Multispectral imaging of organ viability during uterine transplantation surgery in rabbits and sheep

Abstract. Uterine transplantation surgery (UTx) has been proposed as a treatment for permanent absolute uterine factor infertility (AUFI) in the case of the congenital absence or surgical removal of the uterus. Successful surgical attachment of the organ and its associated vasculature is essential for the organ’s reperfusion and long-term viability. Spectral imaging techniques have demonstrated the potential for the measurement of hemodynamics in medical applications. These involve the measurement of reflectance spectra by acquiring images of the tissue in different wavebands. Measures of tissue constituents at each pixel can then be extracted from these spectra through modeling of the light–tissue interaction. A multispectral imaging (MSI) laparoscope was used in sheep and rabbit UTx models to study short- and long-term changes in oxygen saturation following surgery. The whole organ was imaged in the donor and recipient animals in parallel with point measurements from a pulse oximeter. Imaging results confirmed the re-establishment of adequate perfusion in the transplanted organ after surgery. Cornual oxygenation trends measured with MSI are consistent with pulse oximeter readings, showing decreased StO2 immediately after anastomosis of the blood vessels. Long-term results show recovery of StO2 to preoperative levels.

[1]  Guang-Zhong Yang,et al.  Multispectral image alignment using a three channel endoscope in vivo during minimally invasive surgery , 2012, Biomedical optics express.

[2]  Danail Stoyanov,et al.  Robust registration of multispectral images of the cortical surface in neurosurgery , 2012, 2012 9th IEEE International Symposium on Biomedical Imaging (ISBI).

[3]  Joshua R. Smith,et al.  First Prize: Characterization of Renal Ischemia Using DLP® Hyperspectral Imaging: A Pilot Study Comparing Artery-Only Occlusion Versus Artery and Vein Occlusion , 2010 .

[4]  Krishen Sieunarine,et al.  Pulse oximetry and perfusion index measurement to assess uterine perfusion and viability. , 2006, International surgery.

[5]  Guang-Zhong Yang,et al.  Registration and analysis of multispectral images acquired during uterine transplantation surgery , 2012 .

[6]  N. Takano,et al.  Detecting early oral cancer: narrowband imaging system observation of the oral mucosa microvasculature. , 2010, International journal of oral and maxillofacial surgery.

[7]  Michael Boyd,et al.  Achieving uterine auto‐transplantation in a sheep model using iliac vessel anastomosis: a short‐term viability study , 2015, Acta obstetricia et gynecologica Scandinavica.

[8]  J.C. Ramella-Roman,et al.  Spectroscopic Measurements of Oxygen Saturation in the Retina , 2007, IEEE Journal of Selected Topics in Quantum Electronics.

[9]  Mark Hewko,et al.  Regional variations in myocardial tissue oxygenation mapped by near-infrared spectroscopic imaging. , 2002, Journal of molecular and cellular cardiology.

[10]  Milan Milenkovic,et al.  Livebirth after uterus transplantation , 2015, The Lancet.

[11]  Lena Maier-Hein,et al.  Robust near real-time estimation of physiological parameters from megapixel multispectral images with inverse Monte Carlo and random forest regression , 2016, International Journal of Computer Assisted Radiology and Surgery.

[12]  Daniel S. Elson,et al.  Multispectral Imaging using a Fast Filter Wheel System during Vascular Surgery , 2013 .

[13]  Michael B Wallace,et al.  Prospective, controlled tandem endoscopy study of narrow band imaging for dysplasia detection in Barrett's Esophagus. , 2008, Gastroenterology.

[14]  Christopher D. Anderson,et al.  Visible hyperspectral imaging evaluating the cutaneous response to ultraviolet radiation , 2007, SPIE BiOS.

[15]  A. Matsui,et al.  Predicting the survival of experimental ischaemic small bowel using intraoperative near‐infrared fluorescence angiography , 2011, The British journal of surgery.

[16]  Lena Maier-Hein,et al.  Endoscopic Sheffield Index for Unsupervised In Vivo Spectral Band Selection , 2014, CARE@MICCAI.

[17]  H. Mantsch,et al.  Visible-near infrared multispectral imaging of the rat dorsal skin flap. , 1999, Journal of biomedical optics.

[18]  Danail Stoyanov,et al.  Multispectral imaging of organ viability during uterine transplantation surgery , 2014, Photonics West - Biomedical Optics.

[19]  Anna L David,et al.  Uterine allotransplantation in a rabbit model using aorto-caval anastomosis: a long-term viability study. , 2014, European journal of obstetrics, gynecology, and reproductive biology.

[20]  D L Farkas,et al.  Near-simultaneous hemoglobin saturation and oxygen tension maps in mouse brain using an AOTF microscope. , 1997, Biophysical journal.

[21]  L. Billingham,et al.  Narrow‐band imaging flexible cystoscopy in the detection of recurrent urothelial cancer of the bladder , 2008, BJU international.

[22]  Danail Stoyanov,et al.  Robust surface tracking combining features, intensity and illumination compensation , 2015, International Journal of Computer Assisted Radiology and Surgery.

[23]  H. Raffa,et al.  Transplantation of the human uterus , 2002, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[24]  Mehrdad Alemozaffar,et al.  Evidence of a heterogeneous tissue oxygenation: renal ischemia/reperfusion injury in a large animal model , 2013, Journal of biomedical optics.

[25]  M. Brännström,et al.  Uterus transplantation. , 2021, Fertility and sterility.

[26]  M. Brännström,et al.  Experimental uterus transplantation. , 2010, Human reproduction update.

[27]  D. Stoyanov,et al.  Intraoperative measurement of bowel oxygen saturation using a multispectral imaging laparoscope. , 2015, Biomedical optics express.

[28]  M. Dewhirst,et al.  Hyperspectral imaging of hemoglobin saturation in tumor microvasculature and tumor hypoxia development. , 2005, Journal of biomedical optics.

[29]  S. Schlatt,et al.  Uterus Transplantation: On the Edge , 2011, Seminars in reproductive medicine.

[30]  K. Zuzak,et al.  Visible reflectance hyperspectral imaging: characterization of a noninvasive, in vivo system for determining tissue perfusion. , 2002, Analytical chemistry.

[31]  Dirk J. Faber,et al.  A literature review and novel theoretical approach on the optical properties of whole blood , 2013, Lasers in Medical Science.

[32]  M. Gladwin,et al.  Imaging hemoglobin oxygen saturation in sickle cell disease patients using noninvasive visible reflectance hyperspectral techniques: effects of nitric oxide. , 2003, American journal of physiology. Heart and circulatory physiology.

[33]  Michael Olausson,et al.  Uterus transplantation: animal research and human possibilities. , 2012, Fertility and sterility.

[34]  Joshua R. Smith,et al.  Uterine Transplantation, Abdominal Trachelectomy, and Other Reproductive Options for Cancer Patients , 2001, Annals of the New York Academy of Sciences.