Converting a probe-based fluorescence system into an easy-to-use adjunct for the detection of parathyroid glands accidentally resected intraoperatively.

Autor: Chen W; Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, 230026, China., Zhang R; Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, 230026, China., Yang R; Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, 230026, China., Hu J; Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, 230026, China., Phay JE; Department of Surgery, Ohio State University Comprehensive Cancer Center and Ohio State University Wexner Medical Center, 410 W 10Th Ave, Columbus, OH, 43210, USA., Liu P; Suzhou Institute for Advanced Research, University of Science and Technology of China, Renai Road. NO. 188, Suzhou Industrial Park, Suzhou, 215123, Jiangsu Province, China., Ma X; First Affiliated Hospital, University of Science and Technology of China, Hefei, 230031, China., Xu RX; Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, 230026, China. xux@ustc.edu.cn.; Suzhou Institute for Advanced Research, University of Science and Technology of China, Renai Road. NO. 188, Suzhou Industrial Park, Suzhou, 215123, Jiangsu Province, China. xux@ustc.edu.cn.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2023 Jul 01; Vol. 408 (1), pp. 262. Date of Electronic Publication: 2023 Jul 01.
DOI: 10.1007/s00423-023-02985-3
Abstrakt: Purpose: The reported threshold of a near-infrared fluorescence detection probe (FDP) for judging parathyroid glands (PGs) is based on the autofluorescence intensity relative to other non-PG tissues, making it unreliable when not enough reference tissues are measured. We aim to convert FDP into a more convenient tool for identifying accidentally resected PGs by quantitative measurements of autofluorescence in resected tissues.
Methods: It was a prospective study approved by the Institutional Review Board. The research was divided into two stages: (1) In order to calibrate the novel FDP system, autofluorescence intensity of different in / ex vivo tissues was measured and the optimal threshold was obtained using receiver operating characteristic (ROC) curve. (2) To further validate the effectiveness of the new system, detection rates of incidental resected PGs by pathology in the control group and by FDP in the experimental group were compared.
Results: Autofluorescence of PGs was significantly higher than that of non-PG tissue (43 patients, Mann-Whitney U test, p < 0.0001). An optimal threshold of sensitivity / specificity (78.8% and 85.1%) for discriminating PGs was obtained. The detection rates of experimental group (20 patients) and control group (33 patients) are 5.0% and 6.1% respectively (one-tailed Fisher's exact test, p = 0.6837), indicating the novel FDP system can achieve a similar proportion of PG detection compared with pathological examinations.
Conclusions: The novel FDP system can be used as an easy-to-use adjunct for detecting PG accidentally resected intraoperatively before the tissues are sent for frozen sections during thyroidectomy surgeries.
Trial Registration: Registration number: ChiCTR2200057957.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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