Diagnostics (Jan 2021)

Intraoperative Perfusion Assessment in Enhanced Reality Using Quantitative Optical Imaging: An Experimental Study in a Pancreatic Partial Ischemia Model

  • Taiga Wakabayashi,
  • Manuel Barberio,
  • Takeshi Urade,
  • Raoul Pop,
  • Emilie Seyller,
  • Margherita Pizzicannella,
  • Pietro Mascagni,
  • Anne-Laure Charles,
  • Yuta Abe,
  • Bernard Geny,
  • Andrea Baiocchini,
  • Yuko Kitagawa,
  • Jacques Marescaux,
  • Eric Felli,
  • Michele Diana

DOI
https://doi.org/10.3390/diagnostics11010093
Journal volume & issue
Vol. 11, no. 1
p. 93

Abstract

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To reduce the risk of pancreatic fistula after pancreatectomy, a satisfactory blood flow at the pancreatic stump is considered crucial. Our group has developed and validated a real-time computational imaging analysis of tissue perfusion, using fluorescence imaging, the fluorescence-based enhanced reality (FLER). Hyperspectral imaging (HSI) is another emerging technology, which provides tissue-specific spectral signatures, allowing for perfusion quantification. Both imaging modalities were employed to estimate perfusion in a porcine model of partial pancreatic ischemia. Perfusion quantification was assessed using the metrics of both imaging modalities (slope of the time to reach maximum fluorescence intensity and tissue oxygen saturation (StO2), for FLER and HSI, respectively). We found that the HSI-StO2 and the FLER slope were statistically correlated using the Spearman analysis (R = 0.697; p = 0.013). Local capillary lactate values were statistically correlated to the HSI-StO2 and to the FLER slope (R = −0.88; p p = 0.0074). HSI-based and FLER-based lactate prediction models had statistically similar predictive abilities (p = 0.112). Both modalities are promising to assess real-time pancreatic perfusion. Clinical translation in human pancreatic surgery is currently underway.

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