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Conference Paper: Indocyanine green fluorescence angiography for quantitative evaluation of in situ parathyroid gland perfusion and function after total thyroidectomy

TitleIndocyanine green fluorescence angiography for quantitative evaluation of in situ parathyroid gland perfusion and function after total thyroidectomy
Authors
Issue Date2017
PublisherMosby, Inc. The Journal's web site is located at http://www.medicinepublishing.co.uk/index.php/surgery/
Citation
The American Association of Endocrine Surgeons 37th Annual Meeting, Baltimore, USA, 10-12 April 2016. In Surgery, 2017, v. 161 n. 1, p. 87-95 How to Cite?
AbstractBackground: Because the fluorescent light intensity on an indocyanine green fluorescence angiography reflects the blood perfusion within a focused area, the fluorescent light intensity in the remaining in situ parathyroid glands may predict postoperative hypocalcemia risk after total thyroidectomy. Methods: Seventy patients underwent intraoperative indocyanine green fluorescence angiography after total thyroidectomy. Any parathyroid glands with a vascular pedicle was left in situ while any parathyroid glands without pedicle or inadvertently removed was autotransplanted. After total thyroidectomy, an intravenous 2.5 mg indocyanine green fluorescence angiography was given and real-time fluorescent images of the thyroid bed were recorded using the SPY imaging system (Novadaq, Ontario, Canada). The fluorescent light intensity of each indocyanine green fluorescence angiography as well as the average and greatest fluorescent light intensity in each patient were calculated. Postoperative hypocalcemia was defined as adjusted calcium <2.00 mmol/L within 24 hours. Results: The fluorescent light intensity between discolored and normal-looking indocyanine green fluorescence angiographies was similar (P = .479). No patients with a greatest fluorescent light intensity >150% developed postoperative hypocalcemia while 9 (81.8%) patients with a greatest fluorescent light intensity ≤150% did. Similarly, no patients with an average fluorescent light intensity >109% developed PH while 9 (30%) with an average fluorescent light intensity ≤109% did. The greatest fluorescent light intensity was more predictive than day-0 postoperative hypocalcemia (P = .027) and % PTH drop day-0 to 1 (P < .001). Conclusion: Indocyanine green fluorescence angiography is a promising operative adjunct in determining residual parathyroid glands function and predicting postoperative hypocalcemia risk after total thyroidectomy.
DescriptionScientific Session VII: Thyroid - no. 29
Persistent Identifierhttp://hdl.handle.net/10722/236414
ISSN
2019 Impact Factor: 3.356
2015 SCImago Journal Rankings: 1.620
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLang, HHB-
dc.contributor.authorWong, CKH-
dc.contributor.authorHung, HT-
dc.contributor.authorWong, KP-
dc.contributor.authorMak, KL-
dc.contributor.authorAu, KB-
dc.date.accessioned2016-11-25T00:53:03Z-
dc.date.available2016-11-25T00:53:03Z-
dc.date.issued2017-
dc.identifier.citationThe American Association of Endocrine Surgeons 37th Annual Meeting, Baltimore, USA, 10-12 April 2016. In Surgery, 2017, v. 161 n. 1, p. 87-95-
dc.identifier.issn0039-6060-
dc.identifier.urihttp://hdl.handle.net/10722/236414-
dc.descriptionScientific Session VII: Thyroid - no. 29-
dc.description.abstractBackground: Because the fluorescent light intensity on an indocyanine green fluorescence angiography reflects the blood perfusion within a focused area, the fluorescent light intensity in the remaining in situ parathyroid glands may predict postoperative hypocalcemia risk after total thyroidectomy. Methods: Seventy patients underwent intraoperative indocyanine green fluorescence angiography after total thyroidectomy. Any parathyroid glands with a vascular pedicle was left in situ while any parathyroid glands without pedicle or inadvertently removed was autotransplanted. After total thyroidectomy, an intravenous 2.5 mg indocyanine green fluorescence angiography was given and real-time fluorescent images of the thyroid bed were recorded using the SPY imaging system (Novadaq, Ontario, Canada). The fluorescent light intensity of each indocyanine green fluorescence angiography as well as the average and greatest fluorescent light intensity in each patient were calculated. Postoperative hypocalcemia was defined as adjusted calcium <2.00 mmol/L within 24 hours. Results: The fluorescent light intensity between discolored and normal-looking indocyanine green fluorescence angiographies was similar (P = .479). No patients with a greatest fluorescent light intensity >150% developed postoperative hypocalcemia while 9 (81.8%) patients with a greatest fluorescent light intensity ≤150% did. Similarly, no patients with an average fluorescent light intensity >109% developed PH while 9 (30%) with an average fluorescent light intensity ≤109% did. The greatest fluorescent light intensity was more predictive than day-0 postoperative hypocalcemia (P = .027) and % PTH drop day-0 to 1 (P < .001). Conclusion: Indocyanine green fluorescence angiography is a promising operative adjunct in determining residual parathyroid glands function and predicting postoperative hypocalcemia risk after total thyroidectomy.-
dc.languageeng-
dc.publisherMosby, Inc. The Journal's web site is located at http://www.medicinepublishing.co.uk/index.php/surgery/-
dc.relation.ispartofSurgery-
dc.titleIndocyanine green fluorescence angiography for quantitative evaluation of in situ parathyroid gland perfusion and function after total thyroidectomy-
dc.typeConference_Paper-
dc.identifier.emailLang, HHB: Blang@hku.hk-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailWong, KP: kpwongb@hku.hk-
dc.identifier.authorityLang, HHB=rp01828-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityWong, KP=rp02007-
dc.identifier.doi10.1016/j.surg.2016.03.037-
dc.identifier.hkuros270589-
dc.identifier.volume161-
dc.identifier.issue1-
dc.identifier.spage87-
dc.identifier.epage95-
dc.identifier.isiWOS:000390836000020-
dc.publisher.placeUnited States-

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