Rapid intraoperative perfusion assessment of parathyroid adenomas with ICG using a wide-field portable hand-held fluorescence imaging system
Fluorescence angiography (FA) using indocyanine green dye (ICG) has recently been introduced for real-time identification of parathyroid adenomas. However, time to peak fluorescence has not yet been critically evaluated.
This was a retrospective review of parathyroidectomies with ICG FA over a one-year period.
There were 66 patients with average age of 64 years. The average time to initial fluorescence was 26.7 s and to peak fluorescence was 38.0 s. The time to saline flush administration significantly correlated with times to initial and peak fluorescence (p < .0001). The rate of in-situ fluorescence was 97%. The rates of suspected adenoma detection were 69% for sestamibi scan, 71% for ultrasound, and 96% for CT scan. Imaging was discordant in 13 cases (20%), with the adenoma located on the opposite side of the neck in 4 cases.
ICG FA is a rapid and effective adjunct for the intraoperative identification of parathyroid adenomas.
Matson J, Lwin TM, Bouvet M. Rapid intraoperative perfusion assessment of parathyroid adenomas with ICG using a wide-field portable hand-held fluorescence imaging system. Am J Surg. 2021 Jul 26:S0002-9610(21)00407-4. doi: 10.1016/j.amjsurg.2021.07.027. Epub ahead of print. PMID: 34407918.