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在甲状腺和甲状旁腺手术中使用术中探头式甲状旁腺自发荧光识别系统-PTeye™ 的初步临床经验。

Initial clinical experiences using the intraoperative probe-based parathyroid autofluorescence identification system-PTeye™ during thyroid and parathyroid procedures.

机构信息

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.

出版信息

J Surg Oncol. 2021 Sep;124(3):271-281. doi: 10.1002/jso.26500. Epub 2021 Apr 18.

Abstract

BACKGROUND AND OBJECTIVE

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.

METHODS

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™.

RESULTS

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.

CONCLUSIONS

Probe-based NIRAF detection with PTeye™ can be a valuable adjunct device to intraoperatively identify PGs for surgeons of varied training and experience.

摘要

背景与目的

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。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d821/8319062/0f593cd46255/nihms-1705818-f0001.jpg

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