Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, 37235, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA.
Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.
Am J Surg. 2021 Nov;222(5):944-951. doi: 10.1016/j.amjsurg.2021.05.001. Epub 2021 May 13.
Near infrared autofluorescence (NIRAF) detection has previously demonstrated significant potential for real-time parathyroid gland identification. However, the performance of a NIRAF detection device - PTeye® - remains to be evaluated relative to a surgeon's own ability to identify parathyroid glands.
Patients eligible for thyroidectomy and/or parathyroidectomy were enrolled under 6 endocrine surgeons at 3 high-volume institutions. Participating surgeons were categorized based on years of experience. All surgeons were blinded to output of PTeye® when identifying tissues. The surgeon's performance for parathyroid discrimination was then compared with PTeye®. Histology served as gold standard for excised specimens, while expert surgeon's opinion was used to validate in-situ tissues.
PTeye® achieved 92.7% accuracy across 167 patients recruited. Junior surgeons (<5 years of experience) were found to have lower confidence in parathyroid identification and higher tissue misclassification rate per specimen when compared to PTeye® and senior surgeons (>10 years of experience).
NIRAF detection with PTeye® can be a valuable intraoperative adjunct technology to aid in parathyroid identification for surgeons.
近红外自体荧光（NIRAF）检测此前已证明在实时甲状旁腺识别方面具有很大的潜力。然而，NIRAF 检测设备-PTeye®-的性能仍需相对于外科医生自身识别甲状旁腺的能力进行评估。
在 3 家高容量机构的 6 位内分泌外科医生的指导下，招募适合甲状腺切除术和/或甲状旁腺切除术的患者。根据经验年限对参与的外科医生进行分类。在识别组织时，所有外科医生均对 PTeye®的输出结果不知情。然后将外科医生的甲状旁腺鉴别能力与 PTeye®进行比较。组织学是切除标本的金标准，而专家外科医生的意见则用于验证原位组织。
PTeye®在 167 名患者中实现了 92.7%的准确率。与 PTeye®和资深外科医生（>10 年经验）相比，初级外科医生（<5 年经验）对甲状旁腺的识别信心较低，且每份标本的组织误分类率较高。
NIRAF 检测与 PTeye®结合使用可以成为外科医生识别甲状旁腺的有价值的术中辅助技术。
