# Fluorescence-based detection of inflammation and necrosis to inform surgical decision-making and enhance outcomes

> **NIH NIH R01** · UNIVERSITY OF WISCONSIN-MADISON · 2022 · $300,344

## Abstract

Project Summary: Tissue necrosis is a form of cell death caused by a wide variety of diseases and
injuries. Current methods of detecting tissue necrosis to guide surgical decision making are limited. In burn
injury, clinical visualization of tissue necrosis is the standard of care; however, it is an imprecise method that
can result in delays in care, unnecessary surgery, and removal of viable tissue. There is a critical need to
identify novel methods to improve the detection of necrosis in burn injury to aid perioperative clinical decision
making. While Indocyanine Green Angiography (ICGA) has been shown to identify burn depth using perfusion
as a surrogate marker for necrosis, it has not been widely adopted for clinical decision making. Recently,
clinical trials using delayed imaging of high dose ICG (Second Window Indocyanine Green - SWIG) have
shown promise in image-guided surgical resection of tumors. We propose that combined imaging with
ICGA and SWIG can be employed to enhance surgical decision-making in burn injury as well as in
many disease processes involving necrosis. The knowledge gained from this project will fill the critical need
to prevent unnecessary surgery, improve surgical precision, and provide insight into ICG localization in
inflamed and necrotic tissue.
 The goal of this project is to characterize the ICGA and SWIG fluorescence in burn inflammation and
necrosis on a macroscopic and microscopic level. Specific Aim 1 will characterize fluorescent signals from
ICGA and SWIG in the healing potential of indeterminate depth burns in humans. Specific Aim 2 will evaluate
the diagnostic accuracy of intraoperative fluorescence-guided surgical resection of necrotic tissue in humans.
Specific Aim 3 will characterize ICG fluorescence quantification in inflamed, necrotic, and healthy tissues and
determine substrate localization using cell culture and animal models. To attain our goal, we will use a team
science approach including a burn surgeon scientist who has extensive experience in human thermal injury
models and clinical expertise in the surgical care of burn patients along with imaging experts who have a track
record for developing advanced fluorescence-based technologies for in vivo imaging, including a surgical
imaging technology called “transient lighting” that allows simultaneous white light and low-level fluorescence
visualization in ambient lighting conditions. Transient lighting is especially critical in burn surgery to augment
the visualization of the wound with ICG fluorescence under full white lighting.
 This project will result in preclinical and clinical data testing the use of ICG for direct detection of necrotic
tissue using a fluorescence imaging device optimized for burn surgery, while developing a platform for
quantification of tissue necrosis and characterization of ICG-avid necrosis. These studies will provide
necessary data to inform the design of a larger clinical trial to determine the efficacy and validity of...

## Key facts

- **NIH application ID:** 10422210
- **Project number:** 1R01GM145723-01
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** ANGELA L F GIBSON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $300,344
- **Award type:** 1
- **Project period:** 2022-07-01 → 2027-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10422210

## Citation

> US National Institutes of Health, RePORTER application 10422210, Fluorescence-based detection of inflammation and necrosis to inform surgical decision-making and enhance outcomes (1R01GM145723-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10422210. Licensed CC0.

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