2), and non-ischemic bowel (D3). ICG-FI was performed during baseline (T0), occlusion (T1), reperfusion (T2) and after an observation period of 60 minutes (T4). Results All experiments could be finished successfully. ICG-FI was assessed using assessment of background-subtracted peak fluorescence intensity (BSFI), slope of fluorescence intensity (SFI), and a baseline adjusted ratio of both parameters. ICG-FI confirmed loss of perfusion in D1, decreased perfusion in D2, and increased perfusion in D3. After reperfusion ICG-FI increased in group 2 due to a severe tissue damage resulting in a capillary leakage. In group I ICG-FI was equal to baseline values indicating the totally reversible loss of perfusion. Conclusion Using ICG-FI to estimate intestine perfusion after different durations of ischemia is viable using a porcine model of mesenteric ischemia. Even small differences in perfusion can be reliably determined by ICG-FI. Thus, ICG-FI is an encouraging method to evaluate intestine perfusion intraoperatively.
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Kan X, Zhou G, Zhang F, Ji H, Zheng H, Chick JFB, Valji K, Zheng C, Yang X. Interventional Optical Imaging Permits Instant Visualization of Pathological Zones of Ablated Tumor Periphery and Residual Tumor Detection. Cancer Res 2021; 81:4594-4602. [PMID: 34244237 DOI: 10.1158/0008-5472.can-21-1040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/30/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022]
Abstract
Optical imaging (OI) provides real-time clinical imaging capability and simultaneous molecular, morphological, and functional information of disease processes. In this study, we present a new interventional OI technique, which enables in vivo visualization of three distinct pathologic zones of ablated tumor periphery for immediate detection of residual tumors during a radiofrequency ablation (RFA) session. Rabbits with orthotopic hepatic tumors were divided into two groups (n = 8/group): incomplete RFA and complete RFA. Indocyanine green-based interventional OI was used to differentiate three pathological zones: ablated tumor, transition margin, and residual tumor or surrounding normal liver-with quantitative comparison of signal-to-background ratios among the three zones and between incompletely and completely ablated tumors. Subsequent ex vivo OI and pathologic correlation were performed to confirm the findings of interventional OI. Interventional OI could differentiate incompletely or completely ablated tumor peripheries, thus permitting identification of residual tumor. This technique may open new avenues for immediate assessment of tumor eradication during a single interventional ablation session. SIGNIFICANCE: Interventional optical imaging can instantly visualize pathologic zones of ablated tumor peripheries to detect residual tumors, which could revolutionize current image-guided interventional oncologic ablation techniques.
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Affiliation(s)
- Xuefeng Kan
- Image-Guided Bio-Molecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, Washington
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guanhui Zhou
- Image-Guided Bio-Molecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, Washington
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Feng Zhang
- Image-Guided Bio-Molecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, Washington
| | - Hongxiu Ji
- Image-Guided Bio-Molecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, Washington
| | - Hui Zheng
- Image-Guided Bio-Molecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, Washington
- Department of Interventional Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jeffrey Forris Beecham Chick
- Image-Guided Bio-Molecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, Washington
| | - Karim Valji
- Image-Guided Bio-Molecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, Washington
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoming Yang
- Image-Guided Bio-Molecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, Washington.
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Mashalchi S, Pahlavan S, Hejazi M. A novel fluorescent cardiac imaging system for preclinical intraoperative angiography. BMC Med Imaging 2021; 21:37. [PMID: 33632145 PMCID: PMC7905866 DOI: 10.1186/s12880-021-00562-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 02/08/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Intraoperative coronary angiography can tremendously reduce early coronary bypass graft failures. Fluorescent cardiac imaging provides an advanced method for intraoperative observation and real-time quantitation of blood flow with high resolution. METHODS We devised a system comprised of an LED light source, special filters, lenses and a detector for preclinical coronary artery angiography. The optical setup was implemented by using two achromatic doublet lenses, two positive meniscus lenses, a band-pass filter, a pinhole and a CCD sensor. The setup was optimized by Zemax software. Optical design was further challenged to obtain more parallel light beams, less diffusion and higher resolutions to levels as small as arterioles. Ex vivo rat hearts were prepared and coronary arteries were retrogradely perfused by indocyanine green (ICG). Video angiography was employed to assess blood flow and plot time-dependent fluorescence intensity curve (TIC). Quantitation of blood flow was performed by calculating either the gradient of TIC or area under curve. The correlation between blood flow and each calculated parameters was assessed and used to evaluate the quality of flow. RESULTS High-resolution images of flow in coronary arteries were obtained as precise as 62 µm vessel diameter, by our custom-made ICG angiography system. The gradient of TIC was 3.4-6.3 s-1, while the area under curve indicated 712-1282 s values which ultimately gained correlation coefficients of 0.9938 and 0.9951 with relative blood flow, respectively. CONCLUSION The present ICG angiography system may facilitate evaluation of blood flow in animal studies of myocardial infarction and coronary artery grafts intraoperatively.
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Affiliation(s)
- Sara Mashalchi
- Medical Physics and Biomedical Engineering Department, School of Medicine, Tehran University of Medical Sciences, 1417613151, Tehran, Iran
| | - Sara Pahlavan
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Banihashem St., Resalat Highway, P.O. Box: 16635-148, 1665659911, Tehran, Iran.
| | - Marjaneh Hejazi
- Medical Physics and Biomedical Engineering Department, School of Medicine, Tehran University of Medical Sciences, 1417613151, Tehran, Iran. .,Research Center for Molecular and Cellular Imaging, Bio-Optical Imaging Group, Tehran University of Medical Sciences, Tehran, Iran.
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Reiber JHC, Pereira GTR, Bezerra HG, De Sutter J, Schoenhagen P, Stillman AE, Van de Veire NRL. Cardiovascular imaging 2018 in the International Journal of Cardiovascular Imaging. Int J Cardiovasc Imaging 2019; 35:1175-1188. [PMID: 30868339 DOI: 10.1007/s10554-019-01579-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Johan H C Reiber
- Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands.
| | | | - Hiram G Bezerra
- Department of Cardiology, Case Western Hospitals, Cleveland, OH, USA
| | - Johan De Sutter
- Department of Cardiology, AZ Maria Middelares Gent and University Gent, Ghent, Belgium
| | - Paul Schoenhagen
- Department of Radiology, The Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Arthur E Stillman
- Department of Radiology, Emory University Hospital, Atlanta, GA, USA
| | - Nico R L Van de Veire
- Department of Cardiology, AZ Maria Middelares Gent and Free University Brussels, Brussels, Belgium
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Duprée A, Rieß H, Detter C, Debus ES, Wipper SH. Utilization of indocynanine green fluorescent imaging (ICG-FI) for the assessment of microperfusion in vascular medicine. Innov Surg Sci 2018; 3:193-201. [PMID: 31579783 PMCID: PMC6604578 DOI: 10.1515/iss-2018-0014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 06/26/2018] [Indexed: 01/06/2023] Open
Abstract
Intraoperative valuation of organ and tissue microperfusion is always a current topic in different surgical situations. Although indocyanine green fluorescent imaging (ICG-FI) has turned to be a more and more common technique to evaluate organ perfusion, only few studies tried to quantitatively validate the technique for microperfusion assessment. The aim of the following manuscript is to present the results of our interdisciplinary research confirming additional quantitative assessment tools in different surgical conditions. Thus, we are implementing the background-subtracted peak fluorescent intensity (BSFI), the slope of fluorescence intensity (SFI), and the time to slope (TTS) using ICG-FI in several regions of interest (ROI).
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Affiliation(s)
- Anna Duprée
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
- Anna Dupréee and Henrik Rieß contributed equally to the manuscript
| | - Henrik Rieß
- Department of Vascular Medicine, University Heart Center, University Medical Center, Hamburg-Eppendorf, Germany
- Anna Dupréee and Henrik Rieß contributed equally to the manuscript
| | - Christian Detter
- Centre of Cardiology and Cardiovascular Surgery, University Hospital Eppendorf, Hamburg, Germany
| | - Eike S. Debus
- Department of Vascular Medicine, University Heart Center, University Medical Center, Hamburg-Eppendorf, Germany
| | - Sabine H. Wipper
- Department of Vascular Medicine, University Heart Center, University Medical Center, Hamburg-Eppendorf, Germany
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