Advances in optical technology for intraoperative identification of parathyroid gland_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Jin ,  CHENG Ruochuan , SU Yanjun , LIU Wen

Department of Thyroid Surgery, The 1^st Affiliated Hospital of Kunming Medical University, Clinical Research Center of Thyroid Surgery in Yunnan Province, Kunming 650031, P. R. China;

Corresponding author：

CHENG Ruochuan, Email: cruochuan@foxmail.com

Keywords：

optical technology; parathyroid gland; thyroidectomy; review

DOI：

10.7507/1007-9424.201810083

Video：

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Objective To recognize the intraoperative recognition of parathyroid gland optical technology and explore its application value in thyroid surgery to protect the parathyroid gland.Methods Literature review was conducted on the principle and application status of intraoperative recognition of parathyroid gland optical technology by using " thyroidectomy” " parathyroid gland” " Near-Infrared imaging” " laser speckle contrast imaging”, and " optical coherence tomography” as retrieval terms to retrieve literatures.Results Intraoperative optical technique alone or in combination with contrast agent could improve the recognition rate of parathyroid gland, reduce the damage of feeding vessels, and thus reduce the incidence of postoperative hypocalcemia.Conclusions Traditional intraoperative parathyroid gland recognition methods needs to be improved in real-time protection effectiveness and accuracy, and the combination of new optical technology and contrast agent can largely make up for these shortcomings, but there are still obstacles in the promotion.

Citation： LIU Jin, CHENG Ruochuan, SU Yanjun, LIU Wen. Advances in optical technology for intraoperative identification of parathyroid gland. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(4): 498-502. doi: 10.7507/1007-9424.201810083 Copy

1.	朱精强. 甲状腺手术中甲状旁腺保护专家共识. 中国实用外科杂志, 2015, 35(7): 731-736.
2.	Ozogul B, Akcay MN, Akcay G, et al. Factors affecting hypocalcaemia following total thyroidectomy: a prospective study. Eurasian J Med, 2014, 46(1): 15-21.
3.	Crane LM, Themelis G, Arts HJ, et al. Intraoperative near-infrared fluorescence imaging for sentinel lymph node detection in vulvar cancer: first clinical results. Gynecol Oncol, 2011, 120(2): 291-295.
4.	Matsui A, Tanaka E, Choi HS, et al. Real-time, near-infrared, fluorescence-guided identification of the ureters using methylene blue. Surgery, 2010, 148(1): 78-86.
5.	Tummers QR, Boonstra MC, Frangioni JV, et al. Intraoperative near-infrared fluorescence imaging of a paraganglioma using methylene blue: a case report. Int J Surg Case Rep, 2015, 6: 150-153.
6.	van der Vorst JR, Schaafsma BE, Verbeek FP, et al. Near-infrared fluorescence sentinel lymph node mapping of the oral cavity in head and neck cancer patients. Oral Oncol, 2013, 49(1): 15-19.
7.	Hutteman M, van der Vorst JR, Gaarenstroom KN, et al. Optimization of near-infrared fluorescent sentinel lymph node mapping for vulvar cancer. Am J Obstet Gynecol, 2012, 206(1): 89. e1-89.e5.
8.	van der Vorst JR, Schaafsma BE, Verbeek FP, et al. Dose optimization for near-infrared fluorescence sentinel lymph node mapping in patients with melanoma. Br J Dermatol, 2013, 168(1): 93-98.
9.	程若川, 刘文. 再次手术中央区淋巴结清扫中甲状旁腺保护的难点及策略. 中国普外基础与临床杂志, 2017, 24(10): 1173-1179.
10.	程若川, 艾杨卿, 刁畅, 等. 甲状腺手术中甲状旁腺显露及功能保护的临床研究. 中国普外基础与临床杂志, 2009, 16(5): 351-355.
11.	Delattre JF, Flament JB, Palot JP, et al. Variations in the parathyroid glands. Number, situation and arterial vascularization. Anatomical study and surgical application. J Chir (Paris), 1982, 119(11): 633-641.
12.	黄韬. 甲状旁腺术中损伤的预防和处理. 中国实用外科杂志, 2008, 28(3): 179-180.
13.	Hurvitz RJ, Perzik SL, Morgenstern L. in vivo staining of the parathyroid glands. A clinical study. Arch Surg, 1968, 97(5): 722-726.
14.	Dudley NE. Methylene blue for rapid identification of the parathyroids. Br Med J, 1971, 3(5776): 680-681.
15.	Patel HP, Chadwick DR, Harrison BJ, et al. Systematic review of intravenous methylene blue in parathyroid surgery. Br J Surg, 2012, 99(10): 1345-1351.
16.	Ng BK, Cameron AJ, Liang R, et al. Serotonin syndrome following methylene blue infusion during parathyroidectomy: a case report and literature review. Can J Anaesth, 2008, 55(1): 36-41.
17.	Hillary SL, Guillermet S, Brown NJ, et al. Use of methylene blue and near-infrared fluorescence in thyroid and parathyroid surgery. Langenbecks Arch Surg, 2018, 403(1): 111-118.
18.	de Boer E, Harlaar NJ, Taruttis A, et al. Optical innovations in surgery. Br J Surg, 2015, 102(2): e56-e72.
19.	Imboden S, Papadia A, Nauwerk M, et al. A comparison of radiocolloid and indocyanine green fluorescence imaging, sentinel lymph node mapping in patients with cervical cancer undergoing laparoscopic surgery. Ann Surg Oncol, 2015, 22(13): 4198-4203.
20.	Ishizawa T, Fukushima N, Shibahara J, et al. Real-time identification of liver cancers by using indocyanine green fluorescent imaging. Cancer, 2009, 115(11): 2491-2504.
21.	Halle BM, Poulsen TD, Pedersen HP. Indocyanine green plasma disappearance rate as dynamic liver function test in critically ill patients. Acta Anaesthesiol Scand, 2014, 58(10): 1214-1219.
22.	Ris F, Hompes R, Lindsey I, et al. Near infra-red laparoscopic assessment of the adequacy of blood perfusion of intestinal anastomosis-a video vignette. Colorectal Dis, 2014, 16(8): 646-647.
23.	Eguchi T, Kawaguchi K, Basugi A, et al. Intraoperative real-time assessment of blood flow using indocyanine green angiography after anastomoses in free-flap reconstructions. Br J Oral Maxillofac Surg, 2017, 55(6): 628-630.
24.	Landsman ML, Kwant G, Mook GA, et al. Light-absorbing properties, stability, and spectral stabilization of indocyanine green. J Appl Physiol, 1976, 40(4): 575-583.
25.	Oh JK, Shin HC, Kim TY, et al. Intraoperative indocyanine green video-angiography: spinal dural arteriovenous fistula. Spine (Phila Pa 1976), 2011, 36(24): E1578-E1580.
26.	Cochran ST, Bomyea K, Sayre JW. Trends in adverse events after Ⅳ administration of contrast media. AJR Am J Roentgenol, 2001, 176(6): 1385-1388.
27.	Suh YJ, Choi JY, Chai YJ, et al. Indocyanine green as a near-infrared fluorescent agent for identifying parathyroid glands during thyroid surgery in dogs. Surg Endosc, 2015, 29(9): 2811-2817.
28.	Hyun H, Park MH, Owens EA, et al. Structure-inherent targeting of near-infrared fluorophores for parathyroid and thyroid gland imaging. Nat Med, 2015, 21(2): 192-197.
29.	Sadowski SM, Vidal Fortuny J, Triponez F. A reappraisal of vascular anatomy of the parathyroid gland based on fluorescence techniques. Gland Surg, 2017, 6(Suppl 1): S30-S37.
30.	Lang BH, Wong CK, Hung HT, et al. Indocyanine green fluorescence angiography for quantitative evaluation of in situ parathyroid gland perfusion and function after total thyroidectomy. Surgery, 2017, 161(1): 87-95.
31.	Vidal Fortuny J, Sadowski SM, Belfontali V, et al. Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery. Br J Surg, 2018, 105(4): 350-357.
32.	Das K, Stone N, Kendall C, et al. Raman spectroscopy of parathyroid tissue pathology. Lasers Med Sci, 2006, 21(4): 192-197.
33.	Paras C, Keller M, White L, et al. Near-infrared autofluorescence for the detection of parathyroid glands. J Biomed Opt, 2011, 16(6): 067012.
34.	Falco J, Dip F, Quadri P, et al. Cutting edge in thyroid surgery: autofluorescence of parathyroid glands. J Am Coll Surg, 2016, 223(2): 374-380.
35.	Bora K, Fernando D, Fares B, et al. Detection of parathyroid autofluorescence using near-infrared imaging: a multicenter analysis of concordance between different surgeons. Ann Surg Oncol, 2018, (25): 957-962.
36.	De Leeuw F, Breuskin I, Abbaci M, et al. Intraoperative near-infrared imaging for parathyroid gland identification by auto-fluorescence: a feasibility study. World J Surg, 2016, 40(9): 2131-2138.
37.	Benmiloud F, Rebaudet S, Varoquaux A, et al. Impact of autofluorescence-based identification of parathyroids during total thyroidectomy on postoperative hypocalcemia: a before and after controlled study. Surgery, 2018, 163(1): 23-30.
38.	McWade MA, Sanders ME, Broome JT, et al. Establishing the clinical utility of autofluorescence spectroscopy for parathyroid detection. Surgery, 2016, 159(1): 193-202.
39.	Armitage GA, Todd KG, Shuaib A, et al. Laser speckle contrast imaging of collateral blood flow during acute ischemic stroke. J Cereb Blood Flow Metab, 2010, 30(8): 1432-1436.
40.	Mannoh EA, Thomas G, Solórzano CC, et al. Intraoperative assessment of parathyroid viability using laser speckle contrast imaging. Sci Rep, 2017, 7(1): 14798.
41.	吕春晖, 陈曦. 术中甲状旁腺保护及术后功能减退的预测和治疗. 外科理论与实践, 2016, 21(4): 338-344.
42.	Sommerey S, Al Arabi N, Ladurner R, et al. Intraoperative optical coherence tomography imaging to identify parathyroid glands. Surg Endosc, 2015, 29(9): 2698-2704.

1. 朱精强. 甲状腺手术中甲状旁腺保护专家共识. 中国实用外科杂志, 2015, 35(7): 731-736.
2. Ozogul B, Akcay MN, Akcay G, et al. Factors affecting hypocalcaemia following total thyroidectomy: a prospective study. Eurasian J Med, 2014, 46(1): 15-21.
3. Crane LM, Themelis G, Arts HJ, et al. Intraoperative near-infrared fluorescence imaging for sentinel lymph node detection in vulvar cancer: first clinical results. Gynecol Oncol, 2011, 120(2): 291-295.
4. Matsui A, Tanaka E, Choi HS, et al. Real-time, near-infrared, fluorescence-guided identification of the ureters using methylene blue. Surgery, 2010, 148(1): 78-86.
5. Tummers QR, Boonstra MC, Frangioni JV, et al. Intraoperative near-infrared fluorescence imaging of a paraganglioma using methylene blue: a case report. Int J Surg Case Rep, 2015, 6: 150-153.
6. van der Vorst JR, Schaafsma BE, Verbeek FP, et al. Near-infrared fluorescence sentinel lymph node mapping of the oral cavity in head and neck cancer patients. Oral Oncol, 2013, 49(1): 15-19.
7. Hutteman M, van der Vorst JR, Gaarenstroom KN, et al. Optimization of near-infrared fluorescent sentinel lymph node mapping for vulvar cancer. Am J Obstet Gynecol, 2012, 206(1): 89. e1-89.e5.
8. van der Vorst JR, Schaafsma BE, Verbeek FP, et al. Dose optimization for near-infrared fluorescence sentinel lymph node mapping in patients with melanoma. Br J Dermatol, 2013, 168(1): 93-98.
9. 程若川, 刘文. 再次手术中央区淋巴结清扫中甲状旁腺保护的难点及策略. 中国普外基础与临床杂志, 2017, 24(10): 1173-1179.
10. 程若川, 艾杨卿, 刁畅, 等. 甲状腺手术中甲状旁腺显露及功能保护的临床研究. 中国普外基础与临床杂志, 2009, 16(5): 351-355.
11. Delattre JF, Flament JB, Palot JP, et al. Variations in the parathyroid glands. Number, situation and arterial vascularization. Anatomical study and surgical application. J Chir (Paris), 1982, 119(11): 633-641.
12. 黄韬. 甲状旁腺术中损伤的预防和处理. 中国实用外科杂志, 2008, 28(3): 179-180.
13. Hurvitz RJ, Perzik SL, Morgenstern L. in vivo staining of the parathyroid glands. A clinical study. Arch Surg, 1968, 97(5): 722-726.
14. Dudley NE. Methylene blue for rapid identification of the parathyroids. Br Med J, 1971, 3(5776): 680-681.
15. Patel HP, Chadwick DR, Harrison BJ, et al. Systematic review of intravenous methylene blue in parathyroid surgery. Br J Surg, 2012, 99(10): 1345-1351.
16. Ng BK, Cameron AJ, Liang R, et al. Serotonin syndrome following methylene blue infusion during parathyroidectomy: a case report and literature review. Can J Anaesth, 2008, 55(1): 36-41.
17. Hillary SL, Guillermet S, Brown NJ, et al. Use of methylene blue and near-infrared fluorescence in thyroid and parathyroid surgery. Langenbecks Arch Surg, 2018, 403(1): 111-118.
18. de Boer E, Harlaar NJ, Taruttis A, et al. Optical innovations in surgery. Br J Surg, 2015, 102(2): e56-e72.
19. Imboden S, Papadia A, Nauwerk M, et al. A comparison of radiocolloid and indocyanine green fluorescence imaging, sentinel lymph node mapping in patients with cervical cancer undergoing laparoscopic surgery. Ann Surg Oncol, 2015, 22(13): 4198-4203.
20. Ishizawa T, Fukushima N, Shibahara J, et al. Real-time identification of liver cancers by using indocyanine green fluorescent imaging. Cancer, 2009, 115(11): 2491-2504.
21. Halle BM, Poulsen TD, Pedersen HP. Indocyanine green plasma disappearance rate as dynamic liver function test in critically ill patients. Acta Anaesthesiol Scand, 2014, 58(10): 1214-1219.
22. Ris F, Hompes R, Lindsey I, et al. Near infra-red laparoscopic assessment of the adequacy of blood perfusion of intestinal anastomosis-a video vignette. Colorectal Dis, 2014, 16(8): 646-647.
23. Eguchi T, Kawaguchi K, Basugi A, et al. Intraoperative real-time assessment of blood flow using indocyanine green angiography after anastomoses in free-flap reconstructions. Br J Oral Maxillofac Surg, 2017, 55(6): 628-630.
24. Landsman ML, Kwant G, Mook GA, et al. Light-absorbing properties, stability, and spectral stabilization of indocyanine green. J Appl Physiol, 1976, 40(4): 575-583.
25. Oh JK, Shin HC, Kim TY, et al. Intraoperative indocyanine green video-angiography: spinal dural arteriovenous fistula. Spine (Phila Pa 1976), 2011, 36(24): E1578-E1580.
26. Cochran ST, Bomyea K, Sayre JW. Trends in adverse events after Ⅳ administration of contrast media. AJR Am J Roentgenol, 2001, 176(6): 1385-1388.
27. Suh YJ, Choi JY, Chai YJ, et al. Indocyanine green as a near-infrared fluorescent agent for identifying parathyroid glands during thyroid surgery in dogs. Surg Endosc, 2015, 29(9): 2811-2817.
28. Hyun H, Park MH, Owens EA, et al. Structure-inherent targeting of near-infrared fluorophores for parathyroid and thyroid gland imaging. Nat Med, 2015, 21(2): 192-197.
29. Sadowski SM, Vidal Fortuny J, Triponez F. A reappraisal of vascular anatomy of the parathyroid gland based on fluorescence techniques. Gland Surg, 2017, 6(Suppl 1): S30-S37.
30. Lang BH, Wong CK, Hung HT, et al. Indocyanine green fluorescence angiography for quantitative evaluation of in situ parathyroid gland perfusion and function after total thyroidectomy. Surgery, 2017, 161(1): 87-95.
31. Vidal Fortuny J, Sadowski SM, Belfontali V, et al. Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery. Br J Surg, 2018, 105(4): 350-357.
32. Das K, Stone N, Kendall C, et al. Raman spectroscopy of parathyroid tissue pathology. Lasers Med Sci, 2006, 21(4): 192-197.
33. Paras C, Keller M, White L, et al. Near-infrared autofluorescence for the detection of parathyroid glands. J Biomed Opt, 2011, 16(6): 067012.
34. Falco J, Dip F, Quadri P, et al. Cutting edge in thyroid surgery: autofluorescence of parathyroid glands. J Am Coll Surg, 2016, 223(2): 374-380.
35. Bora K, Fernando D, Fares B, et al. Detection of parathyroid autofluorescence using near-infrared imaging: a multicenter analysis of concordance between different surgeons. Ann Surg Oncol, 2018, (25): 957-962.
36. De Leeuw F, Breuskin I, Abbaci M, et al. Intraoperative near-infrared imaging for parathyroid gland identification by auto-fluorescence: a feasibility study. World J Surg, 2016, 40(9): 2131-2138.
37. Benmiloud F, Rebaudet S, Varoquaux A, et al. Impact of autofluorescence-based identification of parathyroids during total thyroidectomy on postoperative hypocalcemia: a before and after controlled study. Surgery, 2018, 163(1): 23-30.
38. McWade MA, Sanders ME, Broome JT, et al. Establishing the clinical utility of autofluorescence spectroscopy for parathyroid detection. Surgery, 2016, 159(1): 193-202.
39. Armitage GA, Todd KG, Shuaib A, et al. Laser speckle contrast imaging of collateral blood flow during acute ischemic stroke. J Cereb Blood Flow Metab, 2010, 30(8): 1432-1436.
40. Mannoh EA, Thomas G, Solórzano CC, et al. Intraoperative assessment of parathyroid viability using laser speckle contrast imaging. Sci Rep, 2017, 7(1): 14798.
41. 吕春晖, 陈曦. 术中甲状旁腺保护及术后功能减退的预测和治疗. 外科理论与实践, 2016, 21(4): 338-344.
42. Sommerey S, Al Arabi N, Ladurner R, et al. Intraoperative optical coherence tomography imaging to identify parathyroid glands. Surg Endosc, 2015, 29(9): 2698-2704.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Advances in optical technology for intraoperative identification of parathyroid gland

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