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General Surgery

Further studies will investigate HSI technology as a method for objective tissue assessment in thyroid surgery. The autofluorescence property of the parathyroid gland offers a promising approach in resection of the parathyroid gland to localize it intraoperatively and to differentiate it from thyroid nodules, adipose tissue, nerve cords and lymph node tissue.

Initial work using the HSI absorption technique to identify the parathyroid gland shows that water content, oxygenation and NIR perfusion in particular are lower in the parathyroid than in the thyroid (Barberio et al. 2018, Gockel et al. 2020). Computer-assisted techniques therefore lend themselves to automated tissue discrimination. In particular, spectral analysis of fluorescent light opens up unique opportunities to optimize the procedure.

SD NSD from Gockel et al. 2020
RGB image and HSI images of a thyroid gland (SD) and parathyroid gland (NSD) with clearly visible lower values for the parathyroid gland. NIR perfusion index (b), StO2(c), water index (d). (Image source: Gockel I et al. Hyperspectral imaging (HSI) - A reliable tissue differentiation? Zentralbl Chir 2020; 145:125-129).