Feasibility of indocyanine green fluorescence imaging for intraoperative identification of parathyroid glands during thyroid surgery

Bos, Jacqueline van den; Kooten, Lottie van; Engelen, Sanne; Lubbers, Tim; Stassen, Laurents P. S.; Bouvy, Nicole D.

doi:10.1002/hed.25451

Cited by 48 publications

(38 citation statements)

References 24 publications

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“…Both techniques-ICG fluorescence and parathyroid autofluorescence-are recent techniques that significantly improve the intraoperative detection of PGs [75]. Regarding ICG application, it is a promising method that provides a higher rate of PGs detection, as well as fewer incidental parathyroidectomies [136,137].…”

Section: Indocyanine Green Fluorescence Vs Parathyroid Autofluorescencementioning

confidence: 99%

Preoperative and Intraoperative Methods of Parathyroid Gland Localization and the Diagnosis of Parathyroid Adenomas

et al. 2020

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Accurate pre-operative determination of parathyroid glands localization is critical in the selection of minimally invasive parathyroidectomy as a surgical treatment approach in patients with primary hyperparathyroidism (PHPT). Its importance cannot be overemphasized as it helps to minimize the harmful side effects associated with damage to the parathyroid glands such as in hypocalcemia, severe hemorrhage or recurrent laryngeal nerve dysfunction. Preoperative and intraoperative methods decrease the incidence of mistakenly injuring the parathyroid glands and allow for the timely diagnosis of various abnormalities, including parathyroid adenomas. This article reviews 139 studies conducted between 1970 and 2020 (49 years). Studies that were reviewed focused on several techniques including application of carbon nanoparticles, carbon nanoparticles with technetium sestamibi (99m Tc-MIBI), Raman spectroscopy, near-infrared autofluorescence, dynamic optical contrast imaging, laser speckle contrast imaging, shear wave elastography, and indocyanine green to test their potential in providing proper parathyroid glands’ localization. Apart from reviewing the aforementioned techniques, this study focused on the applications that helped in the detection of parathyroid adenomas. Results suggest that applying all the reviewed techniques significantly improves the possibility of providing proper localization of parathyroid glands, and the application of indocyanine green has proven to be the ‘ideal’ approach for the diagnosis of parathyroid adenomas.

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Section: Indocyanine Green Fluorescence Vs Parathyroid Autofluorescencementioning

confidence: 99%

Preoperative and Intraoperative Methods of Parathyroid Gland Localization and the Diagnosis of Parathyroid Adenomas

et al. 2020

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“…By using white light 41/72 of PGs were detected while only 31/72 were detected using ICG NIR. It is worth to note that before resection, benign pathology patients had a higher target-tobackground ratio (measured by OsiriX Lite V8.5.2 imaging software) as compared to malignancy patients (28). However, it was not possible to derive any correlation of thyroid pathology with ICG uptake in the rest of the articles reviewed.…”

Section: Discussionmentioning

confidence: 94%

“…Mean operation time was available in half of the studies while intraoperative time devoted to ICG procedure was available in five of them. Both times varied greatly among the different studies (see Table I) (5,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28).…”

Section: Resultsmentioning

confidence: 99%

“…From the reviewed studies regarding PG detection and viability following TT or N-TT, we identified eight case series (5,13,15,16,22,24,26,28), a retrospective cohort (27), a randomized control trial (19) and a case report (25). Most of them were dealing with a mixture of thyroid pathologies:…”

Section: Discussionmentioning

confidence: 99%

“…In another study involving 26 patients of various thyroid pathologies, 30 surgeries were performed (28). By using white light 41/72 of PGs were detected while only 31/72 were detected using ICG NIR.…”

Section: Discussionmentioning

confidence: 99%

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Intraoperative Indocyanine Green (ICG) Angiography for the Identification of the Parathyroid Glands: Current Evidence and Future Perspectives

Spartalis¹,

Ntokos²,

Γεωργίου³

et al. 2019

In Vivo

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Background/Aim: Recently, indocyanine green (ICG) fluorescence imaging has been used for the identification of the parathyroid glands (PG) during thyroid and parathyroid surgery. However, an overall consensus on the optimal technique, the dosage, the timing of the ICG administration and finally its interpretation and clinical usefulness is still lacking evidence. The aim of this review is to investigate the use of ICG angiography during thyroidectomy and/or parathyroidectomy for identification as well as for the perfusion integrity of the parathyroid glands. Materials and Methods: The PubMed database was systematically searched for publications regarding intraoperative ICG imaging in patients that undergo thyroidectomy or parathyroidectomy. Results: Eighteen publications reporting on 612 patients, namely 71 parathyroidectomy and 541 thyroidectomy patients met the inclusion criteria. Eleven publications reported the use of ICG 23 This article is freely accessible online.

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Emerging Imaging Technologies for Parathyroid Gland Identification and Vascular Assessment in Thyroid Surgery

Karcioglu

Triponez

Solórzano

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceIdentification and preservation of parathyroid glands (PGs) remain challenging despite advances in surgical techniques. Considerable morbidity and even mortality result from hypoparathyroidism caused by devascularization or inadvertent removal of PGs. Emerging imaging technologies hold promise to improve identification and preservation of PGs during thyroid surgery.ObservationThis narrative review (1) comprehensively reviews PG identification and vascular assessment using near-infrared autofluorescence (NIRAF)—both label free and in combination with indocyanine green—based on a comprehensive literature review and (2) offers a manual for possible implementation these emerging technologies in thyroid surgery.Conclusions and RelevanceEmerging technologies hold promise to improve PG identification and preservation during thyroidectomy. Future research should address variables affecting the degree of fluorescence in NIRAF, standardization of signal quantification, definitions and standardization of parameters of indocyanine green injection that correlate with postoperative PG function, the financial effect of these emerging technologies on near-term and longer-term costs, the adoption learning curve and effect on surgical training, and long-term outcomes of key quality metrics in adequately powered randomized clinical trials evaluating PG preservation.

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Feasibility of indocyanine green fluorescence imaging for intraoperative identification of parathyroid glands during thyroid surgery

Cited by 48 publications

References 24 publications

Preoperative and Intraoperative Methods of Parathyroid Gland Localization and the Diagnosis of Parathyroid Adenomas

Preoperative and Intraoperative Methods of Parathyroid Gland Localization and the Diagnosis of Parathyroid Adenomas

Intraoperative Indocyanine Green (ICG) Angiography for the Identification of the Parathyroid Glands: Current Evidence and Future Perspectives

Emerging Imaging Technologies for Parathyroid Gland Identification and Vascular Assessment in Thyroid Surgery

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