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Title page for ETD etd-04052012-180257


Type of Document Dissertation
Author Paras, Constantine A
Author's Email Address anita.mahadevan-jansen@vanderbilt.edu
URN etd-04052012-180257
Title A novel optical approach to the intraoperative detection of parathyroid glands
Degree PhD
Department Biomedical Engineering
Advisory Committee
Advisor Name Title
Anita Mahadevan-Jansen Committee Chair
E. Duco Jansen Committee Member
Edward Brown Committee Member
James Broome Committee Member
Robert L. Galloway Committee Member
Keywords
  • Parathyroid gland
  • Detection
  • Near Infrared Fluorescence
Date of Defense 2011-05-02
Availability unrestricted
Abstract
A major challenge in endocrine surgery is the intraoperative identification of parathyroid during both thyroid and parathyroid surgery. Current localization techniques are mostly preoperative and are imprecise. Optical spectroscopy is fast and sensitive and has been used in many in vivo applications. Here, near-infrared (NIR) fluorescence is used to identify parathyroid glands during thyroid and parathyroidectomies. Fluorescence measurements were obtained from patients undergoing endocrine surgery at Vanderbilt University Medical Center. The intensity of the parathyroid signal was observed to be 2-35 times greater than the fluorescence of the surrounding tissue including the thyroid gland. The classification accuracy of the method was found to be 100%. The molecular basis for this near infrared fluorescence is hypothesized to be due to calcium sensing receptors, which are abundantly present in the parathyroid. This hypothesis was preliminarily validated by the increased fluorescence observed in other tissues known to contain these receptors such as the kidney and colon as well as in diseased tissues where these receptors are known to be compromised. Finally, an imaging based system was developed and tested in vitro such the near infrared fluorescence of the parathyroid could be visualized with spatial context for clinical applicability of the technique.
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