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Related Concept Videos

Imaging Studies VII: Vascular Imaging01:19

Imaging Studies VII: Vascular Imaging

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DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
313

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Application of Indocyanine Green Fluorescence Imaging Technology in Laparoscopic Duodenum-Preserving Pancreatic Head Resection
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Indocyanine Green Fluorescence Angiography Can Guide Intraoperative Localization During Parathyroid Surgery.

G Di Meo1,2, I Karampinis2, A Gerken2

  • 1Unit of Endocrine, Digestive, and Emergency Surgery, Department of Biomedical Sciences and Human Oncology, University Medical School "A. Moro" of Bari, Bari, Italy.

Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society
|September 27, 2019
PubMed
Summary
This summary is machine-generated.

Indocyanine green angiography offers high sensitivity for intraoperative parathyroid gland localization during hyperparathyroidism surgery. This method improves gland identification, especially in complex cases, and aids in successful parathyroidectomy.

Keywords:
Indocyanine greenautotransplantationfluorescencefluorescence angiographyhyperparathyroidismneck surgeryparathyroid surgery

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Medical Imaging

Background:

  • Intraoperative localization of parathyroid glands is crucial for effective hyperparathyroidism treatment.
  • Anatomic variability and small gland size present significant localization challenges.
  • Current methods involve preoperative ultrasonography and Technetium-99m sestamibi scintigraphy (MIBI).

Purpose of the Study:

  • To implement and evaluate indocyanine green (ICG) angiography for intraoperative parathyroid gland localization.
  • To compare the sensitivity of ICG angiography with conventional imaging techniques.
  • To assess the impact of ICG imaging on surgical outcomes and postoperative parathyroid hormone levels.

Main Methods:

  • Retrospective analysis of 37 patients undergoing surgery for hyperparathyroidism.
  • Intravenous administration of 2.5 mg indocyanine green solution for visualization.
  • Correlation of fluorescence scores with postoperative parathyroid hormone levels and outcomes.

Main Results:

  • Indocyanine green imaging demonstrated higher sensitivity for intraoperative parathyroid gland detection compared to ultrasonography and MIBI (p < 0.001).
  • A resection rate of 96.8% was achieved, with 62 out of 64 lesions confirmed as parathyroid tissue.
  • No postoperative hypoparathyroidism occurred in the uniglandular disease group; temporary symptoms were noted in three multiglandular cases.

Conclusions:

  • Indocyanine green angiography is a highly sensitive tool for intraoperative parathyroid gland identification, achieving a 95.16% resection rate.
  • The modality is particularly valuable for revisional surgery and cases with ectopic parathyroid glands.
  • Findings support the routine adoption of indocyanine green imaging in parathyroid surgery to improve outcomes and predict postoperative hypocalcemia.