Application of Indocyanine Green Videoangiography in Aneurysm Surgery: Evidence, Techniques, Practical Tips

Norat, Pedro; Soldozy, Sauson; Elsarrag, Mazin; Sokolowski, Jennifer D.; Yağmurlu, Kaan; Park, Min S; Tvrdík, Petr; Kalani, M. Yashar S.

doi:10.3389/fsurg.2019.00034

Cited by 24 publications

(21 citation statements)

References 47 publications

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“…The PA signal increased after ICG injection and subsequently decreased over time [34]. The PA signal returned to near the baseline level, as expected as ICG mainly binds to plasma proteins and does not extravasate in healthy rats with an intact blood-brain barrier [35]. A video of the changes in the PA signal is included (Video S6) to visualize the ICG brain pharmacokinetics.…”

Section: In Vivo Functional Imaging Of Rat Brain Pharmacokinetics Following Icg Injectionmentioning

confidence: 57%

An Adjustable Dark-Field Acoustic-Resolution Photoacoustic Imaging System with Fiber Bundle-Based Illumination

et al. 2021

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Photoacoustic (PA) imaging has become one of the major imaging methods because of its ability to record structural information and its high spatial resolution in biological tissues. Current commercialized PA imaging instruments are limited to varying degrees by their bulky size (i.e., the laser or scanning stage) or their use of complex optical components for light delivery. Here, we present a robust acoustic-resolution PA imaging system that consists of four adjustable optical fibers placed 90° apart around a 50 MHz high-frequency ultrasound (US) transducer. In the compact design concept of the PA probe, the relative illumination parameters (i.e., angles and fiber size) can be adjusted to fit different imaging applications in a single setting. Moreover, this design concept involves a user interface built in MATLAB. We first assessed the performance of our imaging system using in vitro phantom experiments. We further demonstrated the in vivo performance of the developed system in imaging (1) rat ear vasculature, (2) real-time cortical hemodynamic changes in the superior sagittal sinus (SSS) during left-forepaw electrical stimulation, and (3) real-time cerebral indocyanine green (ICG) dynamics in rats. Collectively, this alignment-free design concept of a compact PA probe without bulky optical lens systems is intended to satisfy the diverse needs in preclinical PA imaging studies.

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Section: In Vivo Functional Imaging Of Rat Brain Pharmacokinetics Following Icg Injectionmentioning

confidence: 57%

An Adjustable Dark-Field Acoustic-Resolution Photoacoustic Imaging System with Fiber Bundle-Based Illumination

et al. 2021

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“…Indocyanine green (ICG) intraoperative cerebral videoangiography has been used (Bruneau et al, 2013 ; Norat et al, 2019 ). In addition, ICG infrared videoangiography is a frequently used technique to assess vascular patency and occlusions during cerebrovascular surgeries (Norat et al, 2019 ).…”

Section: Methodsmentioning

confidence: 99%

Deep-Learning-Based Cerebral Artery Semantic Segmentation in Neurosurgical Operating Microscope Vision Using Indocyanine Green Fluorescence Videoangiography

et al. 2022

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There have been few anatomical structure segmentation studies using deep learning. Numbers of training and ground truth images applied were small and the accuracies of which were low or inconsistent. For a surgical video anatomy analysis, various obstacles, including a variable fast-changing view, large deformations, occlusions, low illumination, and inadequate focus occur. In addition, it is difficult and costly to obtain a large and accurate dataset on operational video anatomical structures, including arteries. In this study, we investigated cerebral artery segmentation using an automatic ground-truth generation method. Indocyanine green (ICG) fluorescence intraoperative cerebral videoangiography was used to create a ground-truth dataset mainly for cerebral arteries and partly for cerebral blood vessels, including veins. Four different neural network models were trained using the dataset and compared. Before augmentation, 35,975 training images and 11,266 validation images were used. After augmentation, 260,499 training and 90,129 validation images were used. A Dice score of 79% for cerebral artery segmentation was achieved using the DeepLabv3+ model trained using an automatically generated dataset. Strict validation in different patient groups was conducted. Arteries were also discerned from the veins using the ICG videoangiography phase. We achieved fair accuracy, which demonstrated the appropriateness of the methodology. This study proved the feasibility of operating field view of the cerebral artery segmentation using deep learning, and the effectiveness of the automatic blood vessel ground truth generation method using ICG fluorescence videoangiography. Using this method, computer vision can discern blood vessels and arteries from veins in a neurosurgical microscope field of view. Thus, this technique is essential for neurosurgical field vessel anatomy-based navigation. In addition, surgical assistance, safety, and autonomous surgery neurorobotics that can detect or manipulate cerebral vessels would require computer vision to identify blood vessels and arteries.

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“…ICG FA is now widely used for the intraoperative assessment of vessel patency. 8 Satisfactory clipping was confirmed by ICG FA again to ensure complete clipping of the aneurysmal neck and patency of the LA.…”

Section: Figurementioning

confidence: 99%

Microvascular decompression and aneurysm clipping for a patient with hemifacial spasm and ipsilateral labyrinthine artery aneurysm: A rare case report and literature review

Liu

Chen

et al. 2021

CNS Neurosci Ther

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Preoperative MRI results showed a vascular anomaly at the REZ of the left facial nerve (Figure A) and an anomaly at the internal auditory canal (Figure B). The left AICA was identified as the offending vessel compressing the left facial nerve at the REZ (Figure C). After the artery was dissociated and Teflon felt was placed between the involved vessel and the facial nerve (Figure D), electrophysiological monitoring indicated that the AMR had disappeared (Figure E).

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Application of Indocyanine Green Videoangiography in Aneurysm Surgery: Evidence, Techniques, Practical Tips

Cited by 24 publications

References 47 publications

An Adjustable Dark-Field Acoustic-Resolution Photoacoustic Imaging System with Fiber Bundle-Based Illumination

An Adjustable Dark-Field Acoustic-Resolution Photoacoustic Imaging System with Fiber Bundle-Based Illumination

Deep-Learning-Based Cerebral Artery Semantic Segmentation in Neurosurgical Operating Microscope Vision Using Indocyanine Green Fluorescence Videoangiography

Microvascular decompression and aneurysm clipping for a patient with hemifacial spasm and ipsilateral labyrinthine artery aneurysm: A rare case report and literature review

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