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Pruitt K, Johnson B, Gahan J, Ma L, Fei B. A High-Speed Hyperspectral Laparoscopic Imaging System. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2023; 12466:1246608. [PMID: 38524190 PMCID: PMC10961180 DOI: 10.1117/12.2653922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Minimally invasive surgery (MIS) has expanded broadly in the field of abdominal and pelvic surgery. Laparoscopic and robotic surgery has improved surgeon ergonomics, instrument precision, operative time, and postoperative recovery across various abdominal procedures. The goal of this study is to establish the feasibility of implementing high-speed hyperspectral imaging into a standard laparoscopic setup and exploring its benefit to common intracorporeal procedures. A hyperspectral laparoscopic imaging system was constructed using a customized hyperspectral camera alongside a standard rigid laparoscope and was validated for both spectral and spatial accuracy. Demosaicing methods were investigated for improved full-resolution visualization. Hyperspectral cameras with different spectral ranges were considered and compared with one another alongside two different light sources to determine the most effective configuration. Finally, different porcine tissues were imaged ex-vivo to test the capabilities of the system and spectral footprints of the various tissues were extracted. The tissue was also imaged in a phantom to simulate the system's use in MIS. The results demonstrated a hyperspectral laparoscopic imaging system that could provide quantitative, diagnostic information while not disrupting normal workflow nor adding excessive weight to the laparoscopic setup. The high-speed hyperspectral laparoscopic imaging system can have immediate applications in image-guided surgery.
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Affiliation(s)
- Kelden Pruitt
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX
- Center for Imaging and Surgical Innovation, University of Texas at Dallas, Richardson, TX
| | - Brett Johnson
- University of Texas Southwestern Medical Center, Department of Urology, Dallas, TX
| | - Jeffrey Gahan
- University of Texas Southwestern Medical Center, Department of Urology, Dallas, TX
| | - Ling Ma
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX
- Center for Imaging and Surgical Innovation, University of Texas at Dallas, Richardson, TX
| | - Baowei Fei
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX
- Center for Imaging and Surgical Innovation, University of Texas at Dallas, Richardson, TX
- University of Texas Southwestern Medical Center, Department of Radiology, Dallas, TX
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J Waterhouse D, Stoyanov D. Optimized spectral filter design enables more accurate estimation of oxygen saturation in spectral imaging. BIOMEDICAL OPTICS EXPRESS 2022; 13:2156-2173. [PMID: 35519287 PMCID: PMC9045927 DOI: 10.1364/boe.446975] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/18/2022] [Accepted: 01/23/2022] [Indexed: 06/14/2023]
Abstract
Oxygen saturation (SO2) in tissue is a crucially important physiological parameter with ubiquitous clinical utility in diagnosis, treatment, and monitoring, as well as widespread use as an invaluable preclinical research tool. Multispectral imaging can be used to visualize SO2 non-invasively, non-destructively and without contact in real-time using narrow spectral filter sets, but typically, these spectral filter sets are poorly suited to a specific clinical task, application, or tissue type. In this work, we demonstrate the merit of optimizing spectral filter sets for more accurate estimation of SO2. Using tissue modelling and simulated multispectral imaging, we demonstrate filter optimization reduces the root-mean-square-error (RMSE) in estimating SO2 by up to 37% compared with evenly spaced filters. Moreover, we demonstrate up to a 79% decrease in RMSE for optimized filter sets compared with filter sets chosen to minimize mutual information. Wider adoption of this approach will result in more effective multispectral imaging systems that can address specific clinical needs and consequently, more widespread adoption of multispectral imaging technologies in disease diagnosis and treatment.
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Affiliation(s)
- Dale J Waterhouse
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, Department of Medical Physics and Biomedical Engineering, University College London, UK
| | - Danail Stoyanov
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, Department of Medical Physics and Biomedical Engineering, University College London, UK
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3
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Favre-Inhofer A, Carbonnel M, Domert J, Cornet N, Chastant S, Coscas R, Vialard F, Gelin V, Galio L, Richard C, Trabelsi H, Sandra O, de Ziegler D, Chavatte-Palmer P, Ayoubi JM. Involving Animal Models in Uterine Transplantation. Front Surg 2022; 9:830826. [PMID: 35284480 PMCID: PMC8904568 DOI: 10.3389/fsurg.2022.830826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/24/2022] [Indexed: 01/15/2023] Open
Abstract
Background Absolute uterine factor infertility affects 0. 2% women of childbearing age around the world. Uterine transplantation (UTx) is a promising solution for many of them since the first birth from UTx was described by the Swedish team in 2014. The success of Utx in humans has become possible after a systematic and meticulous approach involving years of research on animal models. To date, more than 80 UTx procedures have been performed worldwide and 30 children were born. Material and Method This review summarizes the research preparation conducted in animals before beginning UTx in humans. It focuses on the advantages and limits of each animal model, their place in surgical training, and current contribution in research to improve UTx successes in humans. The different steps in the process of UTx have been analyzed, such as imaging, surgery, ischemia-reperfusion effects, rejection markers, immunosuppressive treatment, and pregnancy. Conclusion Animal models have played an essential role in the implementation of UTx, which is a highly complex procedure. While respecting the 3R requirements (replacement, refinement, and reduction), the surgical training using large animal models, such as notably ewes remain irreplaceable for teams wishing to initiate a UTx program. Furthermore, animal models are still mandatory in current research to improve the success rates of UTx in humans as well as to reduce the morbidity associated with this experimental infertility treatment.
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Affiliation(s)
- Angeline Favre-Inhofer
- Department of Gynaecology and Obstetrics, Foch Hospital, Suresnes, France
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Marie Carbonnel
- Department of Gynaecology and Obstetrics, Foch Hospital, Suresnes, France
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | | | - Nathalie Cornet
- Department of Gynaecology and Obstetrics, Foch Hospital, Suresnes, France
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | | | - Raphaël Coscas
- Department of Vascular Surgery, Ambroise Paré University Hospital, AP-HP, Boulogne-Billancourt, France
- UMR 1018, Inserm-Paris11 - CESP, Versailles Saint-Quentin-en-Yvelines University, Paris-Saclay University, Boulogne-Billancourt, France
| | - François Vialard
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- École Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
- Département de Génétique, Laboratoire de Biologie Médicale, CHI de Poissy-St Germain en Laye, Poissy, France
| | - Valérie Gelin
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- École Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
| | - Laurent Galio
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- École Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
| | - Christophe Richard
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- École Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
| | - Héla Trabelsi
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- École Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
| | - Olivier Sandra
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- École Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
| | - Dominique de Ziegler
- Department of Gynaecology and Obstetrics, Foch Hospital, Suresnes, France
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Pascale Chavatte-Palmer
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- École Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
| | - Jean-Marc Ayoubi
- Department of Gynaecology and Obstetrics, Foch Hospital, Suresnes, France
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
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Clancy NT, Soares AS, Bano S, Lovat LB, Chand M, Stoyanov D. Intraoperative colon perfusion assessment using multispectral imaging. BIOMEDICAL OPTICS EXPRESS 2021; 12:7556-7567. [PMID: 35003852 PMCID: PMC8713665 DOI: 10.1364/boe.435118] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 06/14/2023]
Abstract
In colorectal surgery an anastomosis performed using poorly-perfused, ischaemic bowel segments may result in a leak and consequent morbidity. Traditional measures of perfusion assessment rely on clinical judgement and are mainly subjective, based on tissue appearance, leading to variability between clinicians. This paper describes a multispectral imaging (MSI) laparoscope that can derive quantitative measures of tissue oxygen saturation (SO2 ). The system uses a xenon surgical light source and fast filter wheel camera to capture eight narrow waveband images across the visible range in approximately 0.3 s. Spectral validation measurements were performed by imaging standardised colour tiles and comparing reflectance with ground truth spectrometer data. Tissue spectra were decomposed into individual contributions from haemoglobin, adipose tissue and scattering, using a previously-developed regression approach. Initial clinical results from seven patients undergoing colorectal surgery are presented and used to characterise measurement stability and reproducibility in vivo. Strategies to improve signal-to-noise ratio and correct for motion are described. Images of healthy bowel tissue (in vivo) indicate that baseline SO2 is approximately 75 ± 6%. The SO2 profile along a bowel segment following ligation of the inferior mesenteric artery (IMA) shows a decrease from the proximal to distal end. In the clinical cases shown, imaging results concurred with clinical judgements of the location of well-perfused tissue. Adipose tissue, visibly yellow in the RGB images, is shown to surround the mesentery and cover some of the serosa. SO2 in this tissue is consistently high, with mean value of 90%. These results show that MSI is a potential intraoperative guidance tool for assessment of perfusion. Mapping of SO2 in the colon could be used by surgeons to guide choice of transection points and ensure that well-perfused tissue is used to form an anastomosis. The observation of high mesenteric SO2 agrees with work in the literature and warrants further exploration. Larger studies incorporating with a wider cohort of clinicians will help to provide retrospective evidence of how this imaging technique may be able to reduce inter-operator variability.
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Affiliation(s)
- Neil T. Clancy
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, UK
- Department of Medical Physics and Biomedical Engineering, University College London, UK
| | - António S. Soares
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, UK
- Division of Surgery and Interventional Sciences, University College London, UK
| | - Sophia Bano
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, UK
- Department of Computer Science, University College London, UK
| | - Laurence B. Lovat
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, UK
- Division of Surgery and Interventional Sciences, University College London, UK
| | - Manish Chand
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, UK
- Division of Surgery and Interventional Sciences, University College London, UK
| | - Danail Stoyanov
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, UK
- Department of Computer Science, University College London, UK
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Mühle R, Markgraf W, Hilsmann A, Malberg H, Eisert P, Wisotzky EL. Comparison of different spectral cameras for image-guided organ transplantation. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210076RR. [PMID: 34304399 PMCID: PMC8305772 DOI: 10.1117/1.jbo.26.7.076007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/24/2021] [Indexed: 06/13/2023]
Abstract
SIGNIFICANCE Hyperspectral and multispectral imaging (HMSI) in medical applications provides information about the physiology, morphology, and composition of tissues and organs. The use of these technologies enables the evaluation of biological objects and can potentially be applied as an objective assessment tool for medical professionals. AIM Our study investigates HMSI systems for their usability in medical applications. APPROACH Four HMSI systems (one hyperspectral pushbroom camera and three multispectral snapshot cameras) were examined and a spectrometer was used as a reference system, which was initially validated with a standardized color chart. The spectral accuracy of the cameras reproducing chemical properties of different biological objects (porcine blood, physiological porcine tissue, and pathological porcine tissue) was analyzed using the Pearson correlation coefficient. RESULTS All the HMSI cameras examined were able to provide the characteristic spectral properties of blood and tissues. A pushbroom camera and two snapshot systems achieve Pearson coefficients of at least 0.97 compared to the ground truth, indicating a very high positive correlation. Only one snapshot camera performs moderately to high positive correlation (0.59 to 0.85). CONCLUSION The knowledge of the suitability of HMSI cameras for accurate measurement of chemical properties of biological objects offers a good opportunity for the selection of the optimal imaging tool for specific medical applications, such as organ transplantation.
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Affiliation(s)
- Richard Mühle
- Technische Universität Dresden, Institute of Biomedical Engineering, Dresden, Germany
- Technische Universität Dresden, Department of Neurosurgery, Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - Wenke Markgraf
- Technische Universität Dresden, Institute of Biomedical Engineering, Dresden, Germany
| | - Anna Hilsmann
- Fraunhofer Heinrich-Hertz-Institute, Department of Vision and Imaging Technologies, Berlin, Germany
| | - Hagen Malberg
- Technische Universität Dresden, Institute of Biomedical Engineering, Dresden, Germany
| | - Peter Eisert
- Fraunhofer Heinrich-Hertz-Institute, Department of Vision and Imaging Technologies, Berlin, Germany
- Humboldt Universität zu Berlin, Department of Visual Computing, Berlin, Germany
| | - Eric L. Wisotzky
- Fraunhofer Heinrich-Hertz-Institute, Department of Vision and Imaging Technologies, Berlin, Germany
- Humboldt Universität zu Berlin, Department of Visual Computing, Berlin, Germany
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Iwaki K, Takagishi S, Arimura K, Murata M, Chiba T, Nishimura A, Ren N, Iihara K. A Novel Hyperspectral Imaging System for Intraoperative Prediction of Cerebral Hyperperfusion Syndrome after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis in Patients with Moyamoya Disease. Cerebrovasc Dis 2021; 50:208-215. [PMID: 33596563 DOI: 10.1159/000513289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 11/15/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Postoperative cerebral hyperperfusion syndrome (CHS) may occur after superficial temporal artery (STA)-middle cerebral artery (MCA) bypass for moyamoya disease (MMD). Predicting postoperative CHS is challenging; however, we previously reported the feasibility of using a hyperspectral camera (HSC) for monitoring intraoperative changes in brain surface hemodynamics during STA-MCA bypass. OBJECTIVE To investigate the utility of HSC to predict postoperative CHS during STA-MCA bypass for patients with MMD. METHODS Hyperspectral images of the cerebral cortex of 29 patients with MMD who underwent STA-MCA bypass were acquired by using an HSC before and after anastomosis. We then analyzed the changes in oxygen saturation after anastomosis and assessed its correlation with CHS. RESULTS Five patients experienced transient neurological deterioration several days after surgery. 123I-N-Isopropyl-iodoamphetamine single-photon emission computed tomography scan results revealed an intense, focal increase in cerebral blood flow at the site of anastomosis without any cerebral infarction. Patients with CHS showed significantly increased oxygen saturation (SO2) in the cerebral cortex after anastomosis relative to those without CHS (33 ± 28 vs. 8 ± 14%, p < 0.0001). Receiver operating characteristic analysis results show that postoperative CHS likely occurs when the increase rate of cortical SO2 value is >15% (sensitivity, 85.0%; specificity, 81.3%; area under curve, 0.871). CONCLUSIONS This study indicates that hyperspectral imaging of the cerebral cortex may be used to predict postoperative CHS in patients with MMD undergoing STA-MCA bypass.
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Affiliation(s)
- Katsuma Iwaki
- Department of Neurosurgery, Kyushu University, Fukuoka, Japan
| | - Soh Takagishi
- Department of Neurosurgery, Kyushu University, Fukuoka, Japan
| | - Koichi Arimura
- Department of Neurosurgery, Kyushu University, Fukuoka, Japan,
| | - Masaharu Murata
- Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan.,Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toru Chiba
- PENTAX Lifecare Division Medical Instrument SBU, HOYA Corporation, Tokyo, Japan
| | - Ataru Nishimura
- Department of Neurosurgery, Kyushu University, Fukuoka, Japan
| | - Nice Ren
- Department of Neurosurgery, Kyushu University, Fukuoka, Japan
| | - Koji Iihara
- Department of Neurosurgery, Kyushu University, Fukuoka, Japan
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7
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Schneider C, Nikitichev D, Xia W, Gurusamy K, Desjardins AE, Davidson BR. Multispectral tissue mapping: developing a concept for the optical evaluation of liver disease. J Med Imaging (Bellingham) 2020; 7:066001. [PMID: 33376759 PMCID: PMC7757517 DOI: 10.1117/1.jmi.7.6.066001] [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: 04/04/2020] [Accepted: 12/01/2020] [Indexed: 11/14/2022] Open
Abstract
Purpose: Alterations in the optical absorption behavior of liver tissue secondary to pathological processes can be evaluated by multispectral analysis, which is increasingly being explored as an imaging adjunct for use in liver surgery. Current methods are either invasive or have a limited wavelength spectrum, which restricts utility. This proof of concept study describes the development of a multispectral imaging (MSI) method called multispectral tissue mapping (MTM) that addresses these issues. Approach: The imaging system consists of a tunable excitation light source and a near-infrared camera. Following the development stage, proof of concept experiments are carried out where absorption spectra from colorectal cancer liver metastasis (CRLM), hepatocellular carcinoma (HCC), and liver steatosis specimen are acquired and compared to controls. Absorption spectra are compared to histopathology examination as the current gold standard for tissue assessment. Generalized linear mixed modeling is employed to compare absorption characteristics of individual pixels and to select wavelengths for false color image processing with the aim of visually enhancing cancer tissue. Results: Analysis of individual pixels revealed distinct absorption spectra therefore suggesting that MTM is possible. A prominent absorption peak at 1210 nm was found in lipid-rich animal tissues and steatotic liver specimen. Liver cancer tissue had a heterogeneous appearance on MSI. Subsequent statistical analysis suggests that measuring changes in absorption behavior may be a feasible method to estimate the pixel-based probability of cancer being present. In CRLM, this was observed throughout 1100 to 1700 nm, whereas in HCC it was concentrated around 1140 and 1430 nm. False color image processing visibly enhances contrast between cancer and normal liver tissues. Conclusions: The system's ability to enable no-touch MSI at 1100 to 1700 nm was demonstrated. Preliminary data suggest that MTM warrants further exploration as a potential imaging tool for the detection of liver cancer during surgery.
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Affiliation(s)
- Crispin Schneider
- University College London, Division of Surgery and Interventional Science, Royal Free Campus, London, United Kingdom
| | - Daniil Nikitichev
- University College London, Wellcome/EPSRC Centre for Surgical and Interventional Sciences, London, United Kingdom.,University College London, Department of Medical Physics and Bioengineering, London, United Kingdom
| | - Wenfeng Xia
- University College London, Wellcome/EPSRC Centre for Surgical and Interventional Sciences, London, United Kingdom.,University College London, Department of Medical Physics and Bioengineering, London, United Kingdom
| | - Kurinchi Gurusamy
- University College London, Division of Surgery and Interventional Science, Royal Free Campus, London, United Kingdom.,University College London, Wellcome/EPSRC Centre for Surgical and Interventional Sciences, London, United Kingdom
| | - Adrien E Desjardins
- University College London, Wellcome/EPSRC Centre for Surgical and Interventional Sciences, London, United Kingdom.,University College London, Department of Medical Physics and Bioengineering, London, United Kingdom
| | - Brian R Davidson
- University College London, Division of Surgery and Interventional Science, Royal Free Campus, London, United Kingdom.,University College London, Wellcome/EPSRC Centre for Surgical and Interventional Sciences, London, United Kingdom
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Custodiol-N Is Superior to Custodiol ® Solution in Experimental Rat Uterus Preservation. Int J Mol Sci 2020; 21:ijms21218015. [PMID: 33126511 PMCID: PMC7662817 DOI: 10.3390/ijms21218015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 01/15/2023] Open
Abstract
Uterus transplantation (UTx) is the first and only available treatment for women with absolute uterine factor infertility. However, clinical application is limited by the lack of organs, ischemia/reperfusion injury, as well as immunosuppression after UTx. Several different preservation solutions are used in experimental and clinical UTx, including Custodiol® solution. Recently, the novel Custodiol-N solution was developed with superior results in organ preservation. However, the solution was not tested yet in UTx. Therefore, the aims of this study were to evaluate the effect of Custodiol-N in uterus prolonged cold preservation time (8 and 24 h), compared to Custodiol® solution. Uterus tissue samples were obtained from adult Sprague Dawley rats (n = 10/group). Cold ischemic injury was estimated by histology, including immunohistochemistry, and biochemical tissue analyses. After 8 h of cold ischemia, higher percentage of tissue edema, necrosis signs and myeloperoxidase expression, as well as lower superoxide dismutase activity were found in Custodiol® compared to Custodiol-N (p < 0.05). These differences were more pronounced after 24 h of cold preservation time (p < 0.05). This study demonstrated that Custodiol-N protects uterus grafts from cold ischemic injury better than standard Custodiol® most likely via inhibition of oxidative stress and tissue edema. It seems that iron chelators in the composition of Custodiol-N play an important protective role against cold ischemia.
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Clancy NT, Jones G, Maier-Hein L, Elson DS, Stoyanov D. Surgical spectral imaging. Med Image Anal 2020; 63:101699. [PMID: 32375102 PMCID: PMC7903143 DOI: 10.1016/j.media.2020.101699] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 03/30/2020] [Accepted: 04/06/2020] [Indexed: 12/24/2022]
Abstract
Recent technological developments have resulted in the availability of miniaturised spectral imaging sensors capable of operating in the multi- (MSI) and hyperspectral imaging (HSI) regimes. Simultaneous advances in image-processing techniques and artificial intelligence (AI), especially in machine learning and deep learning, have made these data-rich modalities highly attractive as a means of extracting biological information non-destructively. Surgery in particular is poised to benefit from this, as spectrally-resolved tissue optical properties can offer enhanced contrast as well as diagnostic and guidance information during interventions. This is particularly relevant for procedures where inherent contrast is low under standard white light visualisation. This review summarises recent work in surgical spectral imaging (SSI) techniques, taken from Pubmed, Google Scholar and arXiv searches spanning the period 2013-2019. New hardware, optimised for use in both open and minimally-invasive surgery (MIS), is described, and recent commercial activity is summarised. Computational approaches to extract spectral information from conventional colour images are reviewed, as tip-mounted cameras become more commonplace in MIS. Model-based and machine learning methods of data analysis are discussed in addition to simulation, phantom and clinical validation experiments. A wide variety of surgical pilot studies are reported but it is apparent that further work is needed to quantify the clinical value of MSI/HSI. The current trend toward data-driven analysis emphasises the importance of widely-available, standardised spectral imaging datasets, which will aid understanding of variability across organs and patients, and drive clinical translation.
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Affiliation(s)
- Neil T Clancy
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, United Kingdom; Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom.
| | - Geoffrey Jones
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, United Kingdom; Centre for Medical Image Computing (CMIC), Department of Computer Science, University College London, United Kingdom
| | | | - Daniel S Elson
- Hamlyn Centre for Robotic Surgery, Institute of Global Health Innovation, Imperial College London, United Kingdom; Department of Surgery and Cancer, Imperial College London, United Kingdom
| | - Danail Stoyanov
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, United Kingdom; Centre for Medical Image Computing (CMIC), Department of Computer Science, University College London, United Kingdom
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10
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Zaffino P, Moccia S, De Momi E, Spadea MF. A Review on Advances in Intra-operative Imaging for Surgery and Therapy: Imagining the Operating Room of the Future. Ann Biomed Eng 2020; 48:2171-2191. [PMID: 32601951 DOI: 10.1007/s10439-020-02553-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/17/2020] [Indexed: 12/19/2022]
Abstract
With the advent of Minimally Invasive Surgery (MIS), intra-operative imaging has become crucial for surgery and therapy guidance, allowing to partially compensate for the lack of information typical of MIS. This paper reviews the advancements in both classical (i.e. ultrasounds, X-ray, optical coherence tomography and magnetic resonance imaging) and more recent (i.e. multispectral, photoacoustic and Raman imaging) intra-operative imaging modalities. Each imaging modality was analyzed, focusing on benefits and disadvantages in terms of compatibility with the operating room, costs, acquisition time and image characteristics. Tables are included to summarize this information. New generation of hybrid surgical room and algorithms for real time/in room image processing were also investigated. Each imaging modality has its own (site- and procedure-specific) peculiarities in terms of spatial and temporal resolution, field of view and contrasted tissues. Besides the benefits that each technique offers for guidance, considerations about operators and patient risk, costs, and extra time required for surgical procedures have to be considered. The current trend is to equip surgical rooms with multimodal imaging systems, so as to integrate multiple information for real-time data extraction and computer-assisted processing. The future of surgery is to enhance surgeons eye to minimize intra- and after-surgery adverse events and provide surgeons with all possible support to objectify and optimize the care-delivery process.
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Affiliation(s)
- Paolo Zaffino
- Department of Experimental and Clinical Medicine, Universitá della Magna Graecia, Catanzaro, Italy
| | - Sara Moccia
- Department of Information Engineering (DII), Universitá Politecnica delle Marche, via Brecce Bianche, 12, 60131, Ancona, AN, Italy.
| | - Elena De Momi
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133, Milano, MI, Italy
| | - Maria Francesca Spadea
- Department of Experimental and Clinical Medicine, Universitá della Magna Graecia, Catanzaro, Italy
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11
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Clancy NT, Gurusamy K, Jones G, Davidson B, Clarkson MJ, Hawkes DJ, Stoyanov D. Spectral Imaging Of Thermal Damage Induced During Microwave Ablation In The Liver. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2018:3001-3004. [PMID: 30441029 DOI: 10.1109/embc.2018.8512901] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Induction of thermal damage to tissue through delivery of microwave energy is frequently applied in surgery to destroy diseased tissue such as cancer cells. Minimization of unwanted harm to healthy tissue is still achieved subjectively, and the surgeon has few tools at their disposal to monitor the spread of the induced damage. This work describes the use of optical methods to monitor the time course of changes to the tissue during delivery of microwave energy in the porcine liver. Multispectral imaging and diffuse reflectance spectroscopy are used to monitor temporal changes in optical properties in parallel with thermal imaging. The results demonstrate the ability to monitor the spatial extent of thermal damage on a whole organ, including possible secondary effects due to vascular damage. Future applications of this type of imaging may see the multispectral data used as a feedback mechanism to avoid collateral damage to critical healthy structures and to potentially verify sufficient application of energy to the diseased tissue.
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Shapey J, Xie Y, Nabavi E, Bradford R, Saeed SR, Ourselin S, Vercauteren T. Intraoperative multispectral and hyperspectral label-free imaging: A systematic review of in vivo clinical studies. JOURNAL OF BIOPHOTONICS 2019; 12:e201800455. [PMID: 30859757 PMCID: PMC6736677 DOI: 10.1002/jbio.201800455] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/26/2019] [Accepted: 03/08/2019] [Indexed: 05/21/2023]
Abstract
Multispectral and hyperspectral imaging (HSI) are emerging optical imaging techniques with the potential to transform the way surgery is performed but it is not clear whether current systems are capable of delivering real-time tissue characterization and surgical guidance. We conducted a systematic review of surgical in vivo label-free multispectral and HSI systems that have been assessed intraoperatively in adult patients, published over a 10-year period to May 2018. We analysed 14 studies including 8 different HSI systems. Current in-vivo HSI systems generate an intraoperative tissue oxygenation map or enable tumour detection. Intraoperative tissue oxygenation measurements may help to predict those patients at risk of postoperative complications and in-vivo intraoperative tissue characterization may be performed with high specificity and sensitivity. All systems utilized a line-scanning or wavelength-scanning method but the spectral range and number of spectral bands employed varied significantly between studies and according to the system's clinical aim. The time to acquire a hyperspectral cube dataset ranged between 5 and 30 seconds. No safety concerns were reported in any studies. A small number of studies have demonstrated the capabilities of intraoperative in-vivo label-free HSI but further work is needed to fully integrate it into the current surgical workflow.
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Affiliation(s)
- Jonathan Shapey
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Yijing Xie
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Eli Nabavi
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Robert Bradford
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
| | - Shakeel R Saeed
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
- The Ear Institute, University College London, London, UK
- The Royal National Throat, Nose and Ear Hospital, London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Tom Vercauteren
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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Aguénounon E, Dadouche F, Uhring W, Gioux S. Real-time optical properties and oxygenation imaging using custom parallel processing in the spatial frequency domain. BIOMEDICAL OPTICS EXPRESS 2019; 10:3916-3928. [PMID: 31452984 PMCID: PMC6701546 DOI: 10.1364/boe.10.003916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/06/2019] [Accepted: 06/11/2019] [Indexed: 05/03/2023]
Abstract
The development of real-time, wide-field and quantitative diffuse optical imaging methods is becoming increasingly popular for biological and medical applications. Recent developments introduced a novel approach for real-time multispectral acquisition in the spatial frequency domain using spatio-temporal modulation of light. Using this method, optical properties maps (absorption and reduced scattering) could be obtained for two wavelengths (665 nm and 860 nm). These maps, in turn, are used to deduce oxygen saturation levels in tissues. However, while the acquisition was performed in real-time, processing was performed post-acquisition and was not in real-time. In the present article, we present CPU and GPU processing implementations for this method with special emphasis on processing time. The obtained results show that the proposed custom direct method using a General Purpose Graphic Processing Unit (GPGPU) and C CUDA (Compute Unified Device Architecture) implementation enables 1.6 milliseconds processing time for a 1 Mega-pixel image with a maximum average error of 0.1% in extracting optical properties.
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Li Q, Lin J, Clancy NT, Elson DS. Estimation of tissue oxygen saturation from RGB images and sparse hyperspectral signals based on conditional generative adversarial network. Int J Comput Assist Radiol Surg 2019; 14:987-995. [PMID: 30900114 PMCID: PMC6544606 DOI: 10.1007/s11548-019-01940-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/07/2019] [Indexed: 11/07/2022]
Abstract
PURPOSE Intra-operative measurement of tissue oxygen saturation ([Formula: see text]) is important in detection of ischaemia, monitoring perfusion and identifying disease. Hyperspectral imaging (HSI) measures the optical reflectance spectrum of the tissue and uses this information to quantify its composition, including [Formula: see text]. However, real-time monitoring is difficult due to capture rate and data processing time. METHODS An endoscopic system based on a multi-fibre probe was previously developed to sparsely capture HSI data (sHSI). These were combined with RGB images, via a deep neural network, to generate high-resolution hypercubes and calculate [Formula: see text]. To improve accuracy and processing speed, we propose a dual-input conditional generative adversarial network, Dual2StO2, to directly estimate [Formula: see text] by fusing features from both RGB and sHSI. RESULTS Validation experiments were carried out on in vivo porcine bowel data, where the ground truth [Formula: see text] was generated from the HSI camera. Performance was also compared to our previous super-spectral-resolution network, SSRNet in terms of mean [Formula: see text] prediction accuracy and structural similarity metrics. Dual2StO2 was also tested using simulated probe data with varying fibre number. CONCLUSIONS [Formula: see text] estimation by Dual2StO2 is visually closer to ground truth in general structure and achieves higher prediction accuracy and faster processing speed than SSRNet. Simulations showed that results improved when a greater number of fibres are used in the probe. Future work will include refinement of the network architecture, hardware optimization based on simulation results, and evaluation of the technique in clinical applications beyond [Formula: see text] estimation.
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Affiliation(s)
- Qingbiao Li
- The Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Jianyu Lin
- The Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK
- Department of Computing, Imperial College London, London, UK
| | - Neil T. Clancy
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK
- Centre for Medical Image Computing (CMIC), Department of Computer Science, University College London, London, UK
| | - Daniel S. Elson
- The Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
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Use of Laser Speckle Contrast Analysis during pelvic surgery in a uterine transplantation model. Future Sci OA 2018; 4:FSO324. [PMID: 30112192 PMCID: PMC6088268 DOI: 10.4155/fsoa-2018-0017] [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: 02/09/2018] [Accepted: 06/04/2018] [Indexed: 11/17/2022] Open
Abstract
Aim Uterine transplantation (UTx) is proposed for treatment of uterine factor infertility. Our aim was to assess whether Endoscopic Laser Speckle Contrast Analysis (eLASCA) could evaluate pelvic blood flow at anastomotic sites required for sheep and rabbit UTx. Results/methodology eLASCA detected blood flow in rabbit UTx #7 and #9. In sheep UTx #2, #3 and #5, the results allowed us to conclude that blood flow was present in the uterine graft following transplantation; and post-UTx, the animal had heart and respiratory rates, and oxygen saturation compatible with a normal hemodynamic status. Conclusion These preliminary results establish the potential of Laser Speckle Contrast Analysis as noncontact and real-time tool for observation of spatially-resolved blood flow from which other parameters can be derived.
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Dual-modality endoscopic probe for tissue surface shape reconstruction and hyperspectral imaging enabled by deep neural networks. Med Image Anal 2018; 48:162-176. [PMID: 29933116 DOI: 10.1016/j.media.2018.06.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 05/09/2018] [Accepted: 06/07/2018] [Indexed: 02/01/2023]
Abstract
Surgical guidance and decision making could be improved with accurate and real-time measurement of intra-operative data including shape and spectral information of the tissue surface. In this work, a dual-modality endoscopic system has been proposed to enable tissue surface shape reconstruction and hyperspectral imaging (HSI). This system centers around a probe comprised of an incoherent fiber bundle, whose fiber arrangement is different at the two ends, and miniature imaging optics. For 3D reconstruction with structured light (SL), a light pattern formed of randomly distributed spots with different colors is projected onto the tissue surface, creating artificial texture. Pattern decoding with a Convolutional Neural Network (CNN) model and a customized feature descriptor enables real-time 3D surface reconstruction at approximately 12 frames per second (FPS). In HSI mode, spatially sparse hyperspectral signals from the tissue surface can be captured with a slit hyperspectral imager in a single snapshot. A CNN based super-resolution model, namely "super-spectral-resolution" network (SSRNet), has also been developed to estimate pixel-level dense hypercubes from the endoscope cameras standard RGB images and the sparse hyperspectral signals, at approximately 2 FPS. The probe, with a 2.1 mm diameter, enables the system to be used with endoscope working channels. Furthermore, since data acquisition in both modes can be accomplished in one snapshot, operation of this system in clinical applications is minimally affected by tissue surface movement and deformation. The whole apparatus has been validated on phantoms and tissue (ex vivo and in vivo), while initial measurements on patients during laryngeal surgery show its potential in real-world clinical applications.
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