Intraoperative perfusion assessment by continuous, low-latency hyperspectral light-field imaging: development, methodology, and clinical application

Abstract: Accurate assessment of tissue perfusion is crucial in visceral surgery, especially during anastomosis. Currently, subjective visual judgment is commonly employed in clinical settings. Hyperspectral imaging (HSI) offers a non-invasive, quantitative alternative. However, HSI imaging lacks continuous integration into the clinical workflow. This study presents a hyperspectral light field system for intraoperative tissue oxygen saturation (SO2) analysis and visualization. We present a correlation method for determining SO2 saturation with low computational demands. We demonstrate clinical application, with our results aligning with the perfusion boundaries determined by the surgeon. We perform and compare continuous perfusion analysis using two hyperspectral cameras (Cubert S5, Cubert X20), achieving processing times of < 170 ms and < 400 ms, respectively. We discuss camera characteristics, system parameters, and the suitability for clinical use and real-time applications.