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Mullen et al: Use of real-time near-infrared fluorescence to assess gastric viability in dogs with gastric dilatation volvulus: A case-control study
Veterinary Surgery 4, 2024

🔍 Key Findings

  • NIRF altered surgical strategy in 3 of 20 GDV dogs, identifying necrosis not appreciated subjectively.
  • Fundic fluorescence <10% indicated histologically confirmed gastric necrosis.
  • In 1 dog, NIRF revealed nonviability despite the surgeon’s impression of viability.
  • Staple line fluorescence resembled viable tissue in the only stapled gastrectomy, suggesting preservation of perfusion.
  • GDV dogs (even “viable”) showed lower fluorescence vs. healthy controls, indicating subclinical vascular compromise.
  • Histology confirmed full-thickness necrosis in all 4 dogs with NIRF-defined nonviability.
  • Pre-op lactate was significantly higher in nonviable GDV dogs (8.55 vs 4.89 mmol/L, p=0.03).
  • No complications were reported from ICG use; imaging was safe and repeatable.

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← Articles

Mullen et al: Use of real-time near-infrared fluorescence to assess gastric viability in dogs with gastric dilatation volvulus: A case-control study
Veterinary Surgery 4, 2024

🔍 Key Findings

  • NIRF altered surgical strategy in 3 of 20 GDV dogs, identifying necrosis not appreciated subjectively.
  • Fundic fluorescence <10% indicated histologically confirmed gastric necrosis.
  • In 1 dog, NIRF revealed nonviability despite the surgeon’s impression of viability.
  • Staple line fluorescence resembled viable tissue in the only stapled gastrectomy, suggesting preservation of perfusion.
  • GDV dogs (even “viable”) showed lower fluorescence vs. healthy controls, indicating subclinical vascular compromise.
  • Histology confirmed full-thickness necrosis in all 4 dogs with NIRF-defined nonviability.
  • Pre-op lactate was significantly higher in nonviable GDV dogs (8.55 vs 4.89 mmol/L, p=0.03).
  • No complications were reported from ICG use; imaging was safe and repeatable.

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Multiple Choice Questions on this study

In Mullen 2024 et al., on NIRF for GDV, what best describes the NIRF findings in stapled partial gastrectomy sites?

A. Markedly reduced fluorescence compared to viable tissue
B. Fluorescence absent in stapled region
C. Fluorescence greater than non-stapled regions
D. Fluorescence similar to viable tissue
E. Fluorescence limited to vascular margins

Answer: Fluorescence similar to viable tissue

Explanation: The stapled edge showed fluorescence intensity comparable to viable tissue, suggesting preserved perfusion.
In Mullen 2024 et al., on NIRF for GDV, what was the typical NIRF finding in histologically confirmed necrotic gastric regions?

A. High fluorescence with defined vessels
B. Moderate fluorescence with irregular margins
C. No change from viable tissue
D. Low fluorescence with absent vessel pattern
E. Increased fluorescence over macrovasculature only

Answer: Low fluorescence with absent vessel pattern

Explanation: Necrotic tissue lacked defined blood vessels and had markedly reduced NIR fluorescence.
In Mullen 2024 et al., on NIRF for GDV, how did near-infrared imaging alter the surgical plan in affected dogs?

A. It prevented surgery in all cases
B. It led to euthanasia in all cases
C. It reduced operative time in all cases
D. It changed resection margins in 3/20 dogs
E. It identified new anatomic anomalies

Answer: It changed resection margins in 3/20 dogs

Explanation: NIRF identified additional nonviable tissue and altered the surgeon’s planned margins in 3 of 20 GDV dogs.
In Mullen 2024 et al., on NIRF for GDV, what intraoperative variable was significantly different between viable and nonviable groups?

A. Preoperative lactate
B. Body temperature
C. ECG rhythm
D. Age
E. PCV

Answer: Preoperative lactate

Explanation: Nonviable dogs had significantly higher pre-op lactate (8.55 vs 4.89 mmol/L, p=0.03).
In Mullen 2024 et al., on NIRF for GDV, which region showed significantly lower fluorescence intensity in nonviable gastric tissue?

A. Cardia
B. Body
C. Pylorus
D. Fundus
E. Duodenum

Answer: Fundus

Explanation: Fundic fluorescence was significantly reduced in nonviable tissue (4.33%) vs viable GDV cases (38.17%).

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