Indocyanine green fluorescence for parathyroid gland identification and function prediction: Systematic review and meta-analysis

Head Neck. 2022 Mar;44(3):783-791. doi: 10.1002/hed.26950. Epub 2021 Dec 15.

Abstract

Background: To evaluate the diagnostic accuracies of indocyanine green (ICG) fluorescence for identifying parathyroid glands during surgery and predicting the postoperative function.

Methods: From six databases, 21 studies were finally included in the study. True-positive, true-negative, false-positive, and false-negative data were extracted for the analysis. The quality of each study was analyzed using the QUADAS-2 tool.

Results: The sensitivity of ICG-based parathyroid gland identification was 0.9380 (95% CI [0.9003, 0.9621]). The diagnostic odds ratio for ICG-based prediction of parathyroid gland function was 54.5652 [13.2059, 225.4570]. The area under the summary receiver operating characteristic curve was 0.909. Fluorescence intensity-based prediction presented higher diagnostic accuracy than that of score-based prediction. The incidence of postoperative hypoparathyroidism was higher in the group with a zero ICG score compared to the high scored group.

Conclusions: Identification of parathyroid gland and prediction of postoperative function using ICG are valuable to patients undergoing thyroidectomy or parathyroidectomy.

Keywords: fluorescence; hypoparathyroidism; indocyanine green; parathyroid glands; thyroidectomy.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Fluorescence
  • Humans
  • Hypoparathyroidism* / etiology
  • Indocyanine Green
  • Parathyroid Glands* / diagnostic imaging
  • Parathyroid Glands* / surgery
  • Postoperative Complications / etiology
  • Thyroidectomy / adverse effects

Substances

  • Indocyanine Green