Intraoperative visualization and quantitative assessment of tissue perfusion by imaging photoplethysmography: comparison with ICG fluorescence angiography

Victor A Kashchenko; Valeriy V Zaytsev; Vyacheslav A Ratnikov; Alexei A Kamshilin

doi:10.1364/BOE.462694

Intraoperative visualization and quantitative assessment of tissue perfusion by imaging photoplethysmography: comparison with ICG fluorescence angiography

Biomed Opt Express. 2022 Jun 16;13(7):3954-3966. doi: 10.1364/BOE.462694. eCollection 2022 Jul 1.

Authors

Victor A Kashchenko^{1

2}, Valeriy V Zaytsev³, Vyacheslav A Ratnikov^{4

5}, Alexei A Kamshilin³

Affiliations

¹ First Surgical Department, North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency, 4 Kultury Pr., St. Petersburg 194291, Russia.
² Department of Faculty Surgery, Saint Petersburg State University, 8A 21st Vasilyevskogo Ostrova Line, Saint-Petersburg 199106, Russia.
³ Laboratory of New Functional Materials for Photonics, Institute of Automation and Control Processes of the Far-Eastern Branch of the Russian Academy of Sciences, 5 Radio str., Vladivostok 690041, Russia.
⁴ Department of Radiology, North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency, 4 Kultury Pr., St. Petersburg 194291, Russia.
⁵ Institute of Advanced Medical Technologies, Saint Petersburg State University, 8A 21st Vasilyevskogo Ostrova Line, Saint-Petersburg 199106, Russia.

Abstract

Intraoperative monitoring of tissue perfusion is of great importance for optimizing surgery and reducing postoperative complications. To date, there is no standard procedure for assessing blood circulation in routine clinical practice. Over the past decade, indocyanine green (ICG) fluorescence angiography is most commonly used for intraoperative perfusion evaluation. Imaging photoplethysmography (iPPG) potentially enables contactless assessment of the blood supply to organs. However, no strong evidence of this potential has been provided so far. Here we report results of a comparative assessment of tissue perfusion obtained using custom-made iPPG and commercial ICG-fluorescence systems during eight different gastrointestinal surgeries. Both systems allow mapping the blood-supply distribution over organs. It was demonstrated for the first time that the quantitative assessment of blood perfusion by iPPG is in good agreement with that obtained by ICG-fluorescence imaging in all surgical cases under study. iPPG can become an objective quantitative monitoring system for tissue perfusion in the operating room due to its simplicity, low cost and no need for any agent injections.