title: Intraoperative Real-Time Localization of Normal Parathyroid Glands With Autofluorescence Imaging.
abstract: This biomedical investigation is valuable for identification and localization of parathyroid glands during thyroidectomy, which can provide an intraoperative real-time visual guidance.
  
  
  
  The objective of the study was to investigate the feasibility of real-time autofluorescence imaging of the parathyroid glands without exogenous contrast dye for their localization and demonstration of relation to the background tissues.
  
  
  
  This research was undertaken at Kosin University Gospel Hospital.
  
  
  
  Sixteen normal parathyroid glands from eight patients with papillary thyroid carcinoma were enrolled. Photo images of the surgical field including the parathyroid and background tissues were taken with a digital camera, 780 nm light-emitting diode to excite the parathyroid, and infrared illuminator to visualize the entire neck. The area-averaged autofluorescence intensity of parathyroid over the area-averaged fluorescence intensity of background tissues was measured.
  
  
  
  The location of the parathyroid gland was verified with a single image.
  
  
  
  The area-averaged autofluorescence intensity of parathyroid over the area-averaged fluorescence intensity of background tissues for all parathyroid glands was higher than 1, with a minimum of 1.95 and a maximum of 5.20 (average 2.76, SD 0.79). By our technique, all 16 parathyroid glands were detected (positive predictive value of 100%), and the entire surgical field including the parathyroid and background tissues was visualized as well. The parathyroid glands that were exposed or even covered by connective tissues or blood vessels could be detected with strong emission.
  
  
  
  This method showed the precise localization of the parathyroid glands and demonstrated their relation to background tissue. We believe that this simple, nonexogenous dye technique of anatomical guidance can aid surgeons to preserve parathyroid glands during thyroidectomy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery (S.W.K., H.S.L., W.J.N., K.D.L.), Kosin University College of Medicine, and Innovative Biomedical Technology Research Center (S.W.K., S.H.S., H.S.L., W.J.N., C.O., Y.-C.A., K.D.L.), College of Medicine, Kosin University, 49267 Busan, South Korea; Department of Internal Medicine (C.O.), Kosin University College of Medicine, 49267 Busan, South Korea; and Department of Biomedical Engineering and Center for Marine-Integrated Biomedical Technology (S.H.S., Y.-C.A.), Pukyong National University, 48513 Busan, South Korea.
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery (S.W.K., H.S.L., W.J.N., K.D.L.), Kosin University College of Medicine, and Innovative Biomedical Technology Research Center (S.W.K., S.H.S., H.S.L., W.J.N., C.O., Y.-C.A., K.D.L.), College of Medicine, Kosin University, 49267 Busan, South Korea; Department of Internal Medicine (C.O.), Kosin University College of Medicine, 49267 Busan, South Korea; and Department of Biomedical Engineering and Center for Marine-Integrated Biomedical Technology (S.H.S., Y.-C.A.), Pukyong National University, 48513 Busan, South Korea.
authors.forename: Seo Hyun
authors.initials: SH
authors.lastname: Song
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery (S.W.K., H.S.L., W.J.N., K.D.L.), Kosin University College of Medicine, and Innovative Biomedical Technology Research Center (S.W.K., S.H.S., H.S.L., W.J.N., C.O., Y.-C.A., K.D.L.), College of Medicine, Kosin University, 49267 Busan, South Korea; Department of Internal Medicine (C.O.), Kosin University College of Medicine, 49267 Busan, South Korea; and Department of Biomedical Engineering and Center for Marine-Integrated Biomedical Technology (S.H.S., Y.-C.A.), Pukyong National University, 48513 Busan, South Korea.
authors.forename: Hyoung Shin
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery (S.W.K., H.S.L., W.J.N., K.D.L.), Kosin University College of Medicine, and Innovative Biomedical Technology Research Center (S.W.K., S.H.S., H.S.L., W.J.N., C.O., Y.-C.A., K.D.L.), College of Medicine, Kosin University, 49267 Busan, South Korea; Department of Internal Medicine (C.O.), Kosin University College of Medicine, 49267 Busan, South Korea; and Department of Biomedical Engineering and Center for Marine-Integrated Biomedical Technology (S.H.S., Y.-C.A.), Pukyong National University, 48513 Busan, South Korea.
authors.forename: Woong Jae
authors.initials: WJ
authors.lastname: Noh
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery (S.W.K., H.S.L., W.J.N., K.D.L.), Kosin University College of Medicine, and Innovative Biomedical Technology Research Center (S.W.K., S.H.S., H.S.L., W.J.N., C.O., Y.-C.A., K.D.L.), College of Medicine, Kosin University, 49267 Busan, South Korea; Department of Internal Medicine (C.O.), Kosin University College of Medicine, 49267 Busan, South Korea; and Department of Biomedical Engineering and Center for Marine-Integrated Biomedical Technology (S.H.S., Y.-C.A.), Pukyong National University, 48513 Busan, South Korea.
authors.forename: Chulho
authors.initials: C
authors.lastname: Oak
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery (S.W.K., H.S.L., W.J.N., K.D.L.), Kosin University College of Medicine, and Innovative Biomedical Technology Research Center (S.W.K., S.H.S., H.S.L., W.J.N., C.O., Y.-C.A., K.D.L.), College of Medicine, Kosin University, 49267 Busan, South Korea; Department of Internal Medicine (C.O.), Kosin University College of Medicine, 49267 Busan, South Korea; and Department of Biomedical Engineering and Center for Marine-Integrated Biomedical Technology (S.H.S., Y.-C.A.), Pukyong National University, 48513 Busan, South Korea.
authors.forename: Yeh-Chan
authors.initials: YC
authors.lastname: Ahn
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery (S.W.K., H.S.L., W.J.N., K.D.L.), Kosin University College of Medicine, and Innovative Biomedical Technology Research Center (S.W.K., S.H.S., H.S.L., W.J.N., C.O., Y.-C.A., K.D.L.), College of Medicine, Kosin University, 49267 Busan, South Korea; Department of Internal Medicine (C.O.), Kosin University College of Medicine, 49267 Busan, South Korea; and Department of Biomedical Engineering and Center for Marine-Integrated Biomedical Technology (S.H.S., Y.-C.A.), Pukyong National University, 48513 Busan, South Korea.
authors.forename: Kang Dae
authors.initials: KD
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000601:surgery*; D002291:Carcinoma, Papillary; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061848:Optical Imaging / Q000379:methods*; D010280:Parathyroid Glands / Q000000981:diagnostic imaging*; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*