Literature DB >> 23720199

Intraoperative near-infrared fluorescence imaging of parathyroid adenomas with use of low-dose methylene blue.

Joost R van der Vorst1, Boudewijn E Schaafsma, Floris P R Verbeek, Rutger-Jan Swijnenburg, Quirijn R J G Tummers, Merlijn Hutteman, Jaap F Hamming, Job Kievit, John V Frangioni, Cornelis J H van de Velde, Alexander L Vahrmeijer.   

Abstract

BACKGROUND: Intraoperative identification of parathyroid adenomas can be challenging. We hypothesized that low-doses methylene blue (MB) and near-infrared fluorescence (NIRF) imaging could be used to identify parathyroid adenomas intraoperatively.
METHODS: MB was injected intravenously after exploration at a dose of 0.5 mg/kg into 12 patients who underwent parathyroid surgery. NIRF imaging was performed using the Mini-FLARE imaging system.
RESULTS: In 10 of 12 patients, histology confirmed a parathyroid adenoma. In 9 of these patients, NIRF could clearly identify the parathyroid adenoma during surgery. Seven of these 9 patients had a positive preoperative (99m) Tc-sestamibi single photon emission CT (SPECT) scan. Importantly, in 2 patients, parathyroid adenomas could be identified only using NIRF.
CONCLUSION: This is the first study to show that low-dose MB can be used as NIRF tracer for identification of parathyroid adenomas, and suggests a correlation with preoperative (99m) Tc-sestamibi SPECT scanning.
© 2013 Wiley Periodicals, Inc.

Entities:  

Keywords:  hyperparathyroidism; image-guided surgery; methylene blue; near-infrared fluorescence imaging; parathyroid adenoma

Mesh:

Substances:

Year:  2013        PMID: 23720199      PMCID: PMC3779489          DOI: 10.1002/hed.23384

Source DB:  PubMed          Journal:  Head Neck        ISSN: 1043-3074            Impact factor:   3.147


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