TY - JOUR
T1 - Emerging Imaging Technologies for Parathyroid Gland Identification and Vascular Assessment in Thyroid Surgery
T2 - A Review from the American Head and Neck Society Endocrine Surgery Section
AU - Silver Karcioglu, Amanda L.
AU - Triponez, Frédéric
AU - Solórzano, Carmen C.
AU - Iwata, Ayaka J.
AU - Abdelhamid Ahmed, Amr H.
AU - Almquist, Martin
AU - Angelos, Peter
AU - Benmiloud, Fares
AU - Berber, Eren
AU - Bergenfelz, Anders
AU - Cha, Jaepyeong
AU - Colaianni, C. Alessandra
AU - Davies, Louise
AU - Duh, Quan Yang
AU - Hartl, Dana
AU - Kandil, Emad
AU - Kim, Wan Wook
AU - Kopp, Peter A.
AU - Liddy, Whitney
AU - Mahadevan-Jansen, Anita
AU - Lee, Kang Dae
AU - Mannstadt, Michael
AU - McMullen, Caitlin P.
AU - Shonka, David C.
AU - Shin, Jennifer J.
AU - Singer, Michael C.
AU - Slough, Cristian M.
AU - Stack, Brendan C.
AU - Tearney, Guillermo
AU - Thomas, Giju
AU - Tolley, Neil
AU - Vidal-Fortuny, Jordi
AU - Randolph, Gregory W.
N1 - Publisher Copyright:
© 2023 American Medical Association. All rights reserved.
PY - 2023/3/9
Y1 - 2023/3/9
N2 - Importance: Identification and preservation of parathyroid glands (PGs) remain challenging despite advances in surgical techniques. Considerable morbidity and even mortality result from hypoparathyroidism caused by devascularization or inadvertent removal of PGs. Emerging imaging technologies hold promise to improve identification and preservation of PGs during thyroid surgery. Observation: This narrative review (1) comprehensively reviews PG identification and vascular assessment using near-infrared autofluorescence (NIRAF) - both label free and in combination with indocyanine green - based on a comprehensive literature review and (2) offers a manual for possible implementation these emerging technologies in thyroid surgery. Conclusions and Relevance: Emerging technologies hold promise to improve PG identification and preservation during thyroidectomy. Future research should address variables affecting the degree of fluorescence in NIRAF, standardization of signal quantification, definitions and standardization of parameters of indocyanine green injection that correlate with postoperative PG function, the financial effect of these emerging technologies on near-term and longer-term costs, the adoption learning curve and effect on surgical training, and long-term outcomes of key quality metrics in adequately powered randomized clinical trials evaluating PG preservation.
AB - Importance: Identification and preservation of parathyroid glands (PGs) remain challenging despite advances in surgical techniques. Considerable morbidity and even mortality result from hypoparathyroidism caused by devascularization or inadvertent removal of PGs. Emerging imaging technologies hold promise to improve identification and preservation of PGs during thyroid surgery. Observation: This narrative review (1) comprehensively reviews PG identification and vascular assessment using near-infrared autofluorescence (NIRAF) - both label free and in combination with indocyanine green - based on a comprehensive literature review and (2) offers a manual for possible implementation these emerging technologies in thyroid surgery. Conclusions and Relevance: Emerging technologies hold promise to improve PG identification and preservation during thyroidectomy. Future research should address variables affecting the degree of fluorescence in NIRAF, standardization of signal quantification, definitions and standardization of parameters of indocyanine green injection that correlate with postoperative PG function, the financial effect of these emerging technologies on near-term and longer-term costs, the adoption learning curve and effect on surgical training, and long-term outcomes of key quality metrics in adequately powered randomized clinical trials evaluating PG preservation.
UR - http://www.scopus.com/inward/record.url?scp=85149911297&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85149911297&partnerID=8YFLogxK
U2 - 10.1001/jamaoto.2022.4421
DO - 10.1001/jamaoto.2022.4421
M3 - Review article
C2 - 36633855
AN - SCOPUS:85149911297
SN - 2168-6181
VL - 149
SP - 253
EP - 260
JO - JAMA Otolaryngology - Head and Neck Surgery
JF - JAMA Otolaryngology - Head and Neck Surgery
IS - 3
ER -