Kim Irene A, Taylor Zachary D, Cheng Harrison, Sebastian Christine, Maccabi Ashkan, Garritano James, Tajudeen Bobby, Razfar Ali, Palma Diaz Fernando, Yeh Michael, Stafsudd Oscar, Grundfest Warren, St John Maie
1 Department of Head and Neck Surgery, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
2 Head and Neck Cancer Program, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
Otolaryngol Head Neck Surg. 2017 Mar;156(3):480-483. doi: 10.1177/0194599816686294. Epub 2017 Jan 24.
The variable location and indistinct features of parathyroid glands can make their intraoperative identification challenging. Currently, there exists no routine use of localization methods during surgery. Dynamic optical contrast imaging (DOCI) leverages a novel realization of temporally dependent measurements of tissue autofluorescence that allows the acquisition of specific tissue properties. A prospective series of patients with primary hyperparathyroidism was examined. Parathyroid lesions and surrounding tissues were collected; fluorescence decay images were acquired via DOCI. Ex vivo samples (81 patients) were processed for histologic assessment. DOCI extracts relative fluorescence decay information in a surgically relevant field of view with a clinically accessible acquisition time <2 minutes. Analysis of DOCI revealed microscopic characterization sufficient for tissue type identification consistent with histology ( P < .05). DOCI is capable of efficiently distinguishing parathyroid tissue from adjacent tissues. Such an intraoperative tool would be transformative, helping surgeons to identify lesions, preserve healthy tissue, and improve patient outcomes.
甲状旁腺位置多变且特征不明显，这使得其在术中的识别具有挑战性。目前，手术过程中尚无常规使用的定位方法。动态光学对比成像（DOCI）利用了一种对组织自发荧光进行时间依赖性测量的新方法，能够获取特定的组织特性。对一系列原发性甲状旁腺功能亢进患者进行了前瞻性研究。收集甲状旁腺病变组织及周围组织；通过DOCI获取荧光衰减图像。对离体样本（81例患者）进行组织学评估。DOCI可在手术视野中提取相对荧光衰减信息，采集时间在临床可接受范围内，小于2分钟。对DOCI分析显示，其微观特征足以进行与组织学一致的组织类型识别（P < 0.05）。DOCI能够有效区分甲状旁腺组织与相邻组织。这样一种术中工具将具有变革性，有助于外科医生识别病变、保留健康组织并改善患者预后。
