Objectives/hypothesis: Identification of parathyroid glands and adjacent tissues intraoperatively can be quite challenging because of their small size, variable locations, and indistinct external features. The objective of this study is to test the efficacy of the dynamic optical contrast imaging (DOCI) technique as a tool in specifically differentiating parathyroid tissue and adjacent structures, facilitating efficient and reliable tissue differentiation.
Study Design: Prospective study.
Methods: Both animal and human tissues were included in this study. Fresh specimens were imaged with DOCI and subsequently processed for hematoxylin and eosin (H&E) stain. The DOCI images were analyzed and compared to the H&E results as ground truth.
Results: In both animal and human experiments, significant DOCI contrast was observed between parathyroid glands and adjacent tissue of all types. Region of interest analysis revealed most distinct DOCI values for each tissue when using 494 and 572 nm-specific band pass filter for signal detection (P < .005 for porcine tissues, and P = .02 for human specimens). Linear discriminant classifier for tissue type prediction based on DOCI also matched the underlying histology.
Conclusions: We demonstrate that the DOCI technique reliably facilitates specific parathyroid gland localization. The DOCI technique constitutes important groundwork for in vivo precision endocrine surgery.
Level Of Evidence: 4 Laryngoscope, 131:2391-2397, 2021.
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http://dx.doi.org/10.1002/lary.29633 | DOI Listing |
Diagnostics (Basel)
December 2024
Department of Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, University of Strasbourg, 67200 Strasbourg, France.
Patients diagnosed with multiple endocrine neoplasia type-1 (MEN1) often initially present with primary hyperparathyroidism (pHPT), and typically undergo surgical intervention. While laboratory tests are fundamental for diagnosis, imaging is crucial for localizing pathological parathyroids to aid in precise surgical planning. In this pictorial review, we will begin by comprehensively examining key imaging techniques and their established protocols, evaluating their effectiveness in detecting abnormal parathyroid glands.
View Article and Find Full Text PDFSurgery
January 2025
Department of Endocrine Surgery, Marienhaus Klinikum Mainz, Germany.
Background: Preoperative localization of hyperfunctioning parathyroid glands in primary hyperparathyroidism is essential for successful parathyroid surgery, particularly in patients with previous negative imaging or reoperations.
Methods: A multicenter registry study was performed in 776 patients with primary hyperparathyroidism from 53 hospitals in Germany and Austria who underwent parathyroid surgery after preoperative F-choline or C-methionine positron emission tomography/computed tomography (PET/CT).
Results: In 683 of 776 patients (88%) (78% female, aged 15-86 years), primary hyperparathyroidism was caused by a single-gland parathyroid adenoma.
Osteoporos Int
January 2025
Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Backgroud: Hypoparathyroidism (hypoPT) is characterized by acute and chronic complications due to insufficient parathyroid hormone (PTH) production or action. Several management guidelines have been developed, but mostly based on evidence from Western countries. Data from Eastern countries have not been systematically compared with those from Western countries.
View Article and Find Full Text PDFEndocrine
January 2025
Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Introduction: Intraoperative parathyroid gland (PG) localization remains challenging during thyroid surgeries, contributing to postoperative hypocalcemia and hypoparathyroidism. This study assessed the efficacy of indocyanine green (ICG) fluorescence in identifying and preserving PGs during thyroid surgeries and its correlation with postoperative outcomes.
Materials And Methods: This ambispective observational study included 57 patients undergoing thyroid surgeries using ICG and compared outcomes with 56 historical controls.
World J Surg
January 2025
General and Endocrine Surgery, CHU Poitiers - University of Poitiers, Poitiers, France.
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