Intraoperative Multimodal Bowel Perfusion Quantification Combining Hyperspectral Imaging and Indocyanine Green

Area of Science:

• Medical Imaging
• Surgical Technology
• Gastroenterology

Background:

• Intraoperative perfusion imaging is crucial for selecting anastomosis sites in colorectal surgery to prevent leaks.
• Indocyanine green-fluorescence angiography (ICG-FA) and hyperspectral imaging (HSI) are emerging modalities but have limitations.
• A comparative analysis and integrated framework for ICG-FA and HSI are needed to optimize their use.

Purpose of the Study:

• To compare quantitative perfusion parameters derived from ICG-FA and HSI.
• To develop a computational framework for combining ICG-FA and HSI data.
• To assess the feasibility of reconstructing ICG-mimicking images from HSI data.

Main Methods:

• Conducted simultaneous ICG-FA and HSI in 26 colorectal surgery patients.
• Compared the identified perfusion transition zones and quantitative parameters between modalities.
• Acquired HSI data before, during, and after ICG-FA for signal reconstruction and analysis.

Main Results:

• Anastomotic leakage occurred in one patient.
• Reconstructed ICG images from HSI data closely matched ground truth in 21 cases.
• ICG administration showed no significant influence on HSI-derived tissue parameters.

Conclusions:

• Subtle differences exist between ICG-based blood flow and HSI-derived tissue oxygenation.
• A combined approach using one HSI system with an ICG reconstruction framework enables comprehensive intraoperative perfusion analysis.
• Further research is required to optimize the combined use of HSI and ICG regarding dosage and timing.