Improved intraoperative verification of parathyroid glands by determining their autofluorescence in the infrared spectrum

Background. Detection of parathyroid glands by spectroscopy of their autofluorescence in the near-infrared spectrum (NIRAF) is considered a promising intraoperative tool in addition to their verification with visual identification. The study was aimed to evaluate the role of NIRAF by using two diffe...

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Autores principales:	M.B. Gorobeiko, A.V. Dinets, V.H. Hoperia, K.M. Abdalla
Formato:	article
Lenguaje:	EN RU UK
Publicado:	Publishing House Zaslavsky 2021
Materias:	parathyroid autofluorescence, near-infrared fluorescence, hypoparathyroidism, parathyroid identification Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/435de878fc3947238262671c424f4355
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spelling	oai:doaj.org-article:435de878fc3947238262671c424f43552021-11-22T11:26:20ZImproved intraoperative verification of parathyroid glands by determining their autofluorescence in the infrared spectrum2224-07212307-142710.22141/2224-0721.17.6.2021.243207https://doaj.org/article/435de878fc3947238262671c424f43552021-10-01T00:00:00Zhttp://iej.zaslavsky.com.ua/article/view/243207https://doaj.org/toc/2224-0721https://doaj.org/toc/2307-1427Background. Detection of parathyroid glands by spectroscopy of their autofluorescence in the near-infrared spectrum (NIRAF) is considered a promising intraoperative tool in addition to their verification with visual identification. The study was aimed to evaluate the role of NIRAF by using two different imaging systems to confirm parathyroid glands during operations for benign and malignant thyroid and parathyroid tumors. Materials and methods. The study included 62 patients who underwent verification of NIRAF by using two different imaging systems equipped with a near-infrared (NIR) camera during surgery. Intravenous fluorophore of indocyanine green was applied to amplify the NIRAF signal. Results. Normal parathyroid glands were identified and mobilized after a visual inspection in 50 patients (80 %), which was subsequently confirmed by evaluation with NIRAF spectroscopy. Determination of NIRAF in the parathyroid glands and their differentiation from lymph nodes was achieved in 8 (13 %) patients with papillary thyroid carcinoma. In 3 (5 %) patients, the parathyroid gland was identified in the area of the postoperative scar, using NIRAF but not by the visual identification. In 2 (3 %) cases, the appearance of the signal was determined but with a decrease in the intensity of the NIRAF from the parathyroid glands during their unintentional removal. The strong NIRAF signal intensity was observed from the parathyroid gland after changing the position of the NIR camera when using the Fluobeam 800 device at an angle of approximately 45–65° to the area of the parathyroid gland location. The Fluobeam LX demonstrated a satisfactory NIRAF signal without any specific changes in camera position. NIRAF signal was determined in the tissue of toxic thyroid adenomas. NIRAF signal of the low intensity was detected in the invasion of thyroid carcinoma in a capsule of a thyroid gland. No NIRAF signal was observed from metastatic and normal lymph nodes. Conclusions. The use of NIRAF parathyroid spectroscopy technology allows improving their imaging and verification as an additional method during surgery of the neck. The practical value of NIRAF spectroscopy of the parathyroid gland is increased in the case of reoperations due to the risk of accidental removal of the parathyroid gland as well as for differential diagnosis between the parathyroid gland and metastatic lymph nodes.M.B. GorobeikoA.V. DinetsV.H. HoperiaK.M. AbdallaPublishing House Zaslavskyarticleparathyroid autofluorescence, near-infrared fluorescence, hypoparathyroidism, parathyroid identificationDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENRUUKMìžnarodnij Endokrinologìčnij Žurnal, Vol 17, Iss 6, Pp 465-471 (2021)
institution	DOAJ
collection	DOAJ
language	EN RU UK
topic	parathyroid autofluorescence, near-infrared fluorescence, hypoparathyroidism, parathyroid identification Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	parathyroid autofluorescence, near-infrared fluorescence, hypoparathyroidism, parathyroid identification Diseases of the endocrine glands. Clinical endocrinology RC648-665 M.B. Gorobeiko A.V. Dinets V.H. Hoperia K.M. Abdalla Improved intraoperative verification of parathyroid glands by determining their autofluorescence in the infrared spectrum
description	Background. Detection of parathyroid glands by spectroscopy of their autofluorescence in the near-infrared spectrum (NIRAF) is considered a promising intraoperative tool in addition to their verification with visual identification. The study was aimed to evaluate the role of NIRAF by using two different imaging systems to confirm parathyroid glands during operations for benign and malignant thyroid and parathyroid tumors. Materials and methods. The study included 62 patients who underwent verification of NIRAF by using two different imaging systems equipped with a near-infrared (NIR) camera during surgery. Intravenous fluorophore of indocyanine green was applied to amplify the NIRAF signal. Results. Normal parathyroid glands were identified and mobilized after a visual inspection in 50 patients (80 %), which was subsequently confirmed by evaluation with NIRAF spectroscopy. Determination of NIRAF in the parathyroid glands and their differentiation from lymph nodes was achieved in 8 (13 %) patients with papillary thyroid carcinoma. In 3 (5 %) patients, the parathyroid gland was identified in the area of the postoperative scar, using NIRAF but not by the visual identification. In 2 (3 %) cases, the appearance of the signal was determined but with a decrease in the intensity of the NIRAF from the parathyroid glands during their unintentional removal. The strong NIRAF signal intensity was observed from the parathyroid gland after changing the position of the NIR camera when using the Fluobeam 800 device at an angle of approximately 45–65° to the area of the parathyroid gland location. The Fluobeam LX demonstrated a satisfactory NIRAF signal without any specific changes in camera position. NIRAF signal was determined in the tissue of toxic thyroid adenomas. NIRAF signal of the low intensity was detected in the invasion of thyroid carcinoma in a capsule of a thyroid gland. No NIRAF signal was observed from metastatic and normal lymph nodes. Conclusions. The use of NIRAF parathyroid spectroscopy technology allows improving their imaging and verification as an additional method during surgery of the neck. The practical value of NIRAF spectroscopy of the parathyroid gland is increased in the case of reoperations due to the risk of accidental removal of the parathyroid gland as well as for differential diagnosis between the parathyroid gland and metastatic lymph nodes.
format	article
author	M.B. Gorobeiko A.V. Dinets V.H. Hoperia K.M. Abdalla
author_facet	M.B. Gorobeiko A.V. Dinets V.H. Hoperia K.M. Abdalla
author_sort	M.B. Gorobeiko
title	Improved intraoperative verification of parathyroid glands by determining their autofluorescence in the infrared spectrum
title_short	Improved intraoperative verification of parathyroid glands by determining their autofluorescence in the infrared spectrum
title_full	Improved intraoperative verification of parathyroid glands by determining their autofluorescence in the infrared spectrum
title_fullStr	Improved intraoperative verification of parathyroid glands by determining their autofluorescence in the infrared spectrum
title_full_unstemmed	Improved intraoperative verification of parathyroid glands by determining their autofluorescence in the infrared spectrum
title_sort	improved intraoperative verification of parathyroid glands by determining their autofluorescence in the infrared spectrum
publisher	Publishing House Zaslavsky
publishDate	2021
url	https://doaj.org/article/435de878fc3947238262671c424f4355
work_keys_str_mv	AT mbgorobeiko improvedintraoperativeverificationofparathyroidglandsbydeterminingtheirautofluorescenceintheinfraredspectrum AT avdinets improvedintraoperativeverificationofparathyroidglandsbydeterminingtheirautofluorescenceintheinfraredspectrum AT vhhoperia improvedintraoperativeverificationofparathyroidglandsbydeterminingtheirautofluorescenceintheinfraredspectrum AT kmabdalla improvedintraoperativeverificationofparathyroidglandsbydeterminingtheirautofluorescenceintheinfraredspectrum
_version_	1718417727992889344

Improved intraoperative verification of parathyroid glands by determining their autofluorescence in the infrared spectrum

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