Real-time visualization of renal microperfusion using laser speckle contrast imaging

Area of Science:

• Nephrology
• Surgical Imaging
• Hemodynamics

Background:

• Intraoperative renal cortical microperfusion (RCM) is crucial for predicting postoperative ischemia/reperfusion injury.
• Current monitoring methods lack the real-time, non-contact capabilities needed for optimal assessment.

Purpose of the Study:

• To validate laser speckle contrast imaging (LSCI) for visualizing RCM.
• To assess LSCI's performance in various hemodynamic conditions using ex vivo perfused porcine kidneys.

Main Methods:

• Comparison of LSCI with total arterial renal blood flow (RBF) and sidestream dark-field (SDF) imaging.
• Evaluation across different ischemia/reperfusion models in human-sized porcine kidneys.

Main Results:

• LSCI demonstrated strong correlation with RBF during reperfusion (0.94 ± 0.02) and ischemia (0.90 ± 0.03 to 0.81 ± 0.08).
• LSCI showed superior correlation with SDF (0.81 ± 0.10) compared to RBF (0.54 ± 0.22) in certain conditions.
• Correlation decreased in low-flow states due to RBF redistribution.

Conclusions:

• LSCI provides high-resolution, real-time imaging of RCM.
• It can instantaneously identify local perfusion deficits, surpassing current standards.
• LSCI holds potential for improving clinical decision-making in transplant surgery.