Dynamic contrast-enhanced near-infrared spectroscopy using indocyanine green on moderate and severe traumatic brain injury: a prospective observational study

Research output: Contribution to journalArticlepeer-review


  • Mario Forcione
  • Kamal Makram Yakoub
  • Antonio Maria Chiarelli
  • David Perpetuini
  • Arcangelo Merla
  • Rosa Sun
  • Piotr Sawosz

External organisations

  • G. d'Annunzio University of Chieti-Pescara
  • Polish Academy of Sciences
  • University Hospitals Birmingham NHS Foundation Trust


Background: The care given to moderate and severe traumatic brain injury (TBI) patients may be hampered by the inability to tailor their treatments according to their neurological status. Contrast-enhanced near-infrared spectroscopy (NIRS) with indocyanine green (ICG) could be a suitable neuromonitoring tool.

Methods: Monitoring the effective attenuation coefficients (EAC), we compared the ICG kinetics between five TBI and five extracranial trauma patients, following a venous-injection of 5 mL of 1 mg/mL ICG, using two commercially available NIRS devices.

Results: A significantly slower passage of the dye through the brain of the TBI group was observed in two parameters related to the first ICG inflow into the brain (P=0.04; P=0.01). This is likely related to the reduction of cerebral perfusion following TBI. Significant changes in ICG optical properties minutes after injection (P=0.04) were registered. The acquisition of valid optical data in a clinical environment was challenging.

Conclusions: Future research should analyze abnormalities in the ICG kinetic following brain trauma, test how these values can enhance care in TBI, and adapt the current optical devices to clinical settings. Also, studies on the pattern in changes of ICG optical properties after venous injection can improve the accuracy of the values detected.


Original languageEnglish
Pages (from-to)2085-2097
Number of pages13
JournalQuantitative Imaging in Medicine and Surgery
Issue number11
Publication statusPublished - 1 Nov 2020


  • Near-infrared spectroscopy (NIRS), traumatic brain injury (TBI), indocyanine green (ICG), cerebral perfusion, blood-brain barrier (BBB)