Comparing intraoperative parathyroid identification based on surgeon experience versus near infrared autofluorescence detection - A surgeon-blinded multi-centric study.

Autor: Thomas G; Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, 37235, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA., Solórzano CC; Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, 37232, USA., Baregamian N; Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, 37232, USA., Mannoh EA; Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, 37235, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA., Gautam R; Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, 37235, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA., Irlmeier RT; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, 37203, USA., Ye F; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, 37203, USA., Nelson JA; Division of Endocrine Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, 48109, USA., Long SE; Department of General Surgery, Austin Regional Clinic South 1st, Austin, TX, 78704, USA., Gauger PG; Division of Endocrine Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, 48109, USA., Magner A; West Virginia University School of Medicine, Morgantown, WV, 26506, USA., Metcalf T; Division of Surgical Oncology, Ohio State University Comprehensive Cancer Center and Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA., Shirley LA; Lexington Surgical Specialists, Lexington, KY, 40503, USA., Phay JE; Division of Surgical Oncology, Ohio State University Comprehensive Cancer Center and Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA., Mahadevan-Jansen A; 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.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2021 Nov; Vol. 222 (5), pp. 944-951. Date of Electronic Publication: 2021 May 13.
DOI: 10.1016/j.amjsurg.2021.05.001
Abstrakt: 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.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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