Faculty Collaboration Database

Current state of intraoperative use of near infrared fluorescence for parathyroid identification and preservation. Surgery 2021 Apr;169(4):868-878

Date

11/04/2020

Pubmed ID

33139065

Pubmed Central ID

PMC7987670

DOI

10.1016/j.surg.2020.09.014

Scopus ID

2-s2.0-85094866898 (requires institutional sign-in at Scopus site)   64 Citations

Abstract

BACKGROUND: Finding and preserving normal parathyroid glands or localizing and removing diseased parathyroid glands are crucial steps to successful thyroid and parathyroid operations. Using near-infrared fluorescence detection to identify parathyroid glands during thyroid and parathyroid operations has lately gained widespread recognition, with 2 Food and Drug Administration-cleared devices currently in the market. We aim to update the endocrine surgery community on how near-infrared fluorescence detection can be most optimally used for rapid intraoperative parathyroid gland identification or preservation.

METHODS: A literature review was performed using the key terms: "parathyroid," "near infrared," and "fluorescence" in relevant search engines. Based on the reviewed literature and expert surgeons' opinions, recommendations were formulated for applying near-infrared fluorescence detection to identify or preserve parathyroid glands during cervical endocrine surgery.

RESULTS: The scope of near-infrared fluorescence detection can be broadly categorized into (1) using near-infrared auto-fluorescence to identify or locate both healthy and diseased parathyroid glands, and (2) using contrast-enhanced near-infrared fluorescence to evaluate parathyroid gland perfusion. The benefits and pitfalls for both near-infrared-based approaches are described herein.

CONCLUSION: Near-infrared fluorescence detection appears helpful for identification and likely preservation of parathyroid glands. We hope these recommendations will be valuable to the practicing endocrine surgeon as they consider incorporating these intraoperative adjuncts in their surgical practice.

Author List

Solórzano CC, Thomas G, Berber E, Wang TS, Randolph GW, Duh QY, Triponez F

Author

Tracy S. Wang MD, MPH Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Clinical Decision-Making
Contrast Media
Disease Management
Humans
Intraoperative Care
Molecular Probes
Organ Preservation
Parathyroid Glands
Parathyroidectomy
Perfusion
Reproducibility of Results
Spectrometry, Fluorescence
Spectroscopy, Near-Infrared
Thyroid Gland
Thyroidectomy