Breakthrough intra-operative detection of the parathyroid glands

描述（由申请人提供）：目前，约有2000万美国人患有某种形式的甲状腺疾病。甲状腺疾病发生时，甲状腺不能提供所需的甲状腺激素的适当量。甲状腺和甲状旁腺疾病结合了内分泌学和肿瘤学领域，导致病理条件的复杂组合。当疾病不能用其他方法治疗时，采用手术手段切除病变腺体。在美国，每年大约有10万例甲状腺手术切除部分或整个甲状腺。当甲状旁腺在甲状腺切除术中意外受伤或切除时，并发症就会发生。这是因为甲状旁腺很难与甲状腺和颈部周围组织区分。腺体位置的变化使情况更加复杂。外科医生最终必须依靠视觉

DESCRIPTION (provided by applicant): Currently, about 20 million Americans have some form of thyroid disease. Thyroid disease occurs when the thyroid gland does not supply the appropriate amount of thyroid hormone needed. Thyroid and parathyroid diseases combine the fields of endocrinology and oncology leading to a complex combination of pathological conditions. When the disease cannot be treated by other methods, surgical means are used to remove the diseased gland(s). They are around 100,000 thyroid surgeries each year in the US to remove part or the entire thyroid. Complications occur when the parathyroid is accidentally injured or removed during thyroidectomies. This happens because Parathyroid glands are difficult to distinguish from the thyroid and surrounding tissues in the neck. The situation is further complicated by the glands' variability in position. Surgeons must ultimately rely on visual inspection to identify the different tissues, which can be subjective and inconclusive. Damage to the gland(s) can cause hypoparathyroidsim and hypocalcemia resulting in serious and deleterious side effects. In a recent (June 2011) publication, the PI Prof. Mahadevan-Jansen's group at Vanderbilt University reported for the first time the breakthrough finding that the Parathyroid Gland has a unique autofluorescence signature in the NIR under illumination at 785nm. The average fluorescent intensity of the parathyroid is over 6 times higher than other tissues in the neck area in a study of over 44 patients. The specific aim of this proposal is to build upon that work and it seeks to a) Characterize the the near-infrared fluorescence signatures of thyroid and parathyroid tissue in order to understand the source of this higher autofluorescence for the parathyroid gland b) To develop prototype instrumentation that provides imaging as well as point analysis including a software interface to implement and automate data acquisition and to provide real-time feedback The goal of this proposal is to develop an intra-operative detection platform for the parathyroid glands. PUBLIC HEALTH RELEVANCE: This goals of this project is to build an intra-operative detector (for surgeons) that can uniquely detect the parathyroid glands based on the technique of near-infrared (NIR) autofluorescence. There are around 100,000 thyroid surgeries each year in the US to remove part or the entire thyroid. Upto 20% of these surgeries lead to accidental removal of the parathyroid glands since they are difficult to distinguish from the thyroid and other neck tissue. The parathyroid glands responsible for the production of parathyroid hormone in order to maintain calcium homeostasis throughout the body. Their removal or injury could lead to health problems that result in lifelong medications to deal with.