Renal oxygenation measurement during partial nephrectomy using hyperspectral imaging may predict acute postoperative...

Area of Science:

• Nephrology
• Surgical Innovation
• Medical Imaging

Background:

• Partial nephrectomy (PN) requires monitoring renal perfusion.
• Digital Light Processing hyperspectral imaging (HsI) offers real-time tissue oxygenation mapping.
• Variability in baseline renal oxygenation was observed during PN.

Purpose of the Study:

• To correlate intraoperative variations in baseline renal oxygenation with postoperative renal function.
• To assess the predictive value of HsI-measured renal oxygenation for postoperative outcomes.
• To investigate if HsI can differentiate patient risk for renal insufficiency.

Main Methods:

• Hyperspectral images were acquired during PN for cortical tumors.
• Oxyhemoglobin percentage (%HbO2) was calculated from visible light reflectance.
• Patients were categorized into high (>75% HbO2) and low (<75% HbO2) baseline oxygenation groups.
• Postoperative estimated glomerular filtration rate (eGFR) was evaluated.

Main Results:

• Nineteen patients had low baseline %HbO2 (mean 69%), and 7 had high %HbO2 (mean 77%).
• No significant differences in tumor size, hematocrit, clamp time, or preoperative eGFR between groups.
• Patients with low baseline %HbO2 showed a significant eGFR decline (-20%, P<0.01).
• Patients with high baseline %HbO2 had no significant postoperative eGFR change (+4%).

Conclusions:

• Baseline renal oxygenation measured by HsI can predict the risk of postoperative renal insufficiency.
• HsI provides individualized renal function assessment during PN.
• Intraoperative HsI data can guide decision-making to preserve renal function.