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Intraoperative Assessment of Parathyroid Viability using Laser Speckle Contrast Imaging
E A Mannoh1,2, G Thomas1,2, C C Solórzano3
1Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA.
Scientific Reports
|November 3, 2017
Summary
Laser Speckle Contrast Imaging (LSCI) offers a new, objective way to assess parathyroid gland viability during thyroid surgery. This technique helps surgeons identify compromised glands in real-time, potentially reducing post-surgical hypoparathyroidism and hypocalcemia.
Area of Science:
- Surgical Innovation
- Medical Imaging
- Endocrinology
Background:
- Post-thyroid surgery hypoparathyroidism and hypocalcemia occur in up to 50% of patients.
- Current methods for assessing parathyroid gland viability rely solely on surgeon's visual inspection.
- Lack of objective tools leads to potential complications like accidental parathyroid gland damage.
Purpose of the Study:
- To introduce and evaluate Laser Speckle Contrast Imaging (LSCI) for real-time assessment of parathyroid gland viability.
- To determine if LSCI can objectively distinguish between healthy and compromised parathyroid glands during surgery.
- To assess LSCI's potential in reducing the incidence of hypoparathyroidism after thyroidectomy.
Main Methods:
- Laser Speckle Contrast Imaging (LSCI) was employed for real-time assessment of parathyroid gland vascularity.
- LSCI measurements were compared against experienced surgeon's visual assessment, considered the gold standard.
- The study included 32 well-vascularized and 27 compromised parathyroid glands during thyroid surgery and parathyroidectomies.
Main Results:
- LSCI demonstrated a 91.5% accuracy in distinguishing between well-vascularized and compromised parathyroid glands.
- The technique successfully detected parathyroid gland devascularization before it was visually apparent to surgeons.
- LSCI measurements were performed in real-time without requiring the operating room lights to be turned off.
Conclusions:
- LSCI provides a real-time, contrast-free, and objective method for assessing parathyroid gland viability.
- This imaging technique shows significant promise in improving surgical outcomes and reducing hypoparathyroidism after thyroid surgery.
- Objective assessment of parathyroid gland vascularity using LSCI can aid surgeons in decision-making regarding gland excision and auto-transplantation.
