Intraoperative Perfusion Assessment in Enhanced Reality Using Quantitative Optical Imaging: An Experimental Study in a Pancreatic Partial Ischemia Model

Wakabayashi, Taiga; Barberio, Manuel; Urade, Takeshi; Pop, Raoul; Seyller, Emilie; Pizzicannella, Margherita; Mascagni, Pietro; Charles, Anne; Abe, Yuta; Gény, Bernard; Baiocchini, Andrea; Kitagawa, Yuko; Marescaux, Jacques; Felli, Eric; Diana, Michele

doi:10.3390/diagnostics11010093

Cited by 17 publications

(13 citation statements)

References 46 publications

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“…In this way, the clinical relevance of the perfusion maps and the iPPG signal as an objective perfusion indicator could be established and the predictive value of this method could be assessed. Additionally, comparing iPPG with imaging techniques that assess different perfusion parameters, such as HSI that acquires oxygen maps from tissues [8], will provide more detailed information about the intraoperative performance.…”

Section: Discussionmentioning

confidence: 99%

“…Several techniques are being researched to objectively assess tissue perfusion intraoperatively, such as fluorescence imaging, laser Doppler and hyperspectral imaging (HSI) [6][7][8]. The main limitations of those techniques are the dependence of indocyanine green (ICG) injections (fluorescence imaging), the limited field of view or disruption of the analysis due to intrinsic or extrinsic motions (laser Doppler).…”

Section: Introductionmentioning

confidence: 99%

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Imaging PPG for In Vivo Human Tissue Perfusion Assessment during Surgery

et al. 2022

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Surgical excision is the golden standard for treatment of intestinal tumors. In this surgical procedure, inadequate perfusion of the anastomosis can lead to postoperative complications, such as anastomotic leakages. Imaging photoplethysmography (iPPG) can potentially provide objective and real-time feedback of the perfusion status of tissues. This feasibility study aims to evaluate an iPPG acquisition system during intestinal surgeries to detect the perfusion levels of the microvasculature tissue bed in different perfusion conditions. This feasibility study assesses three patients that underwent resection of a portion of the small intestine. Data was acquired from fully perfused, non-perfused and anastomosis parts of the intestine during different phases of the surgical procedure. Strategies for limiting motion and noise during acquisition were implemented. iPPG perfusion maps were successfully extracted from the intestine microvasculature, demonstrating that iPPG can be successfully used for detecting perturbations and perfusion changes in intestinal tissues during surgery. This study provides proof of concept for iPPG to detect changes in organ perfusion levels.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Imaging PPG for In Vivo Human Tissue Perfusion Assessment during Surgery

et al. 2022

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“…After the creation of a pancreatic partial ischemia model, researchers were able to quantify perfusion in porcine pancreas using a multimodal optical approach [46]. Among the techniques, HSI (with HYPER) was used, and it could successfully quantify pancreatic blood perfusion correlating well with ischemia biomarkers and other optical imaging techniques (such as FA and CLE).…”

Section: Perfusion Assessment In Hepatopancreaticobiliary Surgery (Hpb)mentioning

confidence: 99%

Intraoperative Guidance Using Hyperspectral Imaging: A Review for Surgeons

Barberio

Benedicenti²,

Pizzicannella³

et al. 2021

Diagnostics

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Hyperspectral imaging (HSI) is a novel optical imaging modality, which has recently found diverse applications in the medical field. HSI is a hybrid imaging modality, combining a digital photographic camera with a spectrographic unit, and it allows for a contactless and non-destructive biochemical analysis of living tissue. HSI provides quantitative and qualitative information of the tissue composition at molecular level in a contrast-free manner, hence making it possible to objectively discriminate between different tissue types and between healthy and pathological tissue. Over the last two decades, HSI has been increasingly used in the medical field, and only recently it has found an application in the operating room. In the last few years, several research groups have used this imaging modality as an intraoperative guidance tool within different surgical disciplines. Despite its great potential, HSI still remains far from being routinely used in the daily surgical practice, since it is still largely unknown to most of the surgical community. The aim of this study is to provide clinical surgeons with an overview of the capabilities, current limitations, and future directions of HSI for intraoperative guidance.

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“…For example, hyperspectral imaging (HSI) provides spatial image data in several contiguous spectral bands to reveal subtle spectral differences in objects. HSI can be used as a widefield intraoperative imaging method to aid tissue demarcation and identification, its potential having been demonstrated in a variety of surgical applications, such as: brain [6]- [9], heart [10] [11], breast [12]- [14], pancreatic [15] [16], intestinal [17]- [23], kidney [25]- [28], liver [29]- [31], skin [32]- [37] and reproductive organ surgery [38] [39]. Despite the promising results of intra-operative HSI, up to now its clinical adaption is hampered by the challenges of integrating the imaging method into pre-existing clinical instrumentation and workflows.…”

Section: Introductionmentioning

confidence: 99%

Integrating hyperspectral imaging in an existing intra-operative environment for detection of intrinsic brain tumors

Vandebriel

Luthman²,

Vunckx³

et al. 2023

Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XXI

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Label-free tissue identification is the new frontier of image guided surgery. One of the most promising modalities is hyperspectral imaging (HSI). Until now, the use of HSI has, however, been limited due to the challenges of integration into the existing clinical workflow. Research to reduce the implementation effort and simplifying the clinical approval procedure is ongoing, especially for the acquisition of feasibility datasets to evaluate HSI methods for specific clinical applications. Here, we successfully demonstrate how an HSI system can interface with a clinically approved surgical microscope making use of the microscope's existing optics. We outline the HSI system adaptations, the data pre-processing methods, perform a spectral and functional system level validation and integration into the clinical workflow. Data were acquired using an imec snapscan VNIR 150 camera enabling hyperspectral measurement in 150 channels in the 470-900 nm range, assembled on a ZEISS OPMI Pentero 900 surgical microscope. The spectral range of the camera was adapted to match the intrinsic illumination of the microscope resulting in 104 channels in the range of 470-787 nm. The system's spectral performance was validated using reflectance wavelength calibration standards. We integrated the HSI system into the clinical workflow of a brain surgery, specifically for resections of low-grade gliomas (LGG). During the study, but out of scope of this paper, the acquired dataset was used to train an AI algorithm to successfully detect LGG in unseen data. Furthermore, dominant spectral channels were identified enabling the future development of a real-time surgical guidance system.

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Intraoperative Perfusion Assessment in Enhanced Reality Using Quantitative Optical Imaging: An Experimental Study in a Pancreatic Partial Ischemia Model

Cited by 17 publications

References 46 publications

Imaging PPG for In Vivo Human Tissue Perfusion Assessment during Surgery

Imaging PPG for In Vivo Human Tissue Perfusion Assessment during Surgery

Intraoperative Guidance Using Hyperspectral Imaging: A Review for Surgeons

Integrating hyperspectral imaging in an existing intra-operative environment for detection of intrinsic brain tumors

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