Laser speckle contrast imaging for intraoperative assessment of liver microcirculation: a clinical pilot study

Sam Eriksson,1,2,* Jan Nilsson,1,2,* Gert Lindell,1,2 Christian Sturesson1,2 1Department of Surgery, Clinical Sciences Lund, Lund University, 2Skåne University Hospital, Lund, Sweden  *These authors contributed equally to the study Background: Liver microcirculation can be affected by a wide variety of causes relevant to liver transplantation and resectional surgery. Intraoperative assessment of the microcirculation could possibly predict postoperative outcome. The present pilot study introduces laser speckle contrast imaging (LSCI) as a new clinical method for assessing liver microcirculation. Methods: LSCI measurements of liver microcirculation were performed on ten patients undergoing liver resection. Measurements were made during apnea with and without liver blood inflow occlusion. Hepatic blood flow was assessed by subtracting zero inflow signal from the total signal. Zero inflow signal was obtained after hepatic artery and portal vein occlusion. Perfusion was expressed in laser speckle perfusion units, and intraindividual and interindividual variability in liver perfusion was investigated using the coefficient of variability. Results: Hepatic microcirculation measurements were successfully made in all patients resulting in analyzable speckle contrast images. Mean hepatic blood flow was 410±36 laser speckle perfusion units. Zero inflow signal amounted to 40%±4% of the total signal. Intraindividual and interindividual coefficients of variability in liver perfusion were 25% and 28%, respectively. Conclusion: Under the conditions of this pilot study, LSCI allows rapid noncontact measurements of hepatic blood perfusion over wide areas. More studies are needed on methods of handling movement artifacts. Keywords: liver surgery, blood perfusio