Evidence map›Paper›PMID 40407549›Full record

ArticleMedical sciences (Basel, Switzerland)2025

A Potential Pitfall in the Interpretation of Microscope-Integrated Fluorescence Angiography: The Center-Periphery Effect.

Dieder Stolk, Paul Bloemen, Richard Martin van den Elzen, Martijn de Bruin, Caroline Driessen

Abstract read
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Article in Medical sciences (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Dieder StolkDepartment of Vascular Surgery, Noordwest Ziekenhuisgroep Alkmaar, 1815 JD Alkmaar, The Netherlands.
Paul BloemenDepartment of Biomedical Engineering and Physics, Amsterdam Universitair Medische Centra, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.ORCID 0000-0002-2845-1378
Richard Martin van den ElzenDepartment of Biomedical Engineering and Physics, Amsterdam Universitair Medische Centra, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.ORCID 0000-0002-3433-7192
Martijn de BruinDepartment of Biomedical Engineering and Physics, Amsterdam Universitair Medische Centra, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Caroline DriessenDepartment of Plastic, Reconstructive and Hand Surgery, Amsterdam Universitair Medische Centra, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.ORCID 0000-0002-8395-527X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesIndocyanine green fluorescence angiography (ICG-FA) enables the real-time visualization of tissue perfusion. However, objective research on microscope-integrated fluorescence angiography (FA) has not been conducted before. This study aims to evaluate the fluorescence light distribution in images formed by ICG-FA in two surgical microscopes using a phantom, and to provide recommendations for their application.

methodsAn 11.8 by 6.8 cm ICG and Intralipid phantom was made to evaluate overall spatial fluorescence sensitivity in two surgical microscopes in multiple working distances (WDs) and magnification factors (MFs). The signal was quantified using a tailor-made software in Python 3.8.10.

resultsA clear center-periphery effect was present in most settings in both microscopes, with the highest peripheral fluorescence signal loss in the lowest MF: 100% in the Tivato and 83% in the Pentero. Increasing the MF improved homogeneity, where the biggest difference was seen between the first and second MF. A 30 cm WD and 3.5× MF produced the most homogeneous images suitable for free-flap surgery. Manually opening the light beam diameter also reduced the center-periphery effect.

conclusionsPeripheral signal loss in microscope-integrated ICG-FA must be considered during clinical interpretation and for the quantification of tissue perfusion. In clinical practice during reconstructive free-flap surgery, a 30 cm WD, 3.5 MF, and manually opened light beam diameter should be applied to achieve the most homogeneous image.

Indexed as

Fluorescein AngiographyHumansIndocyanine GreenMicroscopy, FluorescencePhantoms, ImagingIndocyanine Greenfluorescence angiographyindocyanine green (ICG)microscopenear-infrared imaging

Identifiers

PMID40407549
PMCPMC12101300

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.