Cited 37 times since 2013 (3.2 per year) source: EuropePMC Head & neck, Volume 36, Issue 6, 4 1 2013, Pages 853-858 Intraoperative near-infrared fluorescence imaging of parathyroid adenomas with use of low-dose methylene blue. van der Vorst JR, Schaafsma BE, Verbeek FP, Swijnenburg RJ, Tummers QR, Hutteman M, Hamming JF, Kievit J, Frangioni JV, van de Velde CJ, Vahrmeijer AL
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.
