Wu Zhenguo, Wiseman Sam M, Zeng Haishan
BC Cancer Research Institute, University of British Columbia, Vancouver, BC V5Z 1L3, Canada.
Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, BC V6Z 1Y6, Canada.
Biosensors (Basel). 2025 Jun 3;15(6):352. doi: 10.3390/bios15060352.
Identifying parathyroid glands during surgery is challenging and time-consuming due to their small size (3-5 mm) and camouflaged appearance in the background of the thyroid, lymph nodes, fat, and other neck structures. For the gland itself, it is also important to differentiate abnormal ones from normal ones. Accidental damage or removal of the normal glands can result in complications like hypocalcemia, which may necessitate lifelong medication dependence, and, in extreme cases, lead to death. The study of autofluorescence optical properties of normal and abnormal parathyroid glands and the surrounding tissue will be helpful for developing non-invasive detection devices. The near-infrared (NIR) autofluorescence characteristics of parathyroid and thyroid tissues have been studied extensively and are now used for parathyroid gland detection during surgery. Additionally, there have been a few reports on the UV-visible light-excited autofluorescence characteristics of these tissues with a focus on spectroscopy. However, there is a lack of high-resolution, side-by-side autofluorescence imaging comparisons of both tissue types under various excitation wavelengths, ranging from visible to NIR. We developed a standalone tabletop autofluorescence imaging system to acquire images of ex vivo specimens in the operating room under different excitation wavelengths: visible 405 nm, 454 nm, 520 nm, 628 nm, and NIR 780 nm. Autofluorescence imaging features of parathyroid adenomas for each excitation wavelength were described and compared. It was found that visible light excites much stronger autofluorescence from parathyroid adenoma tissue compared to NIR light. However, NIR excitation provides the best intensity difference/contrast between parathyroid adenoma and thyroid tissue, making it optimal for differentiating these two tissue types, and detecting parathyroid adenoma during surgery. The high fluorescent site under the NIR 780 nm excitation also generates high fluorescence under visible excitation wavelengths. Heterogeneous fluorescence patterns were observed in most of the parathyroid adenoma cases across all the excitation wavelengths.
在手术中识别甲状旁腺具有挑战性且耗时，因为它们体积小（3 - 5毫米），并且在甲状腺、淋巴结、脂肪和其他颈部结构的背景下外观不易辨认。对于甲状旁腺本身而言，区分异常甲状旁腺与正常甲状旁腺也很重要。意外损伤或切除正常甲状旁腺可能会导致诸如低钙血症等并发症，这可能需要终身依赖药物治疗，在极端情况下甚至会导致死亡。研究正常和异常甲状旁腺及其周围组织的自体荧光光学特性将有助于开发非侵入性检测设备。甲状旁腺和甲状腺组织的近红外（NIR）自体荧光特性已得到广泛研究，目前已用于手术中甲状旁腺的检测。此外，也有一些关于这些组织在紫外 - 可见光激发下自体荧光特性的报道，重点是光谱学。然而，缺乏在从可见光到近红外的各种激发波长下对这两种组织类型进行高分辨率、并排的自体荧光成像比较。我们开发了一个独立的桌面式自体荧光成像系统，以在不同激发波长下获取手术室中离体标本的图像：可见光405纳米、454纳米、520纳米、628纳米和近红外780纳米。描述并比较了每个激发波长下甲状旁腺腺瘤的自体荧光成像特征。结果发现，与近红外光相比，可见光激发甲状旁腺腺瘤组织产生的自体荧光要强得多。然而，近红外激发在甲状旁腺腺瘤和甲状腺组织之间提供了最佳的强度差异/对比度，使其最适合区分这两种组织类型，并在手术中检测甲状旁腺腺瘤。在780纳米近红外激发下的高荧光部位在可见光激发波长下也会产生高荧光。在所有激发波长下，大多数甲状旁腺腺瘤病例中都观察到了异质荧光模式。
