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Proceedings Paper

Endosteal and periosteal blood flow quantified with dynamic contrast-enhanced fluorescence to guide open orthopaedic surgery
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Paper Abstract

Due to the lack of objectively measurable or quantifiable methods to assess the bone perfusion, the success of removing devitalized bone is based almost entirely on surgeon’s experience and varies widely across surgeons and centers. In this study, an indocyanine green (ICG)-based dynamic contrast-enhanced fluorescence imaging (DCE-FI) has been developed to objectively assess bone perfusion and guide surgical debridement. A porcine trauma model (n = 6 pigs x 2 legs) with up to 5 conditions of severity in loss of flow in each, was imaged by a commercial fluorescence imaging system. By applying the bone-specific hybrid plug-compartment (HyPC) kinetic model to four-minute video sequences, the perfusion-related metrics, such as peak intensity, total bone blood flow (TBBF) and endosteal bone blood flow to TBBF fraction (EFF) were calculated. The results shown that the combination of TBBF and EFF can effectively differentiate injured from normal bone with the accuracy, sensitivity and specificity of 89%, 88% and 90%, respectively. Our subsequent first inhuman bone blood flow imaging study confirmed DCE-FI can be successfully translated into human orthopaedic trauma patients.

Paper Details

Date Published: 19 February 2020
PDF: 6 pages
Proc. SPIE 11222, Molecular-Guided Surgery: Molecules, Devices, and Applications VI, 112220F (19 February 2020); doi: 10.1117/12.2546173
Show Author Affiliations
Shudong Jiang, Dartmouth College (United States)
Jonathan T. Elliott, Dartmouth-Hitchcock Medical Ctr. (United States)
Jason R. Gunn, Dartmouth College (United States)
Cao Xu, Dartmouth College (United States)
Alberto J. Ruiz, Dartmouth College (United States)
Brian W. Pogue, Dartmouth College (United States)
Eric R. Henderson, Dartmouth-Hitchcock Medical Ctr. (United States)
I. Leah Gitajn, Dartmouth-Hitchcock Medical Ctr. (United States)

Published in SPIE Proceedings Vol. 11222:
Molecular-Guided Surgery: Molecules, Devices, and Applications VI
Sylvain Gioux; Summer L. Gibbs; Brian W. Pogue, Editor(s)

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