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Huang S, Alhiyari Y, Hu Y, Tam K, Han AY, Krane JF, Shori R, St. John MA, Stafsudd O. Ex vivo hypercellular parathyroid gland differentiation using dynamic optical contrast imaging (DOCI). BIOMEDICAL OPTICS EXPRESS 2022; 13:549-558. [PMID: 35284177 PMCID: PMC8884217 DOI: 10.1364/boe.443671] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 06/14/2023]
Abstract
Primary hyperparathyroidism, often caused by a single adenoma (80-85%) or four-gland hyperplasia (10-15%), can lead to elevated parathyroid hormone (PTH) levels and resultant hypercalcemia. Surgical excision of offending lesions is the standard of care, as the removal of pathologic adenomas reduces PTH and calcium values to baseline. The small size, variable location, and indistinct external features of parathyroid glands can make their identification quite challenging intraoperatively. Our group has developed the dynamic optical contrast imaging (DOCI) technique, a novel realization of dynamic temporally dependent measurements of tissue autofluorescence. In this study, we evaluated the efficacy of using the DOCI technique and normalized steady-state fluorescence intensity data for differentiating types of human parathyroid and thyroid tissues. We demonstrate that the DOCI technique has the capability to distinguish normal parathyroid tissue from diseased parathyroid glands as well as from adjacent healthy thyroid and adipose tissue across 8 different spectral channels between 405nm-600nm (p<0.05). Patient tissue DOCI data was further analyzed with a logistic regression classifier trained across the 8 spectral channels. After computer training, the computer-aided identification was able to accurately locate hypercellular parathyroid tissue with 100% sensitivity and 98.8% specificity within the captured DOCI image.
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Affiliation(s)
- Shan Huang
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, CA 90095, USA
- Department of Materials Science and Engineering, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Yazeed Alhiyari
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, CA 90095, USA
- UCLA Head and Neck Cancer Program, University of California Los Angeles, Los Angeles, CA 90095, USA
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Yong Hu
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Kenric Tam
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Albert Y. Han
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Jeffrey F. Krane
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Ramesh Shori
- Department of Electrical and Computer Engineering, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Maie A. St. John
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, CA 90095, USA
- UCLA Head and Neck Cancer Program, University of California Los Angeles, Los Angeles, CA 90095, USA
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA 90095, USA
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Oscar Stafsudd
- Department of Electrical and Computer Engineering, University of California Los Angeles, Los Angeles, CA 90095, USA
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Serra C, Serra J, Ferreira Machado IL, Vieira Ferreira LF. Spectroscopic Analysis of Parathyroid and Thyroid Tissues by Ground-State diffuse Reflectance and Laser Induced Luminescence: a Preliminary Report. J Fluoresc 2021; 31:1235-1239. [PMID: 34283330 DOI: 10.1007/s10895-021-02783-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
Intraoperative discrimination of thyroid and parathyroid tissues is fundamental in thyroid surgery. Recent fluorescence studies have shown stronger NIR emission in parathyroid tissue than in thyroid tissue, presenting a potential avenue for the development of a tool for surgical assistance. However, the fluorophore responsible for this emission has not yet been identified. In this work, spectroscopic analysis was performed to ascertain the origin of the emission peaks in parathyroid tissue. Ground-state diffuse reflectance (GSDR) absorption spectroscopy and laser-induced luminescence (LIL) emission spectroscopy were performed in parathyroid, thyroid, and fatty tissue samples and the resulting spectra were compared with the peaks of known fluorophores to identify the origin of each peak. The spectra of the different tissue types were also compared in order to evaluate the wavelength which presents the highest parathyroid emission relative to the emission of the surrounding tissues, representing the ideal wavelength for parathyroid detection. An emission peak in these conditions was observed for both thyroid and parathyroid tissue at 711 nm, with a higher intensity in parathyroid sample, making it suitable for detection applications. These results show a potential avenue for the development of a system allowing parathyroid detection in a surgical setting.
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Affiliation(s)
- Carlos Serra
- Hospital Dos Sams, 1849-017, Lisboa, Portugal.
- Faculdade de Ciências da Saúde, Universidade da Beira Interior, 6200-506, Covilhã, Portugal.
| | - João Serra
- Instituto de Engenharia de Sistemas e Computadores - Microsistemas e Nanotecnologias (INESC MN) , Lisboa, Portugal
- Instituto Superior Técnico, Universidade de Lisboa, 1049-0011, Lisboa, Portugal
| | - Isabel L Ferreira Machado
- Polytechnic Institute of Portalegre, 7300-110, Portalegre, Portugal
- BSIRG, Biospectroscopy and InterfacesResearch Group From IBB-Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, 1049-001, Lisboa, Portugal
| | - Luís F Vieira Ferreira
- BSIRG, Biospectroscopy and InterfacesResearch Group From IBB-Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, 1049-001, Lisboa, Portugal
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