Giju Thomas1, Melanie A McWade1, John Q Nguyen1, Melinda E Sanders2, James T Broome3, Naira Baregamian4, Carmen C Solórzano4, Anita Mahadevan-Jansen5. 1. Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN. 2. Department of Pathology, Microbiology and Immunology, Vanderbilt University, Nashville, TN. 3. St. Thomas Medical Partners - Endocrine Surgical Specialists, Nashville, TN. 4. Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University, Nashville, TN. 5. Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN. Electronic address: anita.mahadevan-jansen@vanderbilt.edu.
Abstract
BACKGROUND: Difficulty in identifying the parathyroid gland during neck operations can lead to accidental parathyroid gland excisions and postsurgical hypocalcemia. A clinical prototype called as PTeye was developed to guide parathyroid gland identification using a fiber-optic probe that detects near-infrared autofluorescence from parathyroid glands as operating room lights remain on. An Overlay Tissue Imaging System was designed concurrently to detect near-infrared autofluorescence and project visible light precisely onto parathyroid gland location. METHODS: The PTeye and the Overlay Tissue Imaging System were tested in 20 and 15 patients, respectively, and a modified near-infrared imaging system was investigated in 6 patients. All 41 patients underwent thyroidectomy or parathyroidectomy. System accuracy was ascertained with surgeon's visual confirmation for in situ parathyroid glands and histology for excised parathyroid glands. RESULTS: There was no observable difference between near-infrared autofluorescence of healthy and diseased parathyroid glands. The PTeye identified 98% of the parathyroid gland, whereas the near-infrared imaging system and the Overlay Tissue Imaging System identified 100% and 97% of the parathyroid glands, respectively. CONCLUSION: The PTeye can guide in real-time parathyroid gland identification even with ambient operating room lights. The near-infrared imaging system performs parathyroid gland imaging with high sensitivity, whereas the Overlay Tissue Imaging System enhances parathyroid gland visualization directly within the surgical field without requiring display monitors. These label-free technologies can be valuable adjuncts for identifying parathyroid glands intraoperatively.
BACKGROUND: Difficulty in identifying the parathyroid gland during neck operations can lead to accidental parathyroid gland excisions and postsurgical hypocalcemia. A clinical prototype called as PTeye was developed to guide parathyroid gland identification using a fiber-optic probe that detects near-infrared autofluorescence from parathyroid glands as operating room lights remain on. An Overlay Tissue Imaging System was designed concurrently to detect near-infrared autofluorescence and project visible light precisely onto parathyroid gland location. METHODS: The PTeye and the Overlay Tissue Imaging System were tested in 20 and 15 patients, respectively, and a modified near-infrared imaging system was investigated in 6 patients. All 41 patients underwent thyroidectomy or parathyroidectomy. System accuracy was ascertained with surgeon's visual confirmation for in situ parathyroid glands and histology for excised parathyroid glands. RESULTS: There was no observable difference between near-infrared autofluorescence of healthy and diseased parathyroid glands. The PTeye identified 98% of the parathyroid gland, whereas the near-infrared imaging system and the Overlay Tissue Imaging System identified 100% and 97% of the parathyroid glands, respectively. CONCLUSION: The PTeye can guide in real-time parathyroid gland identification even with ambient operating room lights. The near-infrared imaging system performs parathyroid gland imaging with high sensitivity, whereas the Overlay Tissue Imaging System enhances parathyroid gland visualization directly within the surgical field without requiring display monitors. These label-free technologies can be valuable adjuncts for identifying parathyroid glands intraoperatively.
Authors: Jonathan T Elliott; Alisha V Dsouza; Scott C Davis; Jonathan D Olson; Keith D Paulsen; David W Roberts; Brian W Pogue Journal: Biomed Opt Express Date: 2015-09-03 Impact factor: 3.732
Authors: Megan K Applewhite; Michael G White; Maggie Xiong; Jesse D Pasternak; Layth Abdulrasool; Lauren Ogawa; Insoo Suh; Jessica E Gosnell; Edwin L Kaplan; Quan-Yang Duh; Peter Angelos; Wen T Shen; Raymon H Grogan Journal: Ann Surg Oncol Date: 2016-08-19 Impact factor: 5.344
Authors: Fares Benmiloud; Stanislas Rebaudet; Arthur Varoquaux; Guillaume Penaranda; Marie Bannier; Anne Denizot Journal: Surgery Date: 2017-11-06 Impact factor: 3.982
Authors: Suman B Mondal; Christine M O'Brien; Kevin Bishop; Ryan C Fields; Julie A Margenthaler; Samuel Achilefu Journal: J Nucl Med Date: 2020-04-17 Impact factor: 10.057
Authors: Giju Thomas; Carmen C Solórzano; Naira Baregamian; Emmanuel A Mannoh; Rekha Gautam; Rebecca T Irlmeier; Fei Ye; Jon A Nelson; Samuel E Long; Paul G Gauger; Alexa Magner; Tyler Metcalf; Lawrence A Shirley; John E Phay; Anita Mahadevan-Jansen Journal: Am J Surg Date: 2021-05-13 Impact factor: 2.565
Authors: Emmanuel A Mannoh; Giju Thomas; Naira Baregamian; Sarah L Rohde; Carmen C Solórzano; Anita Mahadevan-Jansen Journal: Thyroid Date: 2021-08-18 Impact factor: 6.506