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Quantification of ICG fluorescence for the evaluation of intestinal perfusion: comparison between two software-based
Kristina Gosvig1,2, Signe Steenstrup Jensen3,4, Niels Qvist3,4
1Research Unit for Surgery, Odense University Hospital, J. B. Winsløws Vej 4, Indgang 20, Penthouse, 5000, Odense C, Denmark. kristinagosvig@gmail.com.
Surgical Endoscopy
|September 24, 2020
Summary
Two software algorithms for quantifying indocyanine green fluorescence imaging (ICG-FI) showed significant differences in assessing intestinal perfusion. These discrepancies were most pronounced at very high or very low perfusion levels, with clinical relevance yet to be determined.
Area of Science:
- Surgical Innovation
- Medical Imaging Technology
- Gastrointestinal Surgery
Background:
- Indocyanine green fluorescence imaging (ICG-FI) is utilized for assessing intestinal perfusion before surgical anastomosis.
- Existing software for ICG-FI quantification lacks comparative analysis.
- This study addresses the need to compare different ICG-FI quantification algorithms.
Purpose of the Study:
- To compare quantitative indocyanine green fluorescence imaging (ICG-FI) analysis of relative intestinal perfusion.
- To evaluate two distinct software-based quantification algorithms: FLER and Q-ICG.
- To assess performance in an experimental setting.
Main Methods:
- Twenty pigs underwent laparotomy with induced ischemia in three small intestine segments.
- Fluorescence imaging was performed on ischemic areas, with data analyzed by FLER and Q-ICG algorithms.
- Comparisons involved normalized slope, relative perfusion percentage calculation, and ischemic area length measurement.
Main Results:
- Fifty-four fluorescence recordings from 18 pigs were analyzed.
- FLER and Q-ICG showed significant differences in ischemic segment length and normalized slope at 30% and 100% relative perfusion.
- Q-ICG quantified FLER-defined 30%, 60%, and 100% perfusion as 35.2%, 63.7%, and 84.1%, respectively.
Conclusions:
- The two software algorithms exhibit significant quantitative differences in ICG-FI analysis, particularly at extreme perfusion levels.
- The clinical implications of these observed differences require further investigation.
- Further research is needed to clarify the clinical relevance of these algorithmic disparities.
