ICG-based dynamic contrast-enhanced fluorescence imaging guided open orthopaedic surgery: pilot patient study

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Biomedical Engineering

Background:

• High-energy open fractures pose challenges in assessing bone viability.
• Objective methods are needed to evaluate bone perfusion and guide surgical interventions.

Purpose of the Study:

• To investigate the utility of indocyanine green (ICG)-based dynamic contrast-enhanced fluorescence imaging (DCE-FI) for assessing bone perfusion.
• To determine if DCE-FI can guide surgical debridement in open fracture cases.

Main Methods:

• Forty-two patients with high-energy open fractures were included.
• Intravenous administration of 0.1 mg/kg of ICG followed by fluorescence imaging.
• Application of a bone-specific kinetic model to video sequences for perfusion metric calculation.

Main Results:

• Quantitative ICG-based DCE-FI accurately assessed human bone perfusion.
• The imaging technique provided objective metrics for bone viability.

Conclusions:

• ICG-based DCE-FI is a reliable tool for evaluating bone perfusion in orthopedic surgery.
• This method can objectively guide debridement decisions in open fracture management.