BACKGROUND To evaluate the efficacy of a sensitive, real-time tool for identification and protection for parathyroid glands during thyroidectomy. METHODS Near-infrared (NIR) auto-fluorescence was measured intraoperatively from 20 patients undergoing thyroidectomy. Spectra were measured from suspicious parathyroid glands and surrounding neck tissues during the operation with a NIR fluorescence system. Fast frozen sections were performed on the suspicious parathyroid glands. Accuracy was evaluated by comparison with histology and NIR identification. Data were attracted 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 of 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 histologic results. One suspicious parathyroid did not exhibit typical spectra, and was proved to be fat tissue by histology. The NIR auto-fluorescence method had a 100% sensitivity of parathyroid glands identification and a high accuracy of 95%. The positive predictive value was 95%. The parathyroid gland have specific auto-fluorescence spectrum and can be separated from the other three samples through the Fisher's linear discriminant analysis. CONCLUSIONS NIR auto-fluorescence spectroscopy can accurately identify normal parathyroid gland 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.

中文翻译：

---

近红外自发荧光光谱技术与Fisher线性判别分析相结合，改善了甲状腺切除术中正常甲状旁腺的术中实时识别。

背景技术为了评估在甲状腺切除术期间用于识别和保护甲状旁腺的灵敏，实时工具的功效。方法对20例甲状腺切除术患者进行术中测量近红外（NIR）自发荧光。使用NIR荧光系统在手术过程中从可疑的甲状旁腺和颈部周围组织测量光谱。对可疑的甲状旁腺进行快速冷冻切片。通过与组织学和NIR鉴定进行比较来评估准确性。数据被吸引用于Fisher的线性判别分析。结果甲状旁腺的自发荧光强度明显高于甲状腺，脂肪和淋巴结。甲状旁腺的自发荧光的峰值强度为5。对应波数的甲状腺的55倍。在20例患者中，通过NIR系统对19例患者的甲状旁腺进行了准确的检测，并与组织学结果进行了比较。一个可疑的甲状旁腺没有表现出典型的光谱，并且通过组织学证实是脂肪组织。近红外自发荧光法具有100％的甲状旁腺识别灵敏度和95％的高精度。阳性预测值为95％。甲状旁腺具有特定的自发荧光光谱，可通过Fisher线性判别分析与其他三个样品分离。结论近红外自体荧光光谱法可在甲状腺切除术中准确识别出正常的甲状旁腺。费舍尔