Parathyroid gland detection using an intraoperative autofluorescence handheld imager - early feasibility study.
Parathyroid gland detection using an intraoperative autofluorescence handheld imager - early feasibility study.
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DOI：
10.3389/fendo.2023.1190282
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发表时间：
2023
影响因子：
5.2
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中科院分区：
文献类型：
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甲状腺手术期间甲状旁腺可能会受到损害，从而导致甲状旁腺功能减退和低钙血症。识别甲状旁腺依赖于外科医生的经验，确认其存在的唯一方法是通过组织活检。近红外自发荧光技术为实时、非侵入性识别甲状旁腺提供了机会。我们使用 Optosurgical, LLC 开发的新研究原型 (hANDY-I)。它提供同轴激发光和双红绿蓝/近红外传感器，可引导解剖标志，并通过同时显示组合的自发荧光和彩色图像来帮助识别甲状旁腺。我们在 23 个甲状腺手术病例中测试了成像仪，初步临床可行性数据显示，在检查的 75 个甲状旁腺中，71 个显示出强烈的自发荧光信号，并被成像仪正确识别（准确度为 95%）。 hANDY-I 原型通过帮助甲状旁腺的实时可视化在这项可行性研究中展示了有希望的结果。然而，需要通过进行更大样本量的随机临床试验来进一步测试，以研究其对甲状旁腺功能减退症和低钙血症水平的影响。
Parathyroid glands may be compromised during thyroid surgery which can lead to hypoparathyroidism and hypocalcemia. Identifying the parathyroid glands relies on the surgeon’s experience and the only way to confirm their presence was through tissue biopsy. Near infrared autofluorescence technology offers an opportunity for real-time, non-invasive identification of the parathyroid glands. We used a new research prototype (hANDY-I) developed by Optosurgical, LLC. It offers coaxial excitation light and a dual-Red Green Blue/Near Infrared sensor that guides anatomical landmarks and can aid in identification of parathyroid glands by showing a combined autofluorescence and colored image simultaneously. We tested the imager during 23 thyroid surgery cases, where initial clinical feasibility data showed that out of 75 parathyroid glands inspected, 71 showed strong autofluorescence signal and were correctly identified (95% accuracy) by the imager. The hANDY-I prototype demonstrated promising results in this feasibility study by aiding in real-time visualization of the parathyroid glands. However, further testing by conducting randomized clinical trials with a bigger sample size is required to study the effect on levels of hypoparathyroidism and hypocalcemia.