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Background <p>Indocyanine green fluorescence imaging (ICG-FI) is a novel tool for continuous assessment of tissue perfusion. However, consensus on the optimal methodology is lacking. &#xa0;It was hypothesized that quantitative ICG-FI parameters based on continuous micro-dosing correlate with corresponding transit time flow measurements in the functional renal end artery. &#xa0;This study aimed to examine the feasibility of continuous, quantitative ICG-FI for detecting perfusion changes (hypoperfusion, reperfusion) in porcine kidneys.</p> Methods <p>Renal perfusion was assessed using continuous, quantitative ICG-FI under controlled renal artery flow adjustments (no, partial, full, partial, and no occlusion) in ten healthy female pigs. Four 0.008&#xa0;mg/kg ICG micro-doses were administered with 60-s intervals for each flow adjustment. As a reference, simultaneous renal artery transit time flow probe measurements were recorded. ICG-FI parameters were extracted by PerfusionWorks<sup>®</sup>, providing surrogate markers for perfusion, and correlated to the reference renal artery transit time flow measurements using linear regression modeling.</p> Results <p>During hypoperfusion, mean flow decreased from 277 to 139 to 0&#xa0;ml/min in the no, partial, and full occlusion steps, respectively. <i>F</i><sub>ingress</sub> (<i>R</i><sup>2</sup> = 79%), <i>F</i><sub>max</sub> (<i>R</i><sup>2</sup> = 79%), and slope (<i>R</i><sup>2</sup> = 78%) correlated with flow. During reperfusion, mean flows increased from 0 to 169 to 240&#xa0;ml/min in the full, partial, and no occlusion steps, respectively, and <i>F</i><sub>ingress</sub> (<i>R</i><sup>2</sup> = 71%), <i>F</i><sub>max</sub> (<i>R</i><sup>2</sup> = 69%), and slope (<i>R</i><sup>2</sup> = 79%) also correlated with flow. Overall, slope exhibited the strongest correlation (<i>R</i><sup>2</sup> = 54%). <i>T</i><sub>ingress</sub>, <i>T</i><sub>½max</sub>, time ratio, and <i>T</i><sub>max</sub> exhibited poor correlations with flow.</p> Conclusion <p>Continuous assessment of renal perfusion was technically feasible. In this kidney model, the combined ICG-FI parameter, slope, and the intensity-dependent parameters <i>F</i><sub>ingress</sub> and <i>F</i><sub>max</sub> exhibited convincing correlation with flow, appearing promising for the continuous assessment of tissue perfusion. Time-related parameters did not correlate with flow in this specific model, likely due to the kidney's unique vascular characteristics.</p> Graphical abstract <p></p>

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Continuous assessment of tissue perfusion using quantitative indocyanine green fluorescence imaging during controlled hypo- and reperfusion

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月2日

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  • Frederik Thørholm Andersen,
  • Jacob Petersen,
  • Alexander Emil Kaspersen,
  • Mads Vikkelsø Pedersen,
  • Gustav Singer,
  • Mads Holst Aagaard Madsen,
  • Morten Asp Vonsild Lund,
  • J. Michael Hasenkam,
  • Troels Lading

摘要

Background

Indocyanine green fluorescence imaging (ICG-FI) is a novel tool for continuous assessment of tissue perfusion. However, consensus on the optimal methodology is lacking.  It was hypothesized that quantitative ICG-FI parameters based on continuous micro-dosing correlate with corresponding transit time flow measurements in the functional renal end artery.  This study aimed to examine the feasibility of continuous, quantitative ICG-FI for detecting perfusion changes (hypoperfusion, reperfusion) in porcine kidneys.

Methods

Renal perfusion was assessed using continuous, quantitative ICG-FI under controlled renal artery flow adjustments (no, partial, full, partial, and no occlusion) in ten healthy female pigs. Four 0.008 mg/kg ICG micro-doses were administered with 60-s intervals for each flow adjustment. As a reference, simultaneous renal artery transit time flow probe measurements were recorded. ICG-FI parameters were extracted by PerfusionWorks®, providing surrogate markers for perfusion, and correlated to the reference renal artery transit time flow measurements using linear regression modeling.

Results

During hypoperfusion, mean flow decreased from 277 to 139 to 0 ml/min in the no, partial, and full occlusion steps, respectively. Fingress (R2 = 79%), Fmax (R2 = 79%), and slope (R2 = 78%) correlated with flow. During reperfusion, mean flows increased from 0 to 169 to 240 ml/min in the full, partial, and no occlusion steps, respectively, and Fingress (R2 = 71%), Fmax (R2 = 69%), and slope (R2 = 79%) also correlated with flow. Overall, slope exhibited the strongest correlation (R2 = 54%). Tingress, T½max, time ratio, and Tmax exhibited poor correlations with flow.

Conclusion

Continuous assessment of renal perfusion was technically feasible. In this kidney model, the combined ICG-FI parameter, slope, and the intensity-dependent parameters Fingress and Fmax exhibited convincing correlation with flow, appearing promising for the continuous assessment of tissue perfusion. Time-related parameters did not correlate with flow in this specific model, likely due to the kidney's unique vascular characteristics.

Graphical abstract