There currently exist no tools to provide real-time guidance for surgeons in the management of bowel resection and anastomosis. Practitioners currently rely on their vision, touch, and experience to identify anastomotic site defects that could potentially lead to major complications. Consequently, procedures are guided subjectively, resulting in unacceptable morbidity (24%) and mortality (3%) rates. Given that over 250,000 patients undergo bowel resection and anastomosis every year in the U.S. alone, a novel imaging technology assessing bowel tissue status is desperately needed. The hypothesis underlying this study is that with near-infrared (NIR) light, which travels deep into tissues (<10mm), recent advances in diffuse optical imaging will permit the real-time quantification of bowel tissue optical properties, providing physiologically-relevant information relative to perfusion, oxygen saturation, metabolism, hydration and sub-cellular content. In particular, the method of Single Snapshot Optical Properties (SSOP) imaging, along with robust light propagation models, can enable the quantification of tissue properties in real-time and over large fields of view (>100cm2). Such technology offers the potential to provide quantitative imaging of tissue constituents' composition as surrogate markers for tissue viability, enabling surgeons to intervene with objective information at the time of surgery. The proposed work will translate the fundamental strengths of SSOP into a robust, objective tissue evaluation technology for guidance of bowel resection and anastomosis procedures.
The first aim proposes to implement a robust spectral image acquisition scheme, capable of applying highly accurate height corrections and quantitatively mapping physiological information, such as tissue hemoglobin oxygenation, in real-time.
The second aim i s to develop novel processing methods and to implement parallel computation architectures to enable real-time imaging of tissue properties. Finally, in the third aim an optical index will be developed to maximize specificity an sensitivity to ischemia-related damage in large animal models, using the device and methods developed through this project. Overall, this F31 fellowship application, while launching the career of a biomedical engineer, proposes solutions to solve a longstanding clinical problem and has the potential to impact the way gut surgeries are performed.
Over 250,000 U.S. citizens undergo bowel resection and anastomosis every year experiencing devastating complications such as anastomotic leaks, yet, surgical procedures are still performed without any objective guidance that could permit the identification of potential defects and allow proper and timely intervention during surgery. This F31 application focuses on the development of novel imaging technology for intraoperative guidance for the purpose of objectively monitoring bowel resection and anastomosis. This application also serves as a training vehicle for a promising young scientist whose long-term career goal is independent investigation.
| Angelo, Joseph; Vargas, Christina R; Lee, Bernard T et al. (2016) Ultrafast optical property map generation using lookup tables. J Biomed Opt 21:110501 |
| van de Giessen, Martijn; Angelo, Joseph P; Gioux, Sylvain (2015) Real-time, profile-corrected single snapshot imaging of optical properties. Biomed Opt Express 6:4051-62 |
