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Assessing the development status of intraoperative fluorescence imaging for anatomy visualisation, using the IDEAL
Takeaki Ishizawa1,2, Peter McCulloch3, Laurents Stassen4
1Department of Hepatobiliary-Pancreatic Surgery, Osaka Metropolitan University, Osaka, Japan.
BMJ Surgery, Interventions, & Health Technologies
|November 10, 2022
Summary
Intraoperative fluorescence imaging safely enhances anatomical structure identification across multiple surgical procedures. This review, using the IDEAL framework, shows its potential to improve surgical outcomes and guide future research.
Area of Science:
- Surgical Innovation
- Medical Imaging
- Evidence-Based Medicine
Background:
- Intraoperative fluorescence imaging is utilized for anatomy visualization, perfusion assessment, cancer detection, and lymphatic mapping.
- Understanding the research landscape of fluorescence imaging across surgical fields is crucial for evidence-based guidance.
- The IDEAL framework provides a structured approach to evaluate surgical innovation stages.
Purpose of the Study:
- To evaluate the evidence on intraoperative fluorescence imaging for anatomical structure visualization.
- To assess the current research status using the IDEAL framework for five specific surgical procedures.
- To determine the potential of fluorescence imaging to improve surgical outcomes.
Main Methods:
- A comprehensive literature review of publications on intraoperative fluorescence imaging for anatomical visualization.
- Identification of studies in PubMed up to 2020 for cholangiography, hepatic segmentation, lung segmentation, ureterography, and parathyroid identification.
- Application of the IDEAL framework to stage the research evidence for each procedure.
Main Results:
- Analysis of 225 articles (8427 cases) revealed IDEAL stages 2a, 2b, and 3 for the evaluated procedures.
- Fluorescence imaging demonstrated enhanced tissue identification compared to white-light imaging across all five procedures.
- Studies, including randomized controlled trials, showed improved short- and long-term postoperative outcomes, particularly in hepatobiliary and thyroid surgery.
- No adverse reactions to fluorescent agents were reported.
Conclusions:
- Intraoperative fluorescence imaging is a safe modality for enhancing anatomical structure identification.
- The use of fluorescence imaging shows potential for improving postoperative outcomes in various surgical interventions.
- Utilizing the IDEAL framework aids in directing future research to establish fluorescence imaging as a standard intraoperative tool.
