Rapid head and neck tissue identification in thyroid and parathyroid surgery using optical coherence tomography

Head Neck. 2019 Dec;41(12):4171-4180. doi: 10.1002/hed.25972. Epub 2019 Oct 1.

Abstract

Background: Optical coherence tomography (OCT) is a noninvasive imaging modality that may reproduce the microarchitecture of tissues in real-time. This study examines whether OCT can render distinct images of thyroid, parathyroid glands, adipose tissue, and lymph nodes in both healthy and pathological states.

Methods: Twenty-seven patients undergoing thyroidectomy, parathyroidectomy, and/or neck dissection for thyroid cancer were recruited prospectively for imaging prior to histopathological analysis.

Results: Based on 122 imaged specimens, qualitative OCT descriptions were derived for healthy thyroid, parathyroid gland, adipose tissue, and lymph node. The frequencies at which distinguishing features were present for each tissue type were 88%, 83%, 100%, and 82%. OCT appearance of pathological specimens were also described.

Conclusions: Healthy neck tissues have distinct OCT appearances, which could facilitate parathyroid identification during thyroidectomies. However, images of parathyroid adenomas could be confused with those of lymph nodes, and benign and malignant thyroid nodules could not be differentiated.

Keywords: imaging; optical coherence tomography; parathyroid; thyroid; tissue biopsy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue / diagnostic imaging
  • Adipose Tissue / pathology*
  • Adult
  • Aged
  • Female
  • Head / diagnostic imaging
  • Head / pathology
  • Humans
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology*
  • Male
  • Middle Aged
  • Neck / diagnostic imaging
  • Neck / pathology
  • Neck Dissection / methods
  • Parathyroid Glands / diagnostic imaging
  • Parathyroid Glands / pathology*
  • Parathyroid Neoplasms / pathology
  • Parathyroidectomy / methods
  • Thyroid Gland / diagnostic imaging
  • Thyroid Gland / pathology*
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery*
  • Thyroid Nodule / pathology
  • Thyroidectomy / methods
  • Tomography, Optical Coherence / methods