Intraoperative near‐infrared fluorescence imaging of parathyroid adenomas with use of low‐dose methylene blue. Issue 6 (4th October 2013)

• Record Type: Journal Article
• Authors: van der Vorst, Joost R.; Schaafsma, Boudewijn E.; Verbeek, Floris P. R.; Swijnenburg, Rutger‐Jan; Tummers, Quirijn R.J.G.; Hutteman, Merlijn; Hamming, Jaap F.; Kievit, Job; Frangioni, John V.; van de Velde, Cornelis J.H.; Vahrmeijer, Alexander L.
• Is Part Of: Head & neck. Volume 36:Issue 6(2014:Jun.)
• Page Start: 853
• Page End: 858
• Publication Date: 2013-10-04
• Subjects: Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.23384
• Languages: English
• ISSNs: 1043-3074

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="hed23384-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="hed23384-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="hed23384-sec-0003" sec-type="section"> <title>Results</title> <p>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 ^99mTc‐sestamibi single photon emission CT (SPECT) scan. Importantly, in 2 patients, parathyroid adenomas could be identified only using NIRF.</p> </sec> <sec id="hed23384-sec-0004" sec-type="section"> <title>Conclusion</title> <p>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 ^99mTc‐sestamibi SPECT scanning. © 2013 Wiley Periodicals, Inc. <italic>Head Neck</italic> 36: 853–858, 2014</p> </sec> </abstract>