Challenges and Limitations of Narrow-Band Optical Imaging for Intra-Operative Parathyroid Identification

Laura M. Higgins, Mark C. Pierce, Tomer Davidov

Abstract


Background: Surgical resection of the parathyroid glands can be challenging due to poor visual contrast between the parathyroid and surrounding tissues. We hypothesized that narrow-band imaging (NBI) could enhance subtle differences in the colors of these tissues for improved visual contrast during parathyroid surgery.

Methods: The diffuse optical reflectances of parathyroid, fat, muscle, and thyroid tissue were measured in vivo as a function of wavelength during six surgical procedures, using a fiber-optic probe and spectrophotometer. Analysis of these data led to three candidate NBI wavelength bands which exhibited the largest differences in reflectance between parathyroid and other tissue types. Color filters at these wavelength bands were attached to the surgeon’s loupes for qualitative visual assessment, and also to a digital camera for quantitative assessment of tissue contrast in seven additional surgeries.

Results: Spectroscopic measurements showed that diffuse optical reflectance at green (515 - 565 nm), yellow (570 - 613 nm), and red (604 - 644 nm) wavelengths showed the greatest difference in intensity (appearing brighter or darker) between parathyroid and surrounding tissues. However, visual and digital NBI of the parathyroid using these wavebands generated measured intensities which were not significantly improved as compared to white light, providing only minimal contrast enhancement for the surgeon.

Conclusions: Narrow-band color filters can be added to conventional loupes to selectively view the surgical field with light at specific wavelengths. When the parathyroid is viewed with filters chosen to maximize visual contrast between tissue types, there appears to be little benefit in contrast enhancement between tissues due to diminished overall brightness.




J Curr Surg. 2016;6(1):14-20
doi: http://dx.doi.org/10.14740/jcs295w

 


Keywords


Optical imaging; Surgical guidance; Intra-operative imaging

Full Text: HTML PDF
 

Browse  Journals  

     

Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 

 

 

 

Journal of Current Surgery, quarterly, ISSN 1927-1298 (print), 1927-1301 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.currentsurgery.org   editorial contact: editor@currentsurgery.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.