Giju Thomas1, Carmen C Solórzano2, Naira Baregamian2, Emmanuel A Mannoh1, Rekha Gautam1, Rebecca T Irlmeier3, Fei Ye3, Jon A Nelson4, Samuel E Long5, Paul G Gauger4, Alexa Magner6, Tyler Metcalf7, Lawrence A Shirley8, John E Phay7, Anita Mahadevan-Jansen9. 1. Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, 37235, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA. 2. Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, 37232, USA. 3. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, 37203, USA. 4. Division of Endocrine Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, 48109, USA. 5. Department of General Surgery, Austin Regional Clinic South 1st, Austin, TX, 78704, USA. 6. West Virginia University School of Medicine, Morgantown, WV, 26506, USA. 7. Division of Surgical Oncology, Ohio State University Comprehensive Cancer Center and Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA. 8. Lexington Surgical Specialists, Lexington, KY, 40503, USA. 9. Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, 37235, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA. Electronic address: anita.mahadevan-jansen@vanderbilt.edu.
Abstract
BACKGROUND: Near infrared autofluorescence (NIRAF) detection has previously demonstrated significant potential for real-time parathyroid gland identification. However, the performance of a NIRAF detection device - PTeye® - remains to be evaluated relative to a surgeon's own ability to identify parathyroid glands. METHODS: Patients eligible for thyroidectomy and/or parathyroidectomy were enrolled under 6 endocrine surgeons at 3 high-volume institutions. Participating surgeons were categorized based on years of experience. All surgeons were blinded to output of PTeye® when identifying tissues. The surgeon's performance for parathyroid discrimination was then compared with PTeye®. Histology served as gold standard for excised specimens, while expert surgeon's opinion was used to validate in-situ tissues. RESULTS: PTeye® achieved 92.7% accuracy across 167 patients recruited. Junior surgeons (<5 years of experience) were found to have lower confidence in parathyroid identification and higher tissue misclassification rate per specimen when compared to PTeye® and senior surgeons (>10 years of experience). CONCLUSIONS: NIRAF detection with PTeye® can be a valuable intraoperative adjunct technology to aid in parathyroid identification for surgeons.
BACKGROUND: Near infrared autofluorescence (NIRAF) detection has previously demonstrated significant potential for real-time parathyroid gland identification. However, the performance of a NIRAF detection device - PTeye® - remains to be evaluated relative to a surgeon's own ability to identify parathyroid glands. METHODS: Patients eligible for thyroidectomy and/or parathyroidectomy were enrolled under 6 endocrine surgeons at 3 high-volume institutions. Participating surgeons were categorized based on years of experience. All surgeons were blinded to output of PTeye® when identifying tissues. The surgeon's performance for parathyroid discrimination was then compared with PTeye®. Histology served as gold standard for excised specimens, while expert surgeon's opinion was used to validate in-situ tissues. RESULTS: PTeye® achieved 92.7% accuracy across 167 patients recruited. Junior surgeons (<5 years of experience) were found to have lower confidence in parathyroid identification and higher tissue misclassification rate per specimen when compared to PTeye® and senior surgeons (>10 years of experience). CONCLUSIONS: NIRAF detection with PTeye® can be a valuable intraoperative adjunct technology to aid in parathyroid identification for surgeons.
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