Handheld Photoacoustic Imaging of Indocyanine Green Clearance for Real-time Quantitative Evaluation of Liver Reserve Function

Overview

Journal Biomed Opt Express

Specialty Radiology

Date 2023 Jul 27

PMID 37497492

Authors

Hai Zhang

Si-Lue Zeng

Yun-Zhu Wu

Ruo-Xin Zhang

Liang-Jian Liu

Qiang Xue

Jing-Qin Chen

Kenneth K Y Wong

Jin-Feng Xu

Ya-Guang Ren

Chi-Hua Fang

Cheng-Bo Liu

Affiliations

Soon will be listed here.

Abstract

Preoperative assessment of liver function reserve (LFR) is essential for determining the extent of liver resection and predicting the prognosis of patients with liver disease. In this paper, we present a real-time, handheld photoacoustic imaging (PAI) system-based noninvasive approach for rapid LFR assessment. A linear-array ultrasound transducer was sealed in a housing filled with water; its front end was covered with a plastic wrap. This PAI system was first implemented on phantoms to confirm that the photoacoustic (PA) intensity of indocyanine green (ICG) in blood reflects the concentration of ICG in blood. studies on normal rabbits and rabbits with liver fibrosis were carried out by recording the dynamic PA signal of ICG in their jugular veins. By analyzing the PA intensity-time curve, a clear difference was identified in the pharmacokinetic behavior of ICG between the two groups. In normal rabbits, the mean ICG clearance rate obtained by PAI at 15 min after administration (PAI-R15) was below 21.6%, whereas in rabbits with liver fibrosis, PAI-R15 exceeded 62.0% because of poor liver metabolism. The effectiveness of the proposed method was further validated by the conventional ICG clearance test and pathological examination. Our findings suggest that PAI is a rapid, noninvasive, and convenient method for LFR assessment and has immense potential for assisting clinicians in diagnosing and managing patients with liver disease.

References

Imai T, Takahashi K, Goto F, Morishita Y . Measurement of blood concentration of indocyanine green by pulse dye densitometry--comparison with the conventional spectrophotometric method. J Clin Monit Comput. 1999; 14(7-8):477-84. DOI: 10.1023/a:1009948128543. View

Li Y, Li L, Zhu L, Maslov K, Shi J, Hu P . Snapshot Photoacoustic Topography Through an Ergodic Relay for High-throughput Imaging of Optical Absorption. Nat Photonics. 2021; 14(3):164-170. PMC: 8223468. DOI: 10.1038/s41566-019-0576-2. View

Thomas M, Weninger E, Angele M, Bosch F, Pratschke S, Andrassy J . Intraoperative simulation of remnant liver function during anatomic liver resection with indocyanine green clearance (LiMON) measurements. HPB (Oxford). 2015; 17(6):471-6. PMC: 4430775. DOI: 10.1111/hpb.12380. View

Reekers M, Simon M, Boer F, Mooren R, van Kleef J, Dahan A . Pulse dye densitometry and indocyanine green plasma disappearance in ASA physical status I-II patients. Anesth Analg. 2010; 110(2):466-72. DOI: 10.1213/ANE.0b013e3181c92b09. View

Wang L, Hu S . Photoacoustic tomography: in vivo imaging from organelles to organs. Science. 2012; 335(6075):1458-62. PMC: 3322413. DOI: 10.1126/science.1216210. View

Landsman M, Kwant G, Mook G, ZIJLSTRA W . Light-absorbing properties, stability, and spectral stabilization of indocyanine green. J Appl Physiol. 1976; 40(4):575-83. DOI: 10.1152/jappl.1976.40.4.575. View

Matsumata T, Kanematsu T, Yoshida Y, Furuta T, Yanaga K, Sugimachi K . The indocyanine green test enables prediction of postoperative complications after hepatic resection. World J Surg. 1987; 11(5):678-81. DOI: 10.1007/BF01655848. View

Huang G, Lv J, He Y, Yang J, Zeng L, Nie L . In vivo quantitative photoacoustic evaluation of the liver and kidney pathology in tyrosinemia. Photoacoustics. 2022; 28:100410. PMC: 9531282. DOI: 10.1016/j.pacs.2022.100410. View

Manizate F, Hiotis S, Labow D, Roayaie S, Schwartz M . Liver functional reserve estimation: state of the art and relevance for local treatments: the Western perspective. J Hepatobiliary Pancreat Sci. 2009; 17(4):385-8. DOI: 10.1007/s00534-009-0228-x. View

10.

Malinchoc M, Kamath P, Gordon F, Peine C, Rank J, ter Borg P . A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000; 31(4):864-71. DOI: 10.1053/he.2000.5852. View

11.

Ott P . Hepatic elimination of indocyanine green with special reference to distribution kinetics and the influence of plasma protein binding. Pharmacol Toxicol. 1998; 83 Suppl 2:1-48. DOI: 10.1111/j.1600-0773.1998.tb01945.x. View

12.

Huang M, Shen S, Cai H, Peng Z, Hang Keith Chiu W, Li Z . Regional liver function analysis with gadoxetic acid-enhanced MRI and virtual hepatectomy: prediction of postoperative short-term outcomes for HCC. Eur Radiol. 2021; 31(7):4720-4730. DOI: 10.1007/s00330-020-07606-x. View

13.

Attia A, Balasundaram G, Moothanchery M, Dinish U, Bi R, Ntziachristos V . A review of clinical photoacoustic imaging: Current and future trends. Photoacoustics. 2019; 16:100144. PMC: 6911900. DOI: 10.1016/j.pacs.2019.100144. View

14.

Watanabe Y, Kumon K . Assessment by pulse dye-densitometry indocyanine green (ICG) clearance test of hepatic function of patients before cardiac surgery: its value as a predictor of serious postoperative liver dysfunction. J Cardiothorac Vasc Anesth. 1999; 13(3):299-303. DOI: 10.1016/s1053-0770(99)90267-7. View

15.

Lv J, Xu Y, Xu L, Nie L . Quantitative Functional Evaluation of Liver Fibrosis in Mice with Dynamic Contrast-enhanced Photoacoustic Imaging. Radiology. 2021; 300(1):89-97. DOI: 10.1148/radiol.2021204134. View

16.

Qiu T, Yang J, Pan T, Peng C, Jiang H, Luo Y . Assessment of liver function reserve by photoacoustic tomography: a feasibility study. Biomed Opt Express. 2020; 11(7):3985-3995. PMC: 7510925. DOI: 10.1364/BOE.394344. View

17.

Yoon J, Choi J, Jeong Y, Schenk A, Chen L, Laue H . Pre-treatment estimation of future remnant liver function using gadoxetic acid MRI in patients with HCC. J Hepatol. 2016; 65(6):1155-1162. DOI: 10.1016/j.jhep.2016.07.024. View

18.

Lim M, Tan C, Cai J, Zheng J, Kow A . CT volumetry of the liver: where does it stand in clinical practice?. Clin Radiol. 2014; 69(9):887-95. DOI: 10.1016/j.crad.2013.12.021. View

19.

Cucchetti A, Cescon M, Trevisani F, Pinna A . Current concepts in hepatic resection for hepatocellular carcinoma in cirrhotic patients. World J Gastroenterol. 2012; 18(44):6398-408. PMC: 3508634. DOI: 10.3748/wjg.v18.i44.6398. View

20.

Imamura H, Sano K, Sugawara Y, Kokudo N, Makuuchi M . Assessment of hepatic reserve for indication of hepatic resection: decision tree incorporating indocyanine green test. J Hepatobiliary Pancreat Surg. 2005; 12(1):16-22. DOI: 10.1007/s00534-004-0965-9. View