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Surgical Endoscopy

Published in:

01-08-2017

Intraoperative near-infrared autofluorescence imaging of parathyroid glands

Authors: Roland Ladurner, Sandra Sommerey, Nora Al Arabi, Klaus K. J. Hallfeldt, Herbert Stepp, Julia K. S. Gallwas

Published in: Surgical Endoscopy | Issue 8/2017

Abstract

Objective

To identify parathyroid glands intraoperatively by exposing their autofluorescence using near-infrared light.

Methods

Fluorescence imaging was carried out during minimally invasive and open parathyroid and thyroid surgery. After identification, the parathyroid glands as well as the surrounding tissue were exposed to near-infrared (NIR) light with a wavelength of 690–770 nm using a modified Karl Storz near-infrared/indocyanine green (NIR/ICG) endoscopic system. Parathyroid tissue was expected to show near-infrared autofluorescence, captured in the blue channel of the camera. Whenever possible the visual identification of parathyroid tissue was confirmed histologically.

Results

In preliminary investigations, using the original NIR/ICG endoscopic system we noticed considerable interference of light in the blue channel overlying the autofluorescence. Therefore, we modified the light source by interposing additional filters. In a second series, we investigated 35 parathyroid glands from 25 patients. Twenty-seven glands were identified correctly based on NIR autofluorescence. Regarding the extent of autofluorescence, there were no noticeable differences between parathyroid adenomas, hyperplasia and normal parathyroid glands. In contrast, thyroid tissue, lymph nodes and adipose tissue revealed no substantial autofluorescence.

Conclusion

Parathyroid tissue is characterized by showing autofluorescence in the near-infrared spectrum. This effect can be used to distinguish parathyroid glands from other cervical tissue entities.

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Title: Intraoperative near-infrared autofluorescence imaging of parathyroid glands
Authors: Roland Ladurner
Sandra Sommerey
Nora Al Arabi
Klaus K. J. Hallfeldt
Herbert Stepp
Julia K. S. Gallwas
Publication date: 01-08-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 8/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-5338-3

At a glance: The STEP trials

Springer Medicine

Intraoperative near-infrared autofluorescence imaging of parathyroid glands

Abstract

Objective

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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