Intraoperative Fluorescence Visualization of the Parathyroid Gland in Rats
Bilateral neck exploration is the standard procedure of primary hyperparathyroidism. Preoperative localization is not mandatory. Intraoperative visualization methods help to avoid unsuccessful explorations and to reduce morbidity rates. In our study, the application of 5-Aminolevulinic acid (5-ALA),...
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| Veröffentlicht in: | Endocrinology (Philadelphia) 2001-11, Vol.142 (11), p.5031-5031 |
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| creator | Gahlen, Johannes Winkler, Steffi Flechtenmacher, Christa Prosst, Ruediger L Herfarth, Christian |
| description | Bilateral neck exploration is the standard procedure of primary
hyperparathyroidism. Preoperative localization is not mandatory.
Intraoperative visualization methods help to avoid unsuccessful
explorations and to reduce morbidity rates. In our study, the
application of 5-Aminolevulinic acid (5-ALA), a precursor in the heme
biosynthesis pathway, led to Protoporphyrin IX (PpIX) accumulation
within the parathyroid gland (PTG). PpIX, a metabolite of 5-ALA, causes
red fluorescence (635 nm) when stimulated by light of a defined
wavelength. Largely invisible under conventional illumination, all PTGs
were fluorescence positive and detectable after PpIX targeting and blue
light excitation (380–440 nm). Point spectrometry to measure
fluorescence intensities, showed a fluorescence ratio between PTG and
surrounding thyroid gland tissue of 5.7:1 (p < 0.001). Fluorescence
guided PTG biopsies showed no false positive findings in histology.
5-ALA induced PpIX fluorescence to detect PTGs suggests to be
a highly sensitive intraoperative visualization method. Hence, the
performance of minimally invasive video-assisted parathyroidectomy will
be facilitated by this innovative technique. |
| doi_str_mv | 10.1210/endo.142.11.8594 |
| format | Article |
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hyperparathyroidism. Preoperative localization is not mandatory.
Intraoperative visualization methods help to avoid unsuccessful
explorations and to reduce morbidity rates. In our study, the
application of 5-Aminolevulinic acid (5-ALA), a precursor in the heme
biosynthesis pathway, led to Protoporphyrin IX (PpIX) accumulation
within the parathyroid gland (PTG). PpIX, a metabolite of 5-ALA, causes
red fluorescence (635 nm) when stimulated by light of a defined
wavelength. Largely invisible under conventional illumination, all PTGs
were fluorescence positive and detectable after PpIX targeting and blue
light excitation (380–440 nm). Point spectrometry to measure
fluorescence intensities, showed a fluorescence ratio between PTG and
surrounding thyroid gland tissue of 5.7:1 (p < 0.001). Fluorescence
guided PTG biopsies showed no false positive findings in histology.
5-ALA induced PpIX fluorescence to detect PTGs suggests to be
a highly sensitive intraoperative visualization method. Hence, the
performance of minimally invasive video-assisted parathyroidectomy will
be facilitated by this innovative technique.</description><identifier>ISSN: 0013-7227</identifier><identifier>EISSN: 1945-7170</identifier><identifier>DOI: 10.1210/endo.142.11.8594</identifier><language>eng</language><publisher>Washington: Endocrine Society</publisher><subject>Aminolevulinic acid ; Biopsy ; Biosynthesis ; Endocrine system ; Excitation spectra ; Fluorescence ; Histology ; Hyperparathyroidism ; Light ; Localization ; Luminous intensity ; Metabolites ; Morbidity ; Parathyroid ; Parathyroid gland ; Parathyroidectomy ; Protoporphyrin ; Protoporphyrin IX ; Spectrometry ; Thyroid ; Thyroid gland ; Visualization</subject><ispartof>Endocrinology (Philadelphia), 2001-11, Vol.142 (11), p.5031-5031</ispartof><rights>Copyright © 2001 by The Endocrine Society 2001</rights><rights>Copyright © 2001 by The Endocrine Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2424-6262d720664c7e9132152d8e07e42e01f3e834f7a79b88e8f8cdefc3376770853</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids></links><search><creatorcontrib>Gahlen, Johannes</creatorcontrib><creatorcontrib>Winkler, Steffi</creatorcontrib><creatorcontrib>Flechtenmacher, Christa</creatorcontrib><creatorcontrib>Prosst, Ruediger L</creatorcontrib><creatorcontrib>Herfarth, Christian</creatorcontrib><title>Intraoperative Fluorescence Visualization of the Parathyroid Gland in Rats</title><title>Endocrinology (Philadelphia)</title><description>Bilateral neck exploration is the standard procedure of primary
hyperparathyroidism. Preoperative localization is not mandatory.
Intraoperative visualization methods help to avoid unsuccessful
explorations and to reduce morbidity rates. In our study, the
application of 5-Aminolevulinic acid (5-ALA), a precursor in the heme
biosynthesis pathway, led to Protoporphyrin IX (PpIX) accumulation
within the parathyroid gland (PTG). PpIX, a metabolite of 5-ALA, causes
red fluorescence (635 nm) when stimulated by light of a defined
wavelength. Largely invisible under conventional illumination, all PTGs
were fluorescence positive and detectable after PpIX targeting and blue
light excitation (380–440 nm). Point spectrometry to measure
fluorescence intensities, showed a fluorescence ratio between PTG and
surrounding thyroid gland tissue of 5.7:1 (p < 0.001). Fluorescence
guided PTG biopsies showed no false positive findings in histology.
5-ALA induced PpIX fluorescence to detect PTGs suggests to be
a highly sensitive intraoperative visualization method. Hence, the
performance of minimally invasive video-assisted parathyroidectomy will
be facilitated by this innovative technique.</description><subject>Aminolevulinic acid</subject><subject>Biopsy</subject><subject>Biosynthesis</subject><subject>Endocrine system</subject><subject>Excitation spectra</subject><subject>Fluorescence</subject><subject>Histology</subject><subject>Hyperparathyroidism</subject><subject>Light</subject><subject>Localization</subject><subject>Luminous intensity</subject><subject>Metabolites</subject><subject>Morbidity</subject><subject>Parathyroid</subject><subject>Parathyroid gland</subject><subject>Parathyroidectomy</subject><subject>Protoporphyrin</subject><subject>Protoporphyrin IX</subject><subject>Spectrometry</subject><subject>Thyroid</subject><subject>Thyroid gland</subject><subject>Visualization</subject><issn>0013-7227</issn><issn>1945-7170</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><recordid>eNqNkE1LxDAQhoMouK7ePQY8Smu-2qRHWdx1RVBEvYaYTtkua1KTVlh_vSkVPAmehmGed2Z4EDqnJKeMkitwtc-pYDmluSoqcYBmtBJFJqkkh2hGCOWZZEweo5MYt6kVQvAZulu7PhjfQTB9-wl4uRt8gGjBWcCvbRzMrv1KI--wb3C_AfxoErrZB9_WeLUzrsatw0-mj6foqDG7CGc_dY5eljfPi9vs_mG1XlzfZ5YJJrKSlayWjJSlsBIqyhktWK2ASBAMCG04KC4aaWT1phSoRtkaGsu5LKUkquBzdDHt7YL_GCD2euuH4NJJzSknBZOkEokiE2WDjzFAo7vQvpuw15To0ZgejelkTFOqR2MpcjlF_ND9h5YTPU5saB10SVz8febP5DdAUH6A</recordid><startdate>200111</startdate><enddate>200111</enddate><creator>Gahlen, Johannes</creator><creator>Winkler, Steffi</creator><creator>Flechtenmacher, Christa</creator><creator>Prosst, Ruediger L</creator><creator>Herfarth, Christian</creator><general>Endocrine Society</general><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QG</scope><scope>7QP</scope><scope>7QR</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope></search><sort><creationdate>200111</creationdate><title>Intraoperative Fluorescence Visualization of the Parathyroid Gland in Rats</title><author>Gahlen, Johannes ; Winkler, Steffi ; Flechtenmacher, Christa ; Prosst, Ruediger L ; Herfarth, Christian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2424-6262d720664c7e9132152d8e07e42e01f3e834f7a79b88e8f8cdefc3376770853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aminolevulinic acid</topic><topic>Biopsy</topic><topic>Biosynthesis</topic><topic>Endocrine system</topic><topic>Excitation spectra</topic><topic>Fluorescence</topic><topic>Histology</topic><topic>Hyperparathyroidism</topic><topic>Light</topic><topic>Localization</topic><topic>Luminous intensity</topic><topic>Metabolites</topic><topic>Morbidity</topic><topic>Parathyroid</topic><topic>Parathyroid gland</topic><topic>Parathyroidectomy</topic><topic>Protoporphyrin</topic><topic>Protoporphyrin IX</topic><topic>Spectrometry</topic><topic>Thyroid</topic><topic>Thyroid gland</topic><topic>Visualization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gahlen, Johannes</creatorcontrib><creatorcontrib>Winkler, Steffi</creatorcontrib><creatorcontrib>Flechtenmacher, Christa</creatorcontrib><creatorcontrib>Prosst, Ruediger L</creatorcontrib><creatorcontrib>Herfarth, Christian</creatorcontrib><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Endocrinology (Philadelphia)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gahlen, Johannes</au><au>Winkler, Steffi</au><au>Flechtenmacher, Christa</au><au>Prosst, Ruediger L</au><au>Herfarth, Christian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intraoperative Fluorescence Visualization of the Parathyroid Gland in Rats</atitle><jtitle>Endocrinology (Philadelphia)</jtitle><date>2001-11</date><risdate>2001</risdate><volume>142</volume><issue>11</issue><spage>5031</spage><epage>5031</epage><pages>5031-5031</pages><issn>0013-7227</issn><eissn>1945-7170</eissn><abstract>Bilateral neck exploration is the standard procedure of primary
hyperparathyroidism. Preoperative localization is not mandatory.
Intraoperative visualization methods help to avoid unsuccessful
explorations and to reduce morbidity rates. In our study, the
application of 5-Aminolevulinic acid (5-ALA), a precursor in the heme
biosynthesis pathway, led to Protoporphyrin IX (PpIX) accumulation
within the parathyroid gland (PTG). PpIX, a metabolite of 5-ALA, causes
red fluorescence (635 nm) when stimulated by light of a defined
wavelength. Largely invisible under conventional illumination, all PTGs
were fluorescence positive and detectable after PpIX targeting and blue
light excitation (380–440 nm). Point spectrometry to measure
fluorescence intensities, showed a fluorescence ratio between PTG and
surrounding thyroid gland tissue of 5.7:1 (p < 0.001). Fluorescence
guided PTG biopsies showed no false positive findings in histology.
5-ALA induced PpIX fluorescence to detect PTGs suggests to be
a highly sensitive intraoperative visualization method. Hence, the
performance of minimally invasive video-assisted parathyroidectomy will
be facilitated by this innovative technique.</abstract><cop>Washington</cop><pub>Endocrine Society</pub><doi>10.1210/endo.142.11.8594</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | EZB Electronic Journals Library; Oxford Journals |
| subjects | Aminolevulinic acid Biopsy Biosynthesis Endocrine system Excitation spectra Fluorescence Histology Hyperparathyroidism Light Localization Luminous intensity Metabolites Morbidity Parathyroid Parathyroid gland Parathyroidectomy Protoporphyrin Protoporphyrin IX Spectrometry Thyroid Thyroid gland Visualization |
| title | Intraoperative Fluorescence Visualization of the Parathyroid Gland in Rats |
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