Vanderbilt University, Department of Biomedical Engineering, VU Station B Box 351631, Nashville, Tennessee 37235, USA.
J Biomed Opt. 2011 Jun;16(6):067012. doi: 10.1117/1.3583571.
A major challenge in endocrine surgery is the intraoperative detection of parathyroid glands during both thyroidectomies and parathyroidectomies. Current localization techniques such as ultrasound and sestamibi scan are mostly preoperative and rely on an abnormal parathyroid for its detection. In this paper, we present near-infrared (NIR) autofluorescence as a nonintrusive, real-time, automated in vivo method for the detection of the parathyroid gland. A pilot in vivo study was conducted to assess the ability of NIR fluorescence to identify parathyroid glands during thyroid and parathyroidectomies. Fluorescence measurements at 785 nm excitation were obtained intra-operatively from the different tissues exposed in the neck region in 21 patients undergoing endocrine surgery. The fluorescence intensity of the parathyroid gland was found to be consistently greater than that of the thyroid and all other tissues in the neck of all patients. In particular, parathyroid fluorescence was two to eleven times higher than that of the thyroid tissues with peak fluorescence occurring at 820 to 830 nm. These results indicate that NIR fluorescence has the potential to be an excellent optical tool to locate parathyroid tissue during surgery.
内分泌手术的一个主要挑战是在甲状腺切除术和甲状旁腺切除术期间术中检测甲状旁腺。目前的定位技术，如超声和 sestamibi 扫描，大多是术前的，并且依赖于异常的甲状旁腺进行检测。在本文中，我们提出近红外（NIR）自发荧光作为一种非侵入性、实时、自动的体内方法，用于检测甲状旁腺。进行了一项初步的体内研究，以评估 NIR 荧光在甲状腺和甲状旁腺切除术期间识别甲状旁腺的能力。在 21 名接受内分泌手术的患者中，从颈部暴露的不同组织中术中获得了 785nm 激发的荧光测量值。发现在所有患者的颈部，甲状旁腺的荧光强度始终大于甲状腺和所有其他组织。特别是，甲状旁腺荧光比甲状腺组织高 2 到 11 倍，峰值荧光发生在 820 到 830nm 处。这些结果表明，近红外荧光具有成为手术中定位甲状旁腺组织的优秀光学工具的潜力。
