Digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy

Abstract As indocyanine green (ICG) with near-infrared (NIR) endoscopy enhances real-time intraoperative tissue microperfusion appreciation, it may also dynamically reveal neoplasia distinctively from normal tissue especially with video software fluorescence analysis. Colorectal tumours of patients...

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Autores principales:	Jeffrey Dalli, Eamon Loughman, Niall Hardy, Anwesha Sarkar, Mohammad Faraz Khan, Haseeb A. Khokhar, Paul Huxel, Donal F. O’Shea, Ronan A. Cahill
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dde4493d19774d68a2d8d1de0639de35
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spelling	oai:doaj.org-article:dde4493d19774d68a2d8d1de0639de352021-12-02T15:02:40ZDigital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy10.1038/s41598-021-90089-72045-2322https://doaj.org/article/dde4493d19774d68a2d8d1de0639de352021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90089-7https://doaj.org/toc/2045-2322Abstract As indocyanine green (ICG) with near-infrared (NIR) endoscopy enhances real-time intraoperative tissue microperfusion appreciation, it may also dynamically reveal neoplasia distinctively from normal tissue especially with video software fluorescence analysis. Colorectal tumours of patients were imaged mucosally following ICG administration (0.25 mg/kg i.v.) using an endo-laparoscopic NIR system (PINPOINT Endoscopic Fluorescence System, Stryker) including immediate, continuous in situ visualization of rectal lesions transanally for up to 20 min. Spot and dynamic temporal fluorescence intensities (FI) were quantified using ImageJ (including videos at one frame/second, fps) and by a bespoke MATLAB® application that provided digitalized video tracking and signal logging at 30fps (Fluorescence Tracker App downloadable via MATLAB® file exchange). Statistical analysis of FI-time plots compared tumours (benign and malignant) against control during FI curve rise, peak and decline from apex. Early kinetic FI signal measurement delineated discriminative temporal signatures from tumours (n = 20, 9 cancers) offering rich data for analysis versus delayed spot measurement (n = 10 cancers). Malignant lesion dynamic curves peaked significantly later with a shallower gradient than normal tissue while benign lesions showed significantly greater and faster intensity drop from apex versus cancer. Automated tracker quantification efficiently expanded manual results and provided algorithmic KNN clustering. Photobleaching appeared clinically irrelevant. Analysis of a continuous stream of intraoperatively acquired early ICG fluorescence data can act as an in situ tumour-identifier with greater detail than later snapshot observation alone. Software quantification of such kinetic signatures may distinguish invasive from non-invasive neoplasia with potential for real-time in silico diagnosis.Jeffrey DalliEamon LoughmanNiall HardyAnwesha SarkarMohammad Faraz KhanHaseeb A. KhokharPaul HuxelDonal F. O’SheaRonan A. CahillNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jeffrey Dalli Eamon Loughman Niall Hardy Anwesha Sarkar Mohammad Faraz Khan Haseeb A. Khokhar Paul Huxel Donal F. O’Shea Ronan A. Cahill Digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy
description	Abstract As indocyanine green (ICG) with near-infrared (NIR) endoscopy enhances real-time intraoperative tissue microperfusion appreciation, it may also dynamically reveal neoplasia distinctively from normal tissue especially with video software fluorescence analysis. Colorectal tumours of patients were imaged mucosally following ICG administration (0.25 mg/kg i.v.) using an endo-laparoscopic NIR system (PINPOINT Endoscopic Fluorescence System, Stryker) including immediate, continuous in situ visualization of rectal lesions transanally for up to 20 min. Spot and dynamic temporal fluorescence intensities (FI) were quantified using ImageJ (including videos at one frame/second, fps) and by a bespoke MATLAB® application that provided digitalized video tracking and signal logging at 30fps (Fluorescence Tracker App downloadable via MATLAB® file exchange). Statistical analysis of FI-time plots compared tumours (benign and malignant) against control during FI curve rise, peak and decline from apex. Early kinetic FI signal measurement delineated discriminative temporal signatures from tumours (n = 20, 9 cancers) offering rich data for analysis versus delayed spot measurement (n = 10 cancers). Malignant lesion dynamic curves peaked significantly later with a shallower gradient than normal tissue while benign lesions showed significantly greater and faster intensity drop from apex versus cancer. Automated tracker quantification efficiently expanded manual results and provided algorithmic KNN clustering. Photobleaching appeared clinically irrelevant. Analysis of a continuous stream of intraoperatively acquired early ICG fluorescence data can act as an in situ tumour-identifier with greater detail than later snapshot observation alone. Software quantification of such kinetic signatures may distinguish invasive from non-invasive neoplasia with potential for real-time in silico diagnosis.
format	article
author	Jeffrey Dalli Eamon Loughman Niall Hardy Anwesha Sarkar Mohammad Faraz Khan Haseeb A. Khokhar Paul Huxel Donal F. O’Shea Ronan A. Cahill
author_facet	Jeffrey Dalli Eamon Loughman Niall Hardy Anwesha Sarkar Mohammad Faraz Khan Haseeb A. Khokhar Paul Huxel Donal F. O’Shea Ronan A. Cahill
author_sort	Jeffrey Dalli
title	Digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy
title_short	Digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy
title_full	Digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy
title_fullStr	Digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy
title_full_unstemmed	Digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy
title_sort	digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/dde4493d19774d68a2d8d1de0639de35
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Digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy

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