Near-infrared autofluorescence imaging to detect parathyroid glands in thyroid surgery

  • R Ladurner
    Department of Surgery, Ludwig Maximilians University Munich, Innenstadt Medical Campus, Munich, Germany
  • N Al Arabi
    Department of Surgery, Ludwig Maximilians University Munich, Innenstadt Medical Campus, Munich, Germany
  • U Guendogar
    Department of Surgery, Ludwig Maximilians University Munich, Innenstadt Medical Campus, Munich, Germany
  • KKJ Hallfeldt
    Department of Surgery, Ludwig Maximilians University Munich, Innenstadt Medical Campus, Munich, Germany
  • H Stepp
    Laser-Research Laboratory, LIFE-Center, Ludwig Maximilians University Munich, Grosshadern Medical Campus, Munich, Germany
  • JKS Gallwas
    Department of Obstetrics and Gynecology, Ludwig Maximilians University Munich, Grosshadern Medical Campus, Munich, Germany

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<jats:sec><jats:title>Objective</jats:title><jats:p> To identify and save parathyroid glands during thyroidectomy by displaying their autofluorescence. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Autofluorescence imaging was carried out during thyroidectomy with and without central lymph node dissection. After visual recognition by the surgeon, the parathyroid glands and the surrounding tissue were exposed to near-infrared light with a wavelength of 690–770 nm using a modified Karl Storz near infrared/indocyanine green endoscopic system. Parathyroid tissue was expected to show near infrared autofluorescence at 820 nm, captured in the blue channel of the camera. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> We investigated 41 parathyroid glands from 20 patients; 37 glands were identified correctly based on near-infrared autofluorescence. Neither lymph nodes nor thyroid revealed substantial autofluorescence and nor did adipose tissue. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Parathyroid tissue is characterised by showing autofluorescence in the near-infrared spectrum. This effect can be used to identify and preserve parathyroid glands during thyroidectomy. </jats:p></jats:sec>

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