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Vogt F, Wagner T, Katou S, Kneifel F, Vogel T, Morgül H, Houben P, Wahl P, Pascher A, Radunz S. Hyperspectral imaging of human liver allografts for prediction of initial graft function. Langenbecks Arch Surg 2024; 409:306. [PMID: 39400566 PMCID: PMC11473603 DOI: 10.1007/s00423-024-03497-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 09/30/2024] [Indexed: 10/15/2024]
Abstract
PURPOSE Ischemia reperfusion injury represents a significant yet difficult to assess risk factor for short- and long-term graft impairment in human liver transplantation (LT). As a non-invasive, non-ionizing tool, hyperspectral imaging (HSI) is capable of correlating optical properties with organ microperfusion. Hence, we here performed a study of human liver allografts assessed by HSI for microperfusion and prediction of initial graft function. METHODS Images of liver parenchyma of 37 human liver allografts were acquired at bench preparation, during normothermic machine perfusion (NMP), if applicable, and after reperfusion in the recipient. A specialized HSI acquisition software computed oxygen saturation (StO2), tissue hemoglobin indices (THI), near infrared perfusion indices (NIR), and tissue water indices (TWI). HSI parameters were analyzed for differences with regard to preservation technique, reperfusion sequence and presence of early allograft dysfunction (EAD). RESULTS Organ preservation was performed by means of NMP (n = 31) or static cold storage (SCS; n = 6). Patients' demographics, donor characteristics, presence of EAD (NMP 36.7% vs. SCS 50%, p = 0.6582), and HSI parameters were comparable between both groups of preservation method. In organs developing EAD, NIR at 1, 2, and 4 h NMP and after reperfusion in the recipient was significantly lower (1 h NMP: 18.6 [8.6-27.6] vs. 28.3 [22.5-39.4], p = 0.0468; 2 h NMP: 19.4 [8.7-30.4] vs. 37.1 [27.5-44.6], p = 0.0011; 4 h NMP: 26.0 [6.8-37.1] vs. 40.3 [32.3-49.9], p = 0.0080; reperfusion: 13.0 [11.5-34.3] vs. 30.6 [19.3-44.0], p = 0.0212). CONCLUSION HSI assessment of human liver allografts is feasible during organ preservation and in the recipient. NIR during NMP and after reperfusion might predict the onset of EAD. Larger trials are warranted for assessment of this novel technique in human LT.
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Affiliation(s)
- Franziska Vogt
- Department of General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Tristan Wagner
- Department of General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Shadi Katou
- Department of General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Felicia Kneifel
- Department of General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Thomas Vogel
- Department of General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Haluk Morgül
- Department of General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Philipp Houben
- Department of General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Philip Wahl
- Diaspective Vision GmbH, Strandstraße 15, 18233, Am Salzhaff, Germany
| | - Andreas Pascher
- Department of General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Sonia Radunz
- Department of General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany.
- Department of General, Visceral and Transplant Surgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
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Schmidt VM, Zelger P, Wöss C, Fodor M, Hautz T, Schneeberger S, Huck CW, Arora R, Brunner A, Zelger B, Schirmer M, Pallua JD. Handheld hyperspectral imaging as a tool for the post-mortem interval estimation of human skeletal remains. Heliyon 2024; 10:e25844. [PMID: 38375262 PMCID: PMC10875450 DOI: 10.1016/j.heliyon.2024.e25844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/21/2024] Open
Abstract
In forensic medicine, estimating human skeletal remains' post-mortem interval (PMI) can be challenging. Following death, bones undergo a series of chemical and physical transformations due to their interactions with the surrounding environment. Post-mortem changes have been assessed using various methods, but estimating the PMI of skeletal remains could still be improved. We propose a new methodology with handheld hyperspectral imaging (HSI) system based on the first results from 104 human skeletal remains with PMIs ranging between 1 day and 2000 years. To differentiate between forensic and archaeological bone material, the Convolutional Neural Network analyzed 65.000 distinct diagnostic spectra: the classification accuracy was 0.58, 0.62, 0.73, 0.81, and 0.98 for PMIs of 0 week-2 weeks, 2 weeks-6 months, 6 months-1 year, 1 year-10 years, and >100 years, respectively. In conclusion, HSI can be used in forensic medicine to distinguish bone materials >100 years old from those <10 years old with an accuracy of 98%. The model has adequate predictive performance, and handheld HSI could serve as a novel approach to objectively and accurately determine the PMI of human skeletal remains.
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Affiliation(s)
- Verena-Maria Schmidt
- Institute of Forensic Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria
| | - Philipp Zelger
- University Clinic for Hearing, Voice and Speech Disorders, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Claudia Wöss
- Institute of Forensic Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria
| | - Margot Fodor
- OrganLifeTM, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Theresa Hautz
- OrganLifeTM, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefan Schneeberger
- OrganLifeTM, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Wolfgang Huck
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, 6020 Innsbruck, Austria
| | - Rohit Arora
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Andrea Brunner
- Institute of Pathology, Neuropathology, and Molecular Pathology, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - Bettina Zelger
- Institute of Pathology, Neuropathology, and Molecular Pathology, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - Michael Schirmer
- Department of Internal Medicine, Clinic II, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Johannes Dominikus Pallua
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
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Brunner A, Willenbacher E, Willenbacher W, Zelger B, Zelger P, Huck CW, Pallua JD. Visible- and near-infrared hyperspectral imaging for the quantitative analysis of PD-L1+ cells in human lymphomas: Comparison with fluorescent multiplex immunohistochemistry. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2023; 285:121940. [PMID: 36208576 DOI: 10.1016/j.saa.2022.121940] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/22/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION We analyzed the expression of PD-L1 in human lymphomas using hyperspectral imaging (HSI) compared to visual assessment (VA) and conventional digital image analysis (DIA) to strengthen further the value of HSI as a tool for the evaluation of brightfield-based immunohistochemistry (IHC). In addition, fluorescent multiplex immunohistochemistry (mIHC) was used as a second detection method to analyze the impact of a different detection method. MATERIAL AND METHODS 18 cases (6 follicular lymphomas and 12 diffuse large B-cell lymphomas) were stained for PD-L1 by IHC and for PD-L1, CD3, and CD8 by fluorescent mIHC. The percentage of positively stained cells was evaluated with VA, HSI, and DIA for IHC and VA and DIA for mIHC. Results were compared between the different methods of detection and analysis. RESULTS An overall high concordance was found between VA, HSI, and DIA in IHC (Cohens Kappa = 0.810VA/HSI, 0.710 VA/DIA, and 0.516 HSI/DIA) and for VAmIHCversus DIAmIHC (Cohens Kappa = 0.894). Comparing IHC and mIHC general agreement differed depending on the methods compared but reached at most a moderate agreement (Coheńs Kappa between 0.250 and 0.483). This is reflected by the significantly higher percentage of PD-L1+ cells found with mIHC (pFriedman = 0.014). CONCLUSION Our study shows a good concordance for the different analysis methods. Compared to VA and DIA, HSI proved to be a reliable tool for assessing IHC. Understanding the regulation of PD-L1 expression will further enlighten the role of PD-L1 as a biomarker. Therefore it is necessary to develop an instrument, such as HSI, which can offer a reliable and objective evaluation of PD-L1 expression.
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Affiliation(s)
- A Brunner
- Innsbruck Medical University, Institute of Pathology, Neuropathology and Molecular Pathology, Innsbruck, Austria
| | - E Willenbacher
- Innsbruck Medical University, Internal Medicine. V, Hematology & Oncology, Innsbruck, Austria
| | - W Willenbacher
- Innsbruck Medical University, Internal Medicine. V, Hematology & Oncology, Innsbruck, Austria; Syndena GmbH, Connect to Cure, Karl-Kapferer-Straße 5, 6020 Innsbruck, Austria
| | - B Zelger
- Innsbruck Medical University, Institute of Pathology, Neuropathology and Molecular Pathology, Innsbruck, Austria
| | - P Zelger
- Innsbruck Medical University, University Clinic for Hearing, Voice and Speech Disorders, Anichstrasse 35, Innsbruck, Austria
| | - C W Huck
- University of Innsbruck, Institute of Analytical Chemistry and Radiochemistry, Innsbruck, Austria
| | - J D Pallua
- Innsbruck Medical University, Department of Traumatology and Orthopaedics, Innsbruck, Austria.
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