Quantitative perfusion assessment using indocyanine green during surgery - current applications and recommendations...

Area of Science:

• Surgical assessment
• Medical imaging technology
• Biomedical engineering

Background:

• Accurate tissue perfusion evaluation is vital in surgery to prevent complications.
• Near-infrared (NIR) fluorescence imaging with Indocyanine Green (ICG) shows promise for perfusion assessment.
• Objective quantification of ICG fluorescence is necessary for reproducible perfusion analysis.

Purpose of the Study:

• To review methods for quantifying ICG NIR fluorescence imaging for tissue perfusion.
• To provide an overview of currently used clinical software for ICG perfusion quantification.
• To highlight the need for standardization in ICG perfusion assessment.

Main Methods:

• A PubMed search was conducted for clinical studies on ICG NIR fluorescence imaging quantification.
• Data on camera systems and quantification methodologies were collected.
• Narrative review of identified literature.

Main Results:

• Eleven software programs for ICG perfusion quantification were identified.
• Five programs (Flow® 800, ROIs Software, IC Calc, SPY-Q™, Quest Research Framework®) appeared in multiple studies.
• Normalization of fluorescence intensity was noted in two software implementations.

Conclusions:

• Multiple software solutions exist for ICG fluorescence quantification.
• Intraoperative applications remain limited, with diverse quantification methods.
• Standardization of methods and data acquisition is essential for reliable ICG perfusion assessment.