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Murine Endoscopy for In Vivo Multimodal Imaging of Carcinogenesis and Assessment of Intestinal Wound Healing and Inflammation
Published on: August 26, 2014
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Computer-assisted quantification and visualization of bowel perfusion using fluorescence-based enhanced reality in
Antonio D'Urso1, Vincent Agnus2, Manuel Barberio2
1Department of General, Digestive, and Endocrine Surgery, University Hospital of Strasbourg, 1, place de l'Hôpital, 67091, Strasbourg, France.
Surgical Endoscopy
|August 29, 2020
Summary
Fluorescence-based enhanced reality (FLER) accurately assesses bowel perfusion during colorectal surgery by correlating with metabolic markers. This technology provides a reproducible estimation, aiding in surgical decision-making and potentially reducing complications.
Area of Science:
- Surgical Innovation
- Medical Imaging
- Gastroenterology
Background:
- Fluorescence-based enhanced reality (FLER) is a novel computer-based quantification method for fluorescence angiographies.
- It is utilized to evaluate bowel perfusion, a critical factor in surgical outcomes.
Purpose of the Study:
- To assess the clinical feasibility of FLER in colorectal resections.
- To correlate FLER findings with metabolic markers of bowel perfusion.
Main Methods:
- FLER analysis was performed on 22 patients undergoing diverticulitis or colorectal cancer resections.
- Indocyanine green fluorescence was captured and computed into a color-coded map overlaid onto the bowel.
- Intestinal lactates and mitochondria efficiency (acceptor control ratio) were measured from surgical specimens at identified regions of interest.
Main Results:
- FLER demonstrated correlation with local capillary lactates proximally (rho=0.89, p=0.0006) and distally (rho=0.73, p=0.0021).
- FLER values correlated with mitochondria efficiency (ACR) proximally (rho=0.76, p=0.04) and in ischemic zones (rho=0.71, p=0.01).
- Higher lactates and reduced ACR were observed in complicated cases, indicating impaired perfusion.
Conclusions:
- FLER enables the imaging of quantified fluorescence signals in augmented reality.
- It provides a reproducible and reliable estimation of bowel perfusion during colorectal surgery.
- This technology can aid in identifying perfusion deficits and guiding surgical decisions.
