Intraoperative near-infrared fluorescence imaging of parathyroid adenomas with use of low-dose methylene blue.

Head & Neck Pub Date : 2014-06-01 Epub Date: 2013-10-04 DOI:10.1002/hed.23384

Joost R van der Vorst, Boudewijn E Schaafsma, Floris P R Verbeek, Rutger-Jan Swijnenburg, Quirijn R J G Tummers, Merlijn Hutteman, Jaap F Hamming, Job Kievit, John V Frangioni, Cornelis J H van de Velde, Alexander L Vahrmeijer

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引用次数: 71

Abstract

Background: Intraoperative identification of parathyroid adenomas can be challenging. We hypothesized that low-doses methylene blue (MB) and near-infrared fluorescence (NIRF) imaging could be used to identify parathyroid adenomas intraoperatively.

Methods: MB was injected intravenously after exploration at a dose of 0.5 mg/kg into 12 patients who underwent parathyroid surgery. NIRF imaging was performed using the Mini-FLARE imaging system.

Results: In 10 of 12 patients, histology confirmed a parathyroid adenoma. In 9 of these patients, NIRF could clearly identify the parathyroid adenoma during surgery. Seven of these 9 patients had a positive preoperative (99m) Tc-sestamibi single photon emission CT (SPECT) scan. Importantly, in 2 patients, parathyroid adenomas could be identified only using NIRF.

Conclusion: This is the first study to show that low-dose MB can be used as NIRF tracer for identification of parathyroid adenomas, and suggests a correlation with preoperative (99m) Tc-sestamibi SPECT scanning.

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低剂量亚甲基蓝在甲状旁腺瘤术中近红外荧光成像的应用。

背景:术中甲状旁腺瘤的鉴别具有挑战性。我们假设低剂量亚甲基蓝(MB)和近红外荧光(NIRF)成像可用于术中识别甲状旁腺瘤。方法:12例甲状旁腺手术患者经探查后静脉注射MB，剂量为0.5 mg/kg。使用Mini-FLARE成像系统进行NIRF成像。结果:12例患者中有10例组织学证实为甲状旁腺瘤。其中9例患者术中NIRF能清晰识别甲状旁腺瘤。9例患者中有7例术前(99m) Tc-sestamibi单光子发射CT (SPECT)扫描阳性。重要的是，在2例患者中，只有使用NIRF才能识别甲状旁腺瘤。结论:本研究首次证明低剂量MB可作为NIRF示踪剂用于甲状旁腺瘤的鉴别，并提示其与术前(99m) Tc-sestamibi SPECT扫描相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Head & Neck

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