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Indocyanine Green Fluorescence-Guided Parathyroidectomy for Primary Hyperparathyroidism

Indocyanine Green Fluorescence-Guided Parathyroidectomy for Primary Hyperparathyroidism

Jonathan C DeLong, Erin P Ward, Thinzar M Lwin, Kevin T Brumund, Kaitlyn J Kelly, Santiago Horgan, Michael Bouvet

Surgery. 2018 Feb;163(2):388-392.

PMID: 29129358

Abstract:

Background:
Our aim was to evaluate the ease and utility of using indocyanine green fluorescence angiography for intraoperative localization of the parathyroid glands.
Methods:
Indocyanine green fluorescence angiography was performed during 60 parathyroidectomies for primary hyperparathyroidism during a 22-month period. Indocyanine green was administered intravenously to guide operative navigation using a commercially available fluorescence imaging system. Video files were graded by 3 independent surgeons for strength of enhancement using an adapted numeric scoring system.
Results:
There were 46 (77%) female patients and 14 (23%) male patients whose ages ranged from 17 to 87 (average 60) years old. Of the 60 patients, 43 (71.6%) showed strong enhancement, 13 (21.7%) demonstrated mild to moderate vascular enhancement, and 4 (6.7%) exhibited little or no vascular enhancement. Of the 54 patients who had a preoperative sestamibi scan, a parathyroid adenoma was identified in 36, while 18 failed to localize. Of the 18 patients who failed to localize, all 18 patients (100%) had an adenoma that fluoresced on indocyanine green imaging. The operations were performed safely with minimal blood loss and short operative times.
Conclusion:
Indocyanine green angiography has the potential to assist surgeons in identifying parathyroid glands rapidly with minimal risk.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP3599324-A	Indocyanine green		3599-32-4	Price

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