Hyperspectral Imaging in Major Hepatectomies: Preliminary Results from the Ex-Machyna Trial

Abstract

Ischemia-reperfusion injury during major hepatic resections is associated with high rates of post-operative complications and liver failure. Real-time intra-operative detection of liver dysfunction could provide great insight into clinical outcomes. In the present study, we demonstrate the intra-operative application of a novel optical technology, hyperspectral imaging (HSI), to predict short-term post-operative outcomes after major hepatectomy. We considered fifteen consecutive patients undergoing major hepatic resection for malignant liver lesions from January 2020 to June 2021. HSI measures included tissue water index (TWI), organ hemoglobin index (OHI), tissue oxygenation (StO2%), and near infrared (NIR). Pre-operative, intra-operative, and post-operative serum and clinical outcomes were collected. NIR values were higher in unhealthy liver tissue (p = 0.003). StO2% negatively correlated with post-operative serum ALT values (r = −0.602), while ΔStO2% positively correlated with ALP (r = 0.594). TWI significantly correlated with post-operative reintervention and OHI with post-operative sepsis and liver failure. In conclusion, the HSI imaging system is accurate and precise in translating from pre-clinical to human studies in this first clinical trial. HSI indices are related to serum and outcome metrics. Further experimental and clinical studies are necessary to determine clinical value of this technology.

Partial Hepatic Vein Occlusion and Venous Congestion in Liver Exploration Using a Hyperspectral Camera: A Proposal for Monitoring Intraoperative Liver Perfusion

“…Potential surgical applications of the hyperspectral camera’s indexes have already been investigated [ 15 , 16 , 17 ], but another valuable application of our method could be the intraoperative estimation of remnant liver congestion. Recently, it has been reported that remnant liver ischemia should be carefully considered in human oncological settings because of a significantly increased risk of morbidity, recurrence, and mortality [ 5 ].…”

In Vitro Antibody Quantification with Hyperspectral Imaging in a Large Field of View for Clinical Applications

“…HSI is a non-invasive, contrast-free tool recently applied in several medical and basic research fields [ 5 , 6 ], like other new emerging technologies [ 7 , 8 ]. Several innovative approaches are under investigation that exploit the capability of HSI to “see beyond” the visible range, such as intraoperative tissue recognition [ 9 ], therapy guidance, and monitoring [ 10 , 11 , 12 , 13 , 14 ].…”

Spectral Characterization and Identification of Natural and Regenerated Leather Based on Hyperspectral Imaging System

“…Hyperspectral imaging technology (HIT) is the most representative, which has the advantage of "image and spectrum in one", with high resolution, continuous channels, more wavebands, and more vital discriminatory ability [13]. HIT originated in remote sensing and has since been widely used in many fields such as feature identification [14,15], environmental monitoring [16,17], agricultural quality inspection [18,19], medical diagnosis [20,21], and criminal forensic investigation [22,23].…”