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The safe values of quantitative perfusion parameters of ICG angiography based on tissue oxygenation of hyperspectral imaging for laparoscopic colorectal surgery: a prospective observational study

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journal contribution
posted on 2024-01-19, 17:08 authored by Gyung Mo Son, Armaan M Nazir, Mi Sook Yun, In Young Lee, Sun Bin Im, Jae Yeong Kwak, Sang-Ho Park, Kwang-Ryul Baek, Ines Gockel

Background: Safe values for quantitative perfusion parameters of indocyanine green (ICG) angiography have not been fully defined, and interpretation remains at the surgeon's discretion. This prospective observational study aimed to establish the safe values for the quantitative perfusion parameters by comparing tissue oxygenation levels from HSI images in laparoscopic colorectal surgery.

Methods: ICG angiography was performed using a laparoscopic near-infrared (NIR) camera system with ICG diluted in 10 mL of distilled water. For quantitative perfusion parameters, the changes in fluorescence intensity with perfusion times were analyzed to plot a time-fluorescence intensity graph. To assess real-time tissue oxygen saturation (StO2) in the colon, the TIVITA® Tissue System was utilized for hyperspectral imaging (HSI) acquisition. The StO2 levels were compared with the quantitative perfusion parameters derived from ICG angiography at corresponding points to define the safe range of ICG parameters reflecting good tissue oxygenation.

Results: In the regression analysis, T1/2MAX, TMAX, slope, and NIR perfusion index were correlated with tissue oxygen saturation. Using this regression model, the cutoff values of quantitative perfusion parameters were calculated as T1/2MAX ≤ 10 s, TMAX ≤ 30 s, slope ≥ 5, and NIR perfusion index ≥50, which best reflected colon StO2 higher than 60%. Diagnostic values were analyzed to predict colon StO2 of 60% or more, and the ICG perfusion parameters T1/2MAX, TMAX, and perfusion TR showed high sensitivity values of 97% or more, indicating their ability to correctly identify cases with acceptable StO2.

Conclusion: The safe values for quantitative perfusion parameters derived from ICG angiography were T1/2MAX ≤ 10 s and TMAX ≤ 30 s, which were associated with colon tissue oxygenation levels higher than 60% in the laparoscopic colorectal surgery.

Funding

Research Institute for Convergence of Biomedical Science and Technology Grant (30-2022-017), Pusan National University Yangsan Hospital.

History

Data Availability Statement

The data presented in this study are available on request from the corresponding author. The data are not publicly available due to ethical and privacy reasons

Comments

The original article is available at https://www.mdpi.com/

Published Citation

Son GM, et al. The safe values of quantitative perfusion parameters of ICG angiography based on tissue oxygenation of hyperspectral imaging for laparoscopic colorectal surgery: a prospective observational study. Biomedicines. 2023;11(7):2029.

Publication Date

19 July 2023

PubMed ID

37509667

Department/Unit

  • Undergraduate Research

Publisher

MDPI

Version

  • Published Version (Version of Record)