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Review
. 2022 Mar 8;12(3):388.
doi: 10.3390/life12030388.

Heterogeneity in Utilization of Optical Imaging Guided Surgery for Identifying or Preserving the Parathyroid Glands-A Meta-Narrative Review

Eline A Feitsma  1   2 , Hugo M Schouw  1 , Milou E Noltes  1   3 , Wido Heeman  1   4   5 , Wendy Kelder  3 , Gooitzen M van Dam  2   6 , Schelto Kruijff  1   6
Affiliations
Review

Heterogeneity in Utilization of Optical Imaging Guided Surgery for Identifying or Preserving the Parathyroid Glands-A Meta-Narrative Review

Eline A Feitsma et al. Life (Basel). .

Abstract

Background: Postoperative hypoparathyroidism is the most common complication after total thyroidectomy. Over the past years, optical imaging techniques, such as parathyroid autofluorescence, indocyanine green (ICG) angiography, and laser speckle contrast imaging (LSCI) have been employed to save parathyroid glands during thyroid surgery. This study provides an overview of the utilized methods of the optical imaging techniques during total thyroidectomy for parathyroid gland identification and preservation.

Methods: PUBMED, EMBASE and Web of Science were searched for studies written in the English language utilizing parathyroid autofluorescence, ICG-angiography, or LSCI during total thyroidectomy to support parathyroid gland identification or preservation. Case reports, reviews, meta-analyses, animal studies, and post-mortem studies were excluded after the title and abstract screening. The data of the studies were analyzed qualitatively, with a focus on the methodologies employed.

Results: In total, 59 articles were included with a total of 6190 patients. Overall, 38 studies reported using parathyroid autofluorescence, 24 using ICG-angiography, and 2 using LSCI. The heterogeneity between the utilized methodology in the studies was large, and in particular, regarding study protocols, imaging techniques, and the standardization of the imaging protocol.

Conclusion: The diverse application of optical imaging techniques and a lack of standardization and quantification leads to heterogeneous conclusions regarding their clinical value. Worldwide consensus on imaging protocols is needed to establish the clinical utility of these techniques for parathyroid gland identification and preservation.

Keywords: autofluorescence; fluorescence; hypoparathyroidism; indocyanine green angiography; laser speckle contrast imaging; near-infrared imaging; optical imaging; parathyroid glands; thyroidectomy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Process of article selection utilizing ASReview. LSCI = laser speckle contrast imaging, ICG = indocyanine green.
Figure 2
Figure 2
Flowchart showing the number of articles per stage ranged from weakest (left) to strongest (right). A study can have met multiple stages and has not necessarily completed all previous steps. ICG = indocyanine green, LSCI = laser speckle contrast imaging.
Figure 3
Figure 3
Variance in imaging protocols with bar graphs illustrating the number of articles that could be scaled in each category. Total amount: autofluorescence (AF) n = 38, ICG-angiography n = 24, laser speckle contrast imaging (LSCI) n = 2.
See this image and copyright information in PMC

References

    1. Lončar I., Noltes M.E., Dickhoff C., Engelsman A.F., Schepers A., Vriens M.R., Bouvy N.D., Kruijff S., van Ginhoven T.M. Persistent Postthyroidectomy Hypoparathyroidism in the Netherlands. JAMA Otolaryngol.-Head Neck Surg. 2021;147:959–965. doi: 10.1001/jamaoto.2021.2475. - DOI - PMC - PubMed
    1. Edafe O., Antakia R., Laskar N., Uttley L., Balasubramanian S.P. Systematic Review and Meta-Analysis of Predictors of Post-Thyroidectomy Hypocalcaemia. Br. J. Surg. 2014;101:307–320. doi: 10.1002/bjs.9384. - DOI - PubMed
    1. Bilezikian J.P., Khan A., Potts J.T., Brandi M.L., Clarke B.L., Shoback D., Jüppner H., D’Amour P., Fox J., Rejnmark L., et al. Hypoparathyroidism in the Adult: Epidemiology, Diagnosis, Pathophysiology, Target-Organ Involvement, Treatment, and Challenges for Future Research. J. Bone Miner. Res. 2011;26:2317–2337. doi: 10.1002/jbmr.483. - DOI - PMC - PubMed
    1. Astor M.C., Løvas K., Debowska A., Eriksen E.F., Evang J.A., Fossum C., Fougner K.J., Holte S.E., Lima K., Moe R.B., et al. Epidemiology and Health-Related Quality of Life in Hypoparathyroidism in Norway. J. Clin. Endocrinol. Metab. 2016;101:3045–3053. doi: 10.1210/jc.2016-1477. - DOI - PMC - PubMed
    1. Mitchell D.M., Regan S., Cooley M.R., Lauter K.B., Vrla M.C., Becker C.B., Burnett-Bowie S.A.M., Mannstadt M. Long-Term Follow-up of Patients with Hypoparathyroidism. J. Clin. Endocrinol. Metab. 2012;97:4507–4514. doi: 10.1210/jc.2012-1808. - DOI - PMC - PubMed

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