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Open AccessFeature PaperArticle

Comparison of Optical Imaging Techniques to Quantitatively Assess the Perfusion of the Gastric Conduit during Oesophagectomy

1
Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
2
Department of Biomedical Engineering & Physics, Cancer Center Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Appl. Sci. 2020, 10(16), 5522; https://doi.org/10.3390/app10165522
Received: 5 July 2020 / Revised: 2 August 2020 / Accepted: 5 August 2020 / Published: 10 August 2020
In this study, four optical techniques—Optical Coherence Tomography, Sidestream Darkfield Microscopy, Laser Speckle Contrast Imaging, and Fluorescence Angiography (FA)—were compared on performing an intraoperative quantitative perfusion assessment of the gastric conduit during oesophagectomy. We hypothesised that the quantitative parameters show decreased perfusion towards the fundus in the gastric conduit and in patients with anastomotic leakage. In a prospective study in patients undergoing oesophagectomy with gastric conduit reconstruction, measurements were taken with all four optical techniques at four locations from the base towards the fundus in the gastric conduit (Loc1, Loc2, Loc3, Loc4). The primary outcome included 14 quantitative parameters and the anastomotic leakage rate. Imaging was performed in 22 patients during oesophagectomy. Ten out of 14 quantitative parameters significantly indicated a reduced perfusion towards the fundus of the gastric conduit. Anastomotic leakage occurred in 4/22 patients (18.4%). At Loc4, the FA quantitative values for “T1/2” and “mean slope” differed between patients with and without anastomotic leakage (p = 0.025 and p = 0.041, respectively). A quantitative perfusion assessment during oesophagectomy is feasible using optical imaging techniques, of which FA is the most promising for future research. View Full-Text
Keywords: optical imaging; fluorescence imaging; fluorescence angiography; indocyanine green (ICG); optical coherence tomography (OCT); laser speckle contrast imaging (LSCI); esophagectomy; gastric conduit; Sidestream Darkfield Microscopy (SDF); multispectral optical imaging; fluorescence imaging; fluorescence angiography; indocyanine green (ICG); optical coherence tomography (OCT); laser speckle contrast imaging (LSCI); esophagectomy; gastric conduit; Sidestream Darkfield Microscopy (SDF); multispectral
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Slooter, M.D.; Jansen, S.M.A.; Bloemen, P.R.; van den Elzen, R.M.; Wilk, L.S.; van Leeuwen, T.G.; van Berge Henegouwen, M.I.; de Bruin, D.M.; Gisbertz, S.S. Comparison of Optical Imaging Techniques to Quantitatively Assess the Perfusion of the Gastric Conduit during Oesophagectomy. Appl. Sci. 2020, 10, 5522.

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