Simultaneous Assessment of Luminal Integrity and Vascular Perfusion of the Gastrointestinal Tract Using Dual-Channel Near-Infrared Fluorescence
Anastomotic complications such as stenosis and leakage in the gastrointestinal (GI) tract can cause high patient morbidity and mortality. To identify the potential preconditions of these complications intraoperatively, we explored the use of two 700 nm near-infrared (NIR) fluorophores administered i...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publications
2012-07-01
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| Series: | Molecular Imaging |
| Online Access: | https://doi.org/10.2310/7290.2011.00048 |
| _version_ | 1797283951146958848 |
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| author | Yoshitomo Ashitate Carrie S. Vooght Merlijn Hutteman Rafiou Oketokoun Hak Soo Choi John V. Frangioni |
| author_facet | Yoshitomo Ashitate Carrie S. Vooght Merlijn Hutteman Rafiou Oketokoun Hak Soo Choi John V. Frangioni |
| author_sort | Yoshitomo Ashitate |
| collection | DOAJ |
| description | Anastomotic complications such as stenosis and leakage in the gastrointestinal (GI) tract can cause high patient morbidity and mortality. To identify the potential preconditions of these complications intraoperatively, we explored the use of two 700 nm near-infrared (NIR) fluorophores administered intraluminally: (1) chlorella, an over-the-counter herbal supplement containing high concentrations of chlorophyll, and (2) methylene blue (MB). In parallel, we administered the 800 nm NIR fluorophore indocyanine green (ICG) intravenously to assess vascular function. Dual-channel, real-time intraoperative imaging and quantitation of the contrast to background ratio (CBR) were performed under normal conditions or after anastomosis or leakage of the stomach and intestines in 35 kg Yorkshire pigs using the Fluorescence-Assisted Resection and Exploration (FLARE) imaging system. Luminal integrity could be assessed with relatively high sensitivity with either chlorella or MB, although chlorella provided significantly higher CBR. ICG angiography provided assessment of blood perfusion of normal, ischemic, and anastomotic areas of the GI tract. Used simultaneously, 700 nm (chlorella or MB) and 800 nm (ICG) NIR fluorescence permitted independent assessment of luminal integrity and vascular perfusion of the GI tract intraoperatively and in real time. This technology has the potential to identify critical complications, such as anastomotic leakage, intraoperatively, when correction is still possible. |
| first_indexed | 2024-03-07T17:38:04Z |
| format | Article |
| id | doaj.art-81d1dee466034218a67e9c19a6402e9e |
| institution | Directory Open Access Journal |
| issn | 1536-0121 |
| language | English |
| last_indexed | 2024-03-07T17:38:04Z |
| publishDate | 2012-07-01 |
| publisher | SAGE Publications |
| record_format | Article |
| series | Molecular Imaging |
| spelling | doaj.art-81d1dee466034218a67e9c19a6402e9e2024-03-02T16:20:33ZengSAGE PublicationsMolecular Imaging1536-01212012-07-011110.2310/7290.2011.0004810.2310_7290.2011.00048Simultaneous Assessment of Luminal Integrity and Vascular Perfusion of the Gastrointestinal Tract Using Dual-Channel Near-Infrared FluorescenceYoshitomo AshitateCarrie S. VooghtMerlijn HuttemanRafiou OketokounHak Soo ChoiJohn V. FrangioniAnastomotic complications such as stenosis and leakage in the gastrointestinal (GI) tract can cause high patient morbidity and mortality. To identify the potential preconditions of these complications intraoperatively, we explored the use of two 700 nm near-infrared (NIR) fluorophores administered intraluminally: (1) chlorella, an over-the-counter herbal supplement containing high concentrations of chlorophyll, and (2) methylene blue (MB). In parallel, we administered the 800 nm NIR fluorophore indocyanine green (ICG) intravenously to assess vascular function. Dual-channel, real-time intraoperative imaging and quantitation of the contrast to background ratio (CBR) were performed under normal conditions or after anastomosis or leakage of the stomach and intestines in 35 kg Yorkshire pigs using the Fluorescence-Assisted Resection and Exploration (FLARE) imaging system. Luminal integrity could be assessed with relatively high sensitivity with either chlorella or MB, although chlorella provided significantly higher CBR. ICG angiography provided assessment of blood perfusion of normal, ischemic, and anastomotic areas of the GI tract. Used simultaneously, 700 nm (chlorella or MB) and 800 nm (ICG) NIR fluorescence permitted independent assessment of luminal integrity and vascular perfusion of the GI tract intraoperatively and in real time. This technology has the potential to identify critical complications, such as anastomotic leakage, intraoperatively, when correction is still possible.https://doi.org/10.2310/7290.2011.00048 |
| spellingShingle | Yoshitomo Ashitate Carrie S. Vooght Merlijn Hutteman Rafiou Oketokoun Hak Soo Choi John V. Frangioni Simultaneous Assessment of Luminal Integrity and Vascular Perfusion of the Gastrointestinal Tract Using Dual-Channel Near-Infrared Fluorescence Molecular Imaging |
| title | Simultaneous Assessment of Luminal Integrity and Vascular Perfusion of the Gastrointestinal Tract Using Dual-Channel Near-Infrared Fluorescence |
| title_full | Simultaneous Assessment of Luminal Integrity and Vascular Perfusion of the Gastrointestinal Tract Using Dual-Channel Near-Infrared Fluorescence |
| title_fullStr | Simultaneous Assessment of Luminal Integrity and Vascular Perfusion of the Gastrointestinal Tract Using Dual-Channel Near-Infrared Fluorescence |
| title_full_unstemmed | Simultaneous Assessment of Luminal Integrity and Vascular Perfusion of the Gastrointestinal Tract Using Dual-Channel Near-Infrared Fluorescence |
| title_short | Simultaneous Assessment of Luminal Integrity and Vascular Perfusion of the Gastrointestinal Tract Using Dual-Channel Near-Infrared Fluorescence |
| title_sort | simultaneous assessment of luminal integrity and vascular perfusion of the gastrointestinal tract using dual channel near infrared fluorescence |
| url | https://doi.org/10.2310/7290.2011.00048 |
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