Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, Tennessee, USA.
J Surg Oncol. 2021 Sep;124(3):271-281. doi: 10.1002/jso.26500. Epub 2021 Apr 18.
The Food and Drug Administration has cleared a probe-based near-infrared autofluorescence (NIRAF) detection system called PTeye™ as an adjunct tool for label-free intraoperative parathyroid gland (PG) identification. Since PTeye™ has been investigated only in a "blinded" manner to date, this study describes the preliminary impressions of PTeye™ when used by surgeons without being blinded to the device output.
Patients undergoing thyroid and parathyroid procedures were prospectively recruited. Target tissues were intraoperatively assessed with PTeye™. The surgeon's confidence in PG identification was recorded concomitantly with NIRAF parameters that were output in real-time from PTeye™.
A retrospective review of prospectively collected data on 83 patients was performed. PTeye™ was used for interrogating 336 target tissues in 46 parathyroid and 37 thyroid procedures. PTeye™ yielded an overall accuracy of 94.3% with a positive predictive value of 93.0% and a negative predictive value of 100%. An increase in confidence for intraoperative PG identification with PTeye™ was observed by all three participating high-volume surgeons, irrespective of their level of accrued surgical experience.
Probe-based NIRAF detection with PTeye™ can be a valuable adjunct device to intraoperatively identify PGs for surgeons of varied training and experience.
美国食品和药物管理局已批准一种基于探头的近红外自发荧光(NIRAF)检测系统,称为 PTeye™,作为一种非标记的术中甲状旁腺(PG)识别辅助工具。由于迄今为止,PTeye™ 仅以“盲法”进行了研究,因此本研究描述了外科医生在不了解设备输出的情况下使用 PTeye™ 的初步印象。
前瞻性招募接受甲状腺和甲状旁腺手术的患者。使用 PTeye™ 对目标组织进行术中评估。同时记录外科医生对 PG 识别的信心以及从 PTeye™ 实时输出的 NIRAF 参数。
对 83 例前瞻性收集的数据进行了回顾性分析。PTeye™ 用于 46 例甲状旁腺和 37 例甲状腺手术中 336 个目标组织的检测。PTeye™ 的总体准确率为 94.3%,阳性预测值为 93.0%,阴性预测值为 100%。所有三位参与的高容量外科医生都观察到,使用 PTeye™ 可提高术中识别 PG 的信心,无论他们的手术经验积累程度如何。
基于探头的 NIRAF 检测与 PTeye™ 可以成为一种有价值的辅助设备,帮助不同培训和经验的外科医生术中识别 PG。