A novel optical approach to the intraoperative detection of parathyroid glands

Abstract

A major challenge in endocrine surgery is the intraoperative identification of parathyroids during both thyroid and parathyroid surgery. Current localization techniques are mostly preoperative and are imprecise. Optical spectroscopy is fast and sensitive and has been used in many in vivo applications. Here, near-infrared (NIR) fluorescence is used to identify parathyroid glands during thyroid and parathyroidectomies. We investigated whether parathyroid tissue had unique optical signals that could be used to identify the parathyroid glands and differentiate them from other tissues in the neck intra-operatively. Fluorescence measurements were obtained from patients undergoing endocrine surgery at Vanderbilt University Medical Center. The intensity of the parathyroid signal was compared to the fluorescence of the surrounding tissue including the thyroid gland. In each case, the parathyroid had markedly higher levels of fluorescence. These results indicate that NIR fluorescence is potentially an excellent tool to locate parathyroid tissue during surgery.