Abstract
(1) Background: Near-infrared fluorescence imaging is a technique capable of assessing tissue perfusion and has been adopted in various fields including plastic surgery, vascular surgery, coronary arterial disease, and gastrointestinal surgery. While the usefulness of this technique has been broadly explored, there is a large variety in the calculation of perfusion parameters. In this systematic review, we aim to provide a detailed overview of current perfusion parameters, and determine the perfusion parameters with the most potential for application in near-infrared fluorescence imaging. (2) Methods: A comprehensive search of the literature was performed in Pubmed, Embase, Medline, and Cochrane Review. We included all clinical studies referencing near-infrared perfusion parameters. (3) Results: A total of 1511 articles were found, of which, 113 were suitable for review, with a final selection of 59 articles. Near-infrared fluorescence imaging parameters are heterogeneous in their correlation to perfusion. Time-related parameters appear superior to absolute intensity parameters in a clinical setting. (4) Conclusions: This literature review demonstrates the variety of parameters selected for the quantification of perfusion in near-infrared fluorescence imaging.
Highlights
Near-infrared fluorescence (NIRF) imaging is a promising technique for visualizing tissue perfusion
For patients with peripheral arterial disease (PAD), NIRF imaging can be used for the assessment of regional tissue perfusion
An overview of the article selection process for this systematic review is reported in a flow diagram in Figure 1, according to the preferred reporting items for systematic review and meta-analysis protocols’ 2015 guidelines
Summary
Near-infrared fluorescence (NIRF) imaging is a promising technique for visualizing tissue perfusion. The measurement of fluorescence in the near-infrared spectrum is feasible for perfusion assessment due to the low tissue auto-fluorescence in this range. This allows for the visualization of an intravenously administered fluorophore. The use of NIRF imaging as a technique to assess tissue perfusion has been explored in various surgical fields. Described applications of NIRF imaging in patients with PAD include (1) diagnosis, (2) the measuring of the effect of revascularization procedures, and (3) the assessment of tissue viability following amputation surgery [2]. NIRF imaging has, been applied in neurosurgery, quantifying cerebral perfusion, both intra- and postoperatively, and in gastrointestinal surgery, assessing anastomotic perfusion after bowel resection [4]
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