Real time mUltimodaL and multidisciplinary pERfusion imaging: the RULER project.

Tissue perfusion can still be seen as a black box as no adequate and precise perfusion assessment techniques exist. In the Ruler-project, the LUMC join arms with Quest Medical Imaging and the Centre for Human Drug Research to assess tissue perfusion using several novel techniques in 4 major clinical challenges.

Momentarily, surgeons in various disciplines have to estimate the degree of tissue perfusion solely by their hands and eyes. An incorrect estimate of tissue perfusion can result in disastrous complications, reoperations and a tremendous increase in costs and hospital length of stay. This problem affects a substantial amount of patients in for example vascular-, endocrine- and reconstructive surgery and surgical oncology. Therefore, it can be called both a scientific and a societal problem. This project aims to use a multimodal platform of optical imaging techniques to address this problem. To save time and make the process more efficient and precise, artificial intelligence will be used.

To reach this goal, a multidisciplinary consortium consisting of clinicians, technicians, industrial partners and engineers was started. Alongside, the produced images will serve as a training set for artificial intelligence models, so future real-time imaging of perfusion can be initiated.

Within this project, patients with a diabetic foot ulcer or peripheral artery disease, patients with colorectal cancer undergoing a resection, patients planned for breast reconstruction and patients undergoing thyroid surgery will be included. In these patients, the before mentioned imaging platform will be used to improve the assessment of tissue perfusion before, during and after surgery. Furthermore, this project will have its effect on several other fields of surgery/medicine, as the results will be easily translated.