Background: Fluorescence angiography (FA) using indocyanine green dye (ICG) has recently been introduced for real-time identification of parathyroid adenomas. However, time to peak fluorescence has not yet been critically evaluated.
Methods: This was a retrospective review of parathyroidectomies with ICG FA over a one-year period.
Results: There were 66 patients with average age of 64 years. The average time to initial fluorescence was 26.7 s and to peak fluorescence was 38.0 s. The time to saline flush administration significantly correlated with times to initial and peak fluorescence (p < .0001). The rate of in-situ fluorescence was 97%. The rates of suspected adenoma detection were 69% for sestamibi scan, 71% for ultrasound, and 96% for CT scan. Imaging was discordant in 13 cases (20%), with the adenoma located on the opposite side of the neck in 4 cases.
Conclusions: ICG FA is a rapid and effective adjunct for the intraoperative identification of parathyroid adenomas.
Keywords: Fluorescence imaging; ICG; Parathyroid adenoma; Parathyroidectomy; Primary hyperparathyroidism.
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