Indocyanine green fluorescence-guided parathyroidectomy for primary hyperparathyroidism

DeLong, Jonathan C.; Ward, Erin; Lwin, Thinzar M.; Brumund, Kevin T.; Kelly, Kaitlyn J.; Horgan, Santiago; Bouvet, Michael

doi:10.1016/j.surg.2017.08.018

Cited by 42 publications

(43 citation statements)

References 12 publications

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“…In a similar study performed by DeLong et al, it has also been shown that among 54 patients who have a sestamibi scan performed, 36 of them presented a parathyroid adenoma, whereas 18 were not detected, even though the adenomas were present [79]. However, when ICG was applied, parathyroid adenomas were detected in all of the patients presenting a high accuracy of this method.…”

Section: Indocyanine Greenmentioning

confidence: 72%

“…ICG is not the only agent used in the intraoperative detection of PGs. Previous studies have also shown a successful application of aminolaevulinic acid and methylene blue [79,132]. The usage of aminolaevulinic acid provides clear differentiation between PGs and adjacent tissues [133].…”

Section: Indocyanine Greenmentioning

confidence: 96%

“…ICG, at the very beginning (starting in 2015), has been used as a way of detecting PGs in dogs [129]. Further studies reported that ICG can apply to humans in many broad specialties like cholangiography, perfusion assessment of gastrointestinal anastomoses, adrenalectomy, or real-time lymph node mapping [79]. Further, ICG can be used in assessing blood perfusion within the PGs, but also in other cases including skin flaps, bowel anastomosis or lower limbs [126].…”

Section: Indocyanine Greenmentioning

confidence: 99%

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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 Greenmentioning

confidence: 72%

Section: Indocyanine Greenmentioning

confidence: 96%

Section: Indocyanine Greenmentioning

confidence: 99%

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

et al. 2020

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“…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%

“…The exact mechanism of ICG uptake by the PGs the resulting fluorescent contrast compared to surrounding tissues is not known. It has been suggested that this may be related to their substantially increased blood flow compared to the flow in adjacent tissues (20). Additionally, it must be noted that bleeding can induce leakage of ICG into the operative field that may restrict fluorescent PGs visualization (1).…”

Section: Discussionmentioning

confidence: 99%

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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Indocyanine green fluorescence for parathyroid gland identification and function prediction: Systematic review and meta‐analysis

et al. 2021

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Background To evaluate the diagnostic accuracies of indocyanine green (ICG) fluorescence for identifying parathyroid glands during surgery and predicting the postoperative function. Methods From six databases, 21 studies were finally included in the study. True‐positive, true‐negative, false‐positive, and false‐negative data were extracted for the analysis. The quality of each study was analyzed using the QUADAS‐2 tool. Results The sensitivity of ICG‐based parathyroid gland identification was 0.9380 (95% CI [0.9003, 0.9621]). The diagnostic odds ratio for ICG‐based prediction of parathyroid gland function was 54.5652 [13.2059, 225.4570]. The area under the summary receiver operating characteristic curve was 0.909. Fluorescence intensity‐based prediction presented higher diagnostic accuracy than that of score‐based prediction. The incidence of postoperative hypoparathyroidism was higher in the group with a zero ICG score compared to the high scored group. Conclusions Identification of parathyroid gland and prediction of postoperative function using ICG are valuable to patients undergoing thyroidectomy or parathyroidectomy.

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Indocyanine green fluorescence-guided parathyroidectomy for primary hyperparathyroidism

Cited by 42 publications

References 12 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

Indocyanine green fluorescence for parathyroid gland identification and function prediction: Systematic review and meta‐analysis

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