Quantitative Fluorescence Imaging of Perfusion—An Algorithm to Predict Anastomotic Leakage
Sanne M. Jansen,
Daniel M. de Bruin,
Leah S. Wilk,
Mark I. van Berge Henegouwen,
Simon D. Strackee,
Suzanne S. Gisbertz,
Ed T. van Bavel,
Ton G. van Leeuwen
Affiliations
Sanne M. Jansen
Amsterdam UMC, Unit L0, Department of Biomedical Engineering & Physics, Faculty of Medicine, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Daniel M. de Bruin
Amsterdam UMC, Unit L0, Department of Biomedical Engineering & Physics, Faculty of Medicine, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Leah S. Wilk
Amsterdam UMC, Unit L0, Department of Biomedical Engineering & Physics, Faculty of Medicine, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Mark I. van Berge Henegouwen
Amsterdam UMC, Department of Surgery, Cancer Center Amsterdam, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Simon D. Strackee
Amsterdam UMC, Unit G4, Department of Plastic, Reconstructive and Hand Surgery, Faculty of Medicine, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Suzanne S. Gisbertz
Amsterdam UMC, Department of Surgery, Cancer Center Amsterdam, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Ed T. van Bavel
Amsterdam UMC, Unit L0, Department of Biomedical Engineering & Physics, Faculty of Medicine, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Ton G. van Leeuwen
Amsterdam UMC, Unit L0, Department of Biomedical Engineering & Physics, Faculty of Medicine, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
This study tests fluorescence imaging-derived quantitative parameters for perfusion evaluation of the gastric tube during surgery and correlates these parameters with patient outcomes in terms of anastomotic leakage. Poor fundus perfusion is seen as a major factor for the development of anastomotic leakage and strictures. Fluorescence perfusion imaging may reduce the incidence of complications. Parameters for the quantification of the fluorescence signal are still lacking. Quantitative parameters in terms of maximal intensity, mean slope and influx timepoint were tested for significant differences between four perfusion areas of the gastric tube in 22 patients with a repeated ANOVA test. These parameters were compared with patient outcomes. Maximal intensity, mean slope and influx timepoint were significantly different between the base of the gastric tube and the fundus (p p < 0.0001). This study presents quantitative intra-operative perfusion imaging with fluorescence. Quantification of the fluorescence signal allows for early risk stratification of necrosis.
