Intraoperative Imaging Techniques to Visualize Hepatic (Micro)Perfusion: An Overview

Area of Science:

• Hepatology
• Medical Imaging
• Microcirculation Research

Background:

• Microcirculation is key for organ perfusion.
• Dysfunction in microcirculation predicts morbidity and mortality.
• Liver perfusion assessment reveals the liver's physiological state.

Purpose of the Study:

• To review intraoperative perfusion imaging techniques for the liver.
• To discuss the advantages, disadvantages, and applications of these methods.

Main Methods:

• Dynamic contrast-enhanced ultrasound (DCE-US) for deep tissue and tumor perfusion.
• Handheld vital microscopy for direct visualization of liver sinusoidal architecture.
• Indocyanine green (ICG) fluorescence angiography for microvascular perfusion.
• Laser speckle contrast imaging (LSCI) for non-contact, large-area tissue perfusion.

Main Results:

• DCE-US is valuable for tumor perfusion assessment.
• Vital microscopy offers unique visualization of liver sinusoids.
• ICG fluorescence angiography visualizes microvascular perfusion using near-infrared light.
• LSCI provides artifact-free perfusion imaging over large areas.

Conclusions:

• Various intraoperative perfusion imaging techniques offer distinct advantages for liver assessment.
• These modalities provide critical insights into liver (patho)physiology.
• Understanding these techniques aids in clinical and scientific applications for liver health.