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Near-infrared auto-fluorescence spectroscopy combining with Fisher’s linear discriminant analysis improves intraoperative real-time identification of normal parathyroid in thyroidectomy
Xiaobao Yao
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5078-1341
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Surgery.
Background To evaluate the efficacy of a sensitive, real-time tool for identification and protection of parathyroid glands during thyroidectomy. Methods Near-infrared (NIR) auto-fluorescence was measured intraoperatively from 20 patients undergoing thyroidectomy. To determine the accuracy of NIR identification furtherly, intraoperative fast frozen pathological examination and postoperative immunohistochemical staining were performed on the suspicious parathyroid glands and other neck tissues. Data were extracted for Fisher’s linear discriminant analysis. Results The auto-fluorescence intensity of parathyroid was significantly higher than that of thyroid, fat and lymph node. The peak intensity of auto-fluorescence from parathyroid was 5.55 times as much as that from thyroid at the corresponding wave number. Of the 20 patients, the parathyroid was accurately detected and identified in 19 patients by NIR system, compared with their histopathological results. One suspicious parathyroid tissue did not exhibit characteristic spectra, and finally was proved to be fat tissue by histopathological examination. The NIR auto-fluorescence method had a 100% (19/19) sensitivity of parathyroid glands identification and a high accuracy of 95% (19/20). The positive predictive value was 95%. The parathyroid gland has specific auto-fluorescence spectrum and can be separated from the other three types of tissues through the Fisher’s linear discriminant analysis with the average accuracy rate around 90%. Conclusions NIR auto-fluorescence spectoscopy can accurately identify normal parathyroid glands during thyroidectomy. The Fisher’s linear discriminant analysis demonstrated the specificity of the NIR auto-fluorescence of parathyroid tissue and its efficacy in parathyroid discrimination.
Keywords
parathyroid, near-infrared, auto-fluorescence, thyroidectomy
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CURRENT STATUS: Published
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Posted 27 Dec, 2019
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On 24 Dec, 2019
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On 22 Dec, 2019
Editor invited
On 22 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 20 Dec, 2019
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Received 18 Dec, 2019
Review #2 received
Received 05 Dec, 2019
Reviewer #3 agreed
On 24 Nov, 2019
Review #1 received
Received 23 Nov, 2019
Reviewer #2 agreed
On 21 Nov, 2019
Reviewers invited
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Reviewer #1 agreed
On 19 Nov, 2019
Editor assigned
On 30 Oct, 2019
Submission checks complete
On 29 Oct, 2019
Editor invited
On 29 Oct, 2019
No comments provided
Editorial decision: Major revision
On 29 Sep, 2019
Review #5 received
Received 24 Sep, 2019
Review #4 received
Received 18 Sep, 2019
Review #3 received
Received 18 Sep, 2019
Review #2 received
Received 18 Sep, 2019
Reviewer #6 agreed
On 09 Sep, 2019
Reviewer #5 agreed
On 07 Sep, 2019
Reviewer #4 agreed
On 06 Sep, 2019
Reviewer #3 agreed
On 05 Sep, 2019
Reviewer #1 agreed
On 05 Sep, 2019
Reviewer #2 agreed
On 05 Sep, 2019
Review #1 received
Received 05 Sep, 2019
Editor assigned
On 04 Sep, 2019
Reviewers invited
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Submission checks complete
On 02 Sep, 2019
Editor invited
On 02 Sep, 2019
First submitted
On 24 Aug, 2019
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Subject Areas
General Surgery
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This preprint is under consideration at BMC Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Near-infrared auto-fluorescence spectroscopy combining with Fisher’s linear discriminant analysis improves intraoperative real-time identification of normal parathyroid in thyroidectomy
Xiaobao Yao
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5078-1341
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 27 Dec, 2019
Published
On 06 Jan, 2020
No community comments so far
Editorial decision: Accept
On 24 Dec, 2019
Editor assigned
On 23 Dec, 2019
Submission checks complete
On 22 Dec, 2019
Editor invited
On 22 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 20 Dec, 2019
Review #3 received
Received 18 Dec, 2019
Review #2 received
Received 05 Dec, 2019
Reviewer #3 agreed
On 24 Nov, 2019
Review #1 received
Received 23 Nov, 2019
Reviewer #2 agreed
On 21 Nov, 2019
Reviewers invited
Invitations sent on 19 Nov, 2019
Reviewer #1 agreed
On 19 Nov, 2019
Editor assigned
On 30 Oct, 2019
Submission checks complete
On 29 Oct, 2019
Editor invited
On 29 Oct, 2019
No comments provided
Editorial decision: Major revision
On 29 Sep, 2019
Review #5 received
Received 24 Sep, 2019
Review #4 received
Received 18 Sep, 2019
Review #3 received
Received 18 Sep, 2019
Review #2 received
Received 18 Sep, 2019
Reviewer #6 agreed
On 09 Sep, 2019
Reviewer #5 agreed
On 07 Sep, 2019
Reviewer #4 agreed
On 06 Sep, 2019
Reviewer #3 agreed
On 05 Sep, 2019
Reviewer #1 agreed
On 05 Sep, 2019
Reviewer #2 agreed
On 05 Sep, 2019
Review #1 received
Received 05 Sep, 2019
Editor assigned
On 04 Sep, 2019
Reviewers invited
Invitations sent on 04 Sep, 2019
Submission checks complete
On 02 Sep, 2019
Editor invited
On 02 Sep, 2019
First submitted
On 24 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
General Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Surgery.
Background To evaluate the efficacy of a sensitive, real-time tool for identification and protection of parathyroid glands during thyroidectomy. Methods Near-infrared (NIR) auto-fluorescence was measured intraoperatively from 20 patients undergoing thyroidectomy. To determine the accuracy of NIR identification furtherly, intraoperative fast frozen pathological examination and postoperative immunohistochemical staining were performed on the suspicious parathyroid glands and other neck tissues. Data were extracted for Fisher’s linear discriminant analysis. Results The auto-fluorescence intensity of parathyroid was significantly higher than that of thyroid, fat and lymph node. The peak intensity of auto-fluorescence from parathyroid was 5.55 times as much as that from thyroid at the corresponding wave number. Of the 20 patients, the parathyroid was accurately detected and identified in 19 patients by NIR system, compared with their histopathological results. One suspicious parathyroid tissue did not exhibit characteristic spectra, and finally was proved to be fat tissue by histopathological examination. The NIR auto-fluorescence method had a 100% (19/19) sensitivity of parathyroid glands identification and a high accuracy of 95% (19/20). The positive predictive value was 95%. The parathyroid gland has specific auto-fluorescence spectrum and can be separated from the other three types of tissues through the Fisher’s linear discriminant analysis with the average accuracy rate around 90%. Conclusions NIR auto-fluorescence spectoscopy can accurately identify normal parathyroid glands during thyroidectomy. The Fisher’s linear discriminant analysis demonstrated the specificity of the NIR auto-fluorescence of parathyroid tissue and its efficacy in parathyroid discrimination.
Figure 1
Figure 2