Fiber Optic Fluorescence Spectroscopy for Parathyroid Perfusion Assessment
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Solution Overview
Problem
Current surgical methods for identifying and distinguishing parathyroid glands during thyroid and parathyroid surgeries are subjective, time-consuming, and lack real-time quantitative assessment of parathyroid perfusion, leading to complications such as hypocalcemia and hypoparathyroidism due to inaccurate differentiation between well and poorly perfused glands.
Innovation Solution
A method using optical fiber-based fluorescence spectroscopy with a contrast agent like indocyanine green (ICG) for real-time detection of parathyroid perfusion by measuring fluorescence intensity and ratio, unaffected by ambient light, providing auditory and visual feedback when threshold values are reached.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If visual inspection is used to identify parathyroid glands, then the surgical procedure is simple, but the accuracy of differentiation between well and poorly perfused glands is poor
Solution Approach 1:
The patent introduces an optical fiber-based fluorescence detection system as an intermediary tool between the surgeon and the parathyroid tissue. The system uses fluorescent contrast agents that accumulate in parathyroid glands, allowing objective differentiation between well-perfused and poorly perfused glands through quantitative fluorescence intensity measurements, thereby resolving the limitation of subjective visual inspection
Solution Approach 2:
The patent replaces the mechanical/visual inspection method with an optical detection system. Instead of relying on surgeons' visual assessment, the system uses fluorescence spectroscopy to detect and quantify contrast agent accumulation in parathyroid glands, providing objective, real-time data that is independent of surgeon experience and ambient lighting conditions
2Loss of information
If near infrared imaging with contrast agent is used, then real-time imaging is achieved, but the interpretation is highly subjective and lacks quantitative information
Solution Approach 1:
The patent implements a feedback mechanism where the fluorescence detection system provides real-time quantitative measurements of contrast agent accumulation in parathyroid glands. The system compares measured fluorescence intensity against predetermined thresholds and provides immediate feedback to the surgeon, enabling objective decision-making without subjective interpretation
Solution Approach 2:
The patent transforms the visual imaging data into quantitative parameters by measuring fluorescence intensity and calculating ratios. Instead of providing qualitative images that require subjective interpretation, the system outputs numerical values (fluorescence intensity, detection level, detection ratio) that can be objectively compared against thresholds to determine parathyroid perfusion status
3Measurement precision
If ICG imaging is performed in the dark, then image quality is improved, but the surgical workflow is disrupted
Solution Approach 1:
The patent employs dynamic adaptability by using optical fibers that can be positioned close to the tissue surface, allowing the system to operate effectively in ambient lighting conditions. The proximity of the optical fiber to the tissue enables sufficient signal-to-noise ratio without requiring dark room conditions, thus maintaining surgical workflow efficiency while achieving accurate fluorescence detection
4Measurement precision
If multiple ICG doses are injected, then adequate contrast is achieved, but the surgery duration is prolonged
Solution Approach 1:
The patent replaces the trial-and-error approach of multiple contrast agent injections with a sensitive fluorescence detection system that can detect low concentrations of contrast agent. The optical fiber-based system provides high detection sensitivity, allowing adequate contrast to be achieved with a single lower dose of ICG, thereby reducing surgery duration while maintaining measurement precision
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enables accurate, real-time assessment of parathyroid perfusion with high sensitivity and specificity, reducing surgical complications by differentiating between well and poorly vascularized glands, and allowing surgeries to be performed with normal lighting conditions.
Implementation Method 1
detecting fluorescence in an area of the parathyroid tissues with the fluorescence detection system, wherein the fluorescence is emitted from the contrast agent
Data Source
AI summary
A method for assessing tissue perfusion in a living subject comprises identifying a target tissue using autofluorescence detection with a fiber optic probe-based fluorescence detection system; administering a dose of a contrast agent to the living subject, wherein the dose is about 0.6 mg; detecting fluorescence emitted from the contrast agent in the target tissue using the fiber optic probe-based fluorescence detection system, without acquiring an image of the target tissue; quantifying the detected fluorescence to obtain a detection level and/or detection ratio; and determining a degree of perfusion of the target tissue based on the detection level and/or detection ratio.