Hyperspectral Imaging (HSI) as a novel intraoperative diagnostic tool in pancreatic surgery

Keywords Hyperspectral imaging (HSI); Pancreatic surgery; Pancreatic cancer treatment; Pancreatic cancer surgery; Tissue Lipid Index

Background Hyperspectral Imaging (HSI) is a novel, non-invasive technique to deliver real-time information about the tissue composition of solid organs. Complete tumor resection is the only curative therapy option in pancreatic cancer. However, postoperative pancreatic fistula rates remain high, leading to morbidity and possibly mortality. Aim of our prospective pilot study was to evaluate the feasibility and accuracy of intraoperative HSI to assess pancreatic perfusion and tissue composition

Materials and methods Therefore, we examined intraoperative HSI data of 14 patients during pancreatic resections regarding pancreatic texture and perfusion.The subjective texture of the pancreata was described by experienced surgeons and compared to the composition assessed by HSI. Texture was classified as either “hard” or „soft“. The HSI analysis was performed after exposure but before resection of pankreata. Nine circular regions of interest (ROI) of the size of 10 mm were set to discribe the whole gland ([Figure 1 (a, b))].

Results Interestingly, pancreata that were subjectively described as “hard” and “chronically inflamed” had a significantly higher tissue lipid index (TLI) (M=71.83, SD=11.12, p=0.02) and were trending towards a lower tissue water index (TWI) (M=30.40, SD=3.34, p=0.07) than soft and mildly inflamed pancreata (TLI: M=36.23, SD=25.54; TWI: M=39.95, SD=10.1). There was no significant correlation between the body mass index (BMI) and TLI (R=0.32, p=0.26)

Conclusion HSI could evolve as a non-invasive intraoperative tool to objectively assess pancreatic perfusion and texture to enhance safety of pancreatic anastomoses.

Abb. 1 (a) Schematic description of the pancreatic tissue after initial preparation with the analyzing markers.

Abb. 2 HSI RGB-picture (additive color-model of the primary colors red, green and blue) after initial preparation with the analyzing markers

Publikationsverlauf

Artikel online veröffentlicht:
19. August 2022