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HSI enables precise image-guided resection of the liver
24 June 2022, 10:53
Recently, Sucher et al. published in Annals of Surgery another valuable study on the application of HSI in liver surgery. This study investigated the effects of preoperative portal vein embolisation (PVE) and intraoperative vascular inflow control (VIC) on hepatic microcirculation and tissue oxygenation using HSI technology.
In a total of 58 patients with various liver diseases who underwent major liver resection, HSI technology enabled the visualisation of perfusion changes. In venous embolised liver segments, the effect of arterial hyperperfusion was impressively observed by significantly increased StO2 levels and NIR perfusion indices in the colour-coded HSI images. In contrast, total vessel occlusion by ligation of the portal vein and hepatic artery (VIC) resulted in an immediate and dramatic decrease in hepatic oxygenation and perfusion in the affected liver segments. The resulting optical borderline allowed a clear distinction between ischaemic and non-ischaemic tissue in all cases, irrespective of liver disease, thus facilitating precise image-guided parenchymal transection within the boundaries between perfused and non-perfused liver parenchyma.
In addition, HSI made it possible to distinguish between different tumour entities in terms of their oxygen saturation, blood flow status and haemoglobin and water concentrations.
We are very pleased about these impressive and trend-setting results and congratulate the authors on this high-quality publication!
Sucher E, Sucher R, Guice H, Schneeberger S, Brandacher G, Gockel I, Berg T, Seehofer D. Hyperspectral Evaluation of the Human Liver During Major Resection. Annals of Surgery. 2022;2:e169. doi: 10.1097/AS9.0000000000000169