Intraoperative Indocyanine Green (ICG) Angiography for the Identification of the Parathyroid Glands: Current Evidence and Future Perspectives

Overview

Journal In Vivo

Specialty Oncology

Date 2019 Dec 29

PMID 31882459

Citations 32

Authors

Eleftherios Spartalis

Georgios Ntokos

Konstantinos Georgiou

Georgios Zografos

Gerasimos Tsourouflis

Dimitrios Dimitroulis

Nikolaos I Nikiteas

Affiliations

Soon will be listed here.

Abstract

Background/aim: Recently, indocyanine green (ICG) fluorescence imaging has been used for the identification of the parathyroid glands (PG) during thyroid and parathyroid surgery. However, an overall consensus on the optimal technique, the dosage, the timing of the ICG administration and finally its interpretation and clinical usefulness is still lacking evidence. The aim of this review is to investigate the use of ICG angiography during thyroidectomy and/or parathyroidectomy for identification as well as for the perfusion integrity of the parathyroid glands.

Materials And Methods: The PubMed database was systematically searched for publications regarding intraoperative ICG imaging in patients that undergo thyroidectomy or parathyroidectomy.

Results: Eighteen publications reporting on 612 patients, namely 71 parathyroidectomy and 541 thyroidectomy patients met the inclusion criteria. Eleven publications reported the use of ICG angiography for the identification of the parathyroid glands during thyroidectomy and seven during parathyroidectomy for primary and secondary hyperparathyroidism.

Conclusion: ICG fluorescence imaging is a simple, fast and reproducible method capable of intraoperatively visualizing and assessing the function of parathyroid glands, and can, therefore, assist surgeons in their decision-making. Despite all this, ICG fluorescence imaging technique for PG detection still lacks standardization and further studies are needed to establish its clinical utility.

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References

Rudin A, McKenzie T, Thompson G, Farley D, Lyden M . Evaluation of Parathyroid Glands with Indocyanine Green Fluorescence Angiography After Thyroidectomy. World J Surg. 2019; 43(6):1538-1543. DOI: 10.1007/s00268-019-04909-z. View

Alander J, Kaartinen I, Laakso A, Patila T, Spillmann T, Tuchin V . A review of indocyanine green fluorescent imaging in surgery. Int J Biomed Imaging. 2012; 2012:940585. PMC: 3346977. DOI: 10.1155/2012/940585. View

Jitpratoom P, Anuwong A . The use of ICG enhanced fluorescence for the evaluation of parathyroid gland preservation. Gland Surg. 2017; 6(5):579-586. PMC: 5676163. DOI: 10.21037/gs.2017.09.01. View

Van den Bos J, van Kooten L, Engelen S, Lubbers T, Stassen L, Bouvy N . Feasibility of indocyanine green fluorescence imaging for intraoperative identification of parathyroid glands during thyroid surgery. Head Neck. 2018; 41(2):340-348. PMC: 6590433. DOI: 10.1002/hed.25451. View

Zaidi N, Bucak E, Okoh A, Yazici P, Yigitbas H, Berber E . The utility of indocyanine green near infrared fluorescent imaging in the identification of parathyroid glands during surgery for primary hyperparathyroidism. J Surg Oncol. 2016; 113(7):771-4. DOI: 10.1002/jso.24240. View

Chang Y, Lang B . To identify or not to identify parathyroid glands during total thyroidectomy. Gland Surg. 2018; 6(Suppl 1):S20-S29. PMC: 5756751. DOI: 10.21037/gs.2017.06.13. View

Vidal Fortuny J, Karenovics W, Triponez F, Sadowski S . Intra-Operative Indocyanine Green Angiography of the Parathyroid Gland. World J Surg. 2016; 40(10):2378-81. PMC: 5028398. DOI: 10.1007/s00268-016-3493-2. View

Kahramangil B, Berber E . The use of near-infrared fluorescence imaging in endocrine surgical procedures. J Surg Oncol. 2017; 115(7):848-855. DOI: 10.1002/jso.24583. View

Vidal Fortuny J, Sadowski S, Belfontali V, Guigard S, Poncet A, Ris F . Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery. Br J Surg. 2018; 105(4):350-357. PMC: 6084300. DOI: 10.1002/bjs.10783. View

10.

Mohsin K, Alzahrani H, Ali D, Kang S, Kandil E . Robotic transaxillary parathyroidectomy. Gland Surg. 2017; 6(4):410-411. PMC: 5566671. DOI: 10.21037/gs.2017.04.09. View

11.

Sadowski S, Vidal Fortuny J, Triponez F . A reappraisal of vascular anatomy of the parathyroid gland based on fluorescence techniques. Gland Surg. 2018; 6(Suppl 1):S30-S37. PMC: 5756753. DOI: 10.21037/gs.2017.07.10. View

12.

Vidal Fortuny J, Sadowski S, Belfontali V, Karenovics W, Guigard S, Triponez F . Indocyanine Green Angiography in Subtotal Parathyroidectomy: Technique for the Function of the Parathyroid Remnant. J Am Coll Surg. 2016; 223(5):e43-e49. DOI: 10.1016/j.jamcollsurg.2016.08.540. View

13.

Zaidi N, Bucak E, Yazici P, Soundararajan S, Okoh A, Yigitbas H . The feasibility of indocyanine green fluorescence imaging for identifying and assessing the perfusion of parathyroid glands during total thyroidectomy. J Surg Oncol. 2016; 113(7):775-8. DOI: 10.1002/jso.24237. View

14.

Hou F, Yu Y, Liang Y . Automatic identification of parathyroid in optical coherence tomography images. Lasers Surg Med. 2017; 49(3):305-311. DOI: 10.1002/lsm.22622. View

15.

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzsche P, Ioannidis J . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009; 339:b2700. PMC: 2714672. DOI: 10.1136/bmj.b2700. View

16.

Hyun H, Park M, Owens E, Wada H, Henary M, Handgraaf H . Structure-inherent targeting of near-infrared fluorophores for parathyroid and thyroid gland imaging. Nat Med. 2015; 21(2):192-7. PMC: 4319985. DOI: 10.1038/nm.3728. View

17.

Cui L, Gao Y, Yu H, Li M, Wang B, Zhou T . Intraoperative Parathyroid Localization with Near-Infrared Fluorescence Imaging Using Indocyanine Green during Total Parathyroidectomy for Secondary Hyperparathyroidism. Sci Rep. 2017; 7(1):8193. PMC: 5557759. DOI: 10.1038/s41598-017-08347-6. View

18.

Lavazza M, Liu X, Wu C, Anuwong A, Kim H, Liu R . Indocyanine green-enhanced fluorescence for assessing parathyroid perfusion during thyroidectomy. Gland Surg. 2016; 5(5):512-521. PMC: 5106380. DOI: 10.21037/gs.2016.10.06. View

19.

Ladurner R, Sommerey S, Arabi N, Hallfeldt K, Stepp H, Gallwas J . Intraoperative near-infrared autofluorescence imaging of parathyroid glands. Surg Endosc. 2016; 31(8):3140-3145. DOI: 10.1007/s00464-016-5338-3. View

20.

Perry D, Bharara M, Armstrong D, Mills J . Intraoperative fluorescence vascular angiography: during tibial bypass. J Diabetes Sci Technol. 2012; 6(1):204-8. PMC: 3320839. DOI: 10.1177/193229681200600125. View