Noninvasive quantitative assessment of microcirculatory disorders of the upper extremities with 2D fluorescence optical imaging

Article type: Research Article

Authors: Neumann, Jan^a | Schmaderer, Christoph^b | Finsterer, Sebastian^a | Zimmermann, Alexander^c | Steubl, Dominik^b | Helfen, Anne^d | Berninger, Markus^e | Lohöfer, Fabian^a | Rummeny, Ernst J.^a | Meier, Reinhard^a | Wildgruber, Moritz^{a; d; *}

Affiliations: [a] Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany | [b] Department of Nephrology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany | [c] Department of Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany | [d] Department of Clinical Radiology, Münster University Hospital, Münster, Germany | [e] Trauma Center, BG Unfallklinik Murnau, Murnau, Germany

Correspondence: [*] Corresponding author: Moritz Wildgruber, MD, PhD, Department of Clinical Radiology, Münster University Hospital, Albert-Schweitzer Campus 1, D-48149 Münster, Germany. Tel.: +49 251 83 56261; E-mail: [email protected].

Abstract: BACKGROUND:Quantitative Imaging of microcirculatory disorders is challenging. OBJECTIVE:To investigate the feasibility of 2D Fluorescence Optical Imaging (FOI) for characterization and quantification of microcirculatory disorders in peripheral arterial occlusive disease (PAOD) of the upper extremity. METHODS:9 patients with various clinical presentations of PAOD of the upper extremity were included. Quantitative analysis of both hands was performed by assessing the fluorescence intensity of Indocyanine Green (ICG) dynamically over a time period of 360 seconds. Analysis of the signal intensity within multiple regions of both hands was calculated and time-dependent perfusion curves for each region of interest were plotted over time. RESULTS:Compared to the healthy, vascular non-impaired segments, pathological segments with an impaired tissue perfusion were identified through a decreased rate of early tissue enhancement (p = 0.02) and increased signal intensity of the optical perfusion agent per second (p < 0.001). The affected segments showed a decreased maximum signal intensity and a prolonged interval to reach the maximum signal intensity (time to peak). CONCLUSION:2D FOI allows quantitative assessment of the peripheral microcirculation in various vascular pathophysiologies and is able to detect the impaired tissue perfusion in patients with vascular disorders of the upper extremity.

Keywords: Fluorescence optical imaging, microcirculation, peripheral arterial occlusive disease, indocyanine green

DOI: 10.3233/CH-170321

Journal: Clinical Hemorheology and Microcirculation, vol. 70, no. 1, pp. 69-81, 2018