American Association of Endocrine SurgeonA novel optical approach to intraoperative detection of parathyroid glands
Section snippets
Patients and methods
Patients with primary thyroid or parathyroid disease undergoing parathyroidectomy or thyroidectomy at the Vanderbilt Endocrine Surgery Center were considered for this study. The operating endocrine surgeon determined the eligibility of each patient by evaluating their overall health in a preoperative assessment at the Vanderbilt Clinic. Under the approval of the Institutional Review board, written consent was obtained for a total of 45 patients between the ages of 18 and 99, regardless of sex
Results
The goal of this study was to determine whether NIR fluorescence spectroscopy could distinguish the parathyroid gland from the thyroid and all other tissues in the neck during surgery, regardless of disease type Fluorescence spectra of these tissues were obtained from 45 patients. Of these patients, 14 (31%) underwent thyroidectomy for benign thyroid disease, 6 (13%) underwent thyroidectomy for malignant disease, 9 (20%) underwent thyroidectomy for hyperthyroidism, and 16 (36%) underwent
Discussion
We present a novel tool that uses the intrinsic NIR autofluorescence to detect parathyroid tissue and guide surgeons in real-time during endocrine surgeries. The results reported here show that NIR fluorescence spectroscopy is capable of reliable and repeatable detection of the parathyroid gland in patients undergoing thyroidectomy and parathyroidectomy regardless of the disease state. For all patients, parathyroid fluorescence intensity is greater than thyroid fluorescence for all patients.
Conclusions
This study presents a novel tool using NIR autofluorescence spectroscopy to detect the parathyroid gland in real time during endocrine surgeries. We have shown its ability to accurately detect the parathyroid regardless of disease state with greater sensitivity and specificity than other imaging modalities including visual diagnosis. The mechanism of the autofluorescence is still unknown, but this technique shows promise as an intraoperative tool for improving success of parathyroidectomies and
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Autofluorescence of Parathyroid Glands: A Review of Methods of Parathyroid Gland Identification and Parathyroid Vascular Assessment
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2024, Annals of Surgical OncologyTechniques of identifying parathyroid glands and their related clinical research progress
2024, Journal of Xi'an Jiaotong University (Medical Sciences)
Supported by NCI 1R25CA136440-01 and NIH R41 EB015291.
- a
Department of Biomedical Engineering, Vanderbilt University, Nashville, TN
- b
Department of Surgery, Division of Surgical Oncology, The Ohio State University, Columbus, OH
- c
Section of Surgical Sciences, Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University, Nashville, TN