title: Noninvasive measurement of cerebral blood flow in adults using near-infrared spectroscopy and indocyanine green: a pilot study.
abstract: This pilot study was designed to determine the feasibility of measuring cerebral blood flow noninvasively after an intravenous bolus of indocyanine green using near-infrared spectroscopy and pulse dye-densitometry. Feasibility aside, this study did not attempt to validate the measured values of cerebral blood flow against an established method of measurement. Twelve healthy volunteers were investigated after peripheral intravenous injection of indocyanine green. Arterial and cerebral changes in indocyanine green concentration were measured using pulse dye-densitometry and near-infrared spectroscopy, respectively. Two methods of calculating cerebral blood flow were used, and a blood flow index was also estimated. Absolute cerebral blood flow was calculated using a modification of the Fick principle and a deconvolution algorithm to derive the impulse residue function. Mean (range) estimated cerebral blood flow for the Fick method was 8.2 mL/100 g/min (4.2-16.2 mL/100 g/min) and 8.3 mL/100 g/min (4.7-15.3 mL/100 g/min) for the impulse residue function method. The impulse residue function method provided a more precise intrasubject estimation of cerebral blood flow compared with the modified Fick principle, with a coefficient of variation of 10.1% versus 25.5%. The blood flow index was 8.6 mg/sec (range: 5.6-17.3 mg/sec) with an intrasubject coefficient of variation of 12.0%. Estimation of cerebral blood flow using near-infrared spectroscopy and pulse dye-densitometry can be made at the bedside after intravenous injection of indocyanine green, and the precision can be improved using a deconvolution algorithm. Notwithstanding the low values obtained for absolute cerebral blood flow, further investigation and validation of this bedside technique is warranted.
authors.affiliation: Department of Neuroanesthesia and Intensive Care, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: Felix
authors.initials: F
authors.lastname: Gora
authors.forename: Samantha
authors.initials: S
authors.lastname: Shinde
authors.forename: Clare E
authors.initials: CE
authors.lastname: Elwell
authors.forename: John C
authors.initials: JC
authors.lastname: Goldstone
authors.forename: Mark
authors.initials: M
authors.lastname: Cope
authors.forename: David T
authors.initials: DT
authors.lastname: Delpy
authors.forename: Martin
authors.initials: M
authors.lastname: Smith
mesh_terms: D000328:Adult; D000465:Algorithms; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004396:Coloring Agents; D003287:Contrast Media; D006801:Humans; D007208:Indocyanine Green; D010865:Pilot Projects; D019095:Point-of-Care Systems; D019265:Spectroscopy, Near-Infrared
chemical_list: D004396:Coloring Agents; D003287:Contrast Media; D007208:Indocyanine Green