{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T14:38:28Z","timestamp":1754145508592,"version":"3.41.2"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003246","name":"Nederlandse Organisatie voor Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hypoparathyroidism is a complication associated with significant morbidity and results from inadvertent removal of the parathyroid during thyroid surgery. Therefore, intra\u2010operative identification of parathyroid tissue is essential to minimize the risk of hypoparathyroidism. Current identification techniques come with significant limitations in logistics and accuracy. We therefore propose higher\u2010harmonic generation microscopy (HHGM), a rapid, non\u2010invasive, label\u2010free method for the real\u2010time visualization of human tissue, as a potential alternative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective proof\u2010of\u2010concept study was conducted at the Amsterdam University Medical Centers from February to April 2024. Intra\u2010operative HHGM imaging of presumed parathyroid tissue samples was performed, and the results were compared with conventional histopathology by an expert endocrine pathologist in order to evaluate the sensitivity and specificity of HHGM. The logistical process and its potentially associated benefits were also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Intraoperative imaging was performed on 32 fresh, unprocessed tissue samples from 18 patients. HHGM demonstrated a high sensitivity (85%) and specificity (83.3%) for the detection of parathyroid tissue. HHGM imaging was found to be more time\u2010efficient than frozen section, taking ~5\u2009min per biopsy compared to 30\u2009min for FS. HHGM was able to produce high\u2010quality images in cases where frozen section analysis was inconclusive due to insufficient tissue. Logistical challenges and extra workload associated with HHGM were minimal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This proof\u2010of\u2010concept study demonstrates that HHGM could be a promising intraoperative diagnostic imaging modality, offering rapid imaging and detailed visualization capabilities. These features suggest that HHGM might potentially reduce surgery duration and decrease demand on pathology resources.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.28146","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T04:53:39Z","timestamp":1743051219000},"page":"2223-2230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Instant Intraoperative Histopathological Assessment of Fresh Parathyroid Tissue: Higher Harmonic Generation Microscopy as a Potential Alternative to Frozen Section"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7541-6516","authenticated-orcid":false,"given":"P. M. Rodriguez","family":"Schaap","sequence":"first","affiliation":[{"name":"Department of Surgery Amsterdam University Medical Centres, Cancer Center Amsterdam, Location VUmc  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"van den Bosch","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam University Medical Centres, Cancer Center Amsterdam, Location VUmc  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Spies","sequence":"additional","affiliation":[{"name":"Laserlab Amsterdam, Department of Physics, Faculty of Science Vrije Universiteit Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"van Eeden","sequence":"additional","affiliation":[{"name":"Department of Pathology Amsterdam University Medical Centres, Location VUmc  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. J. M. Nieveen","family":"van Dijkum","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam University Medical Centres, Cancer Center Amsterdam, Location VUmc  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. L.","family":"Groot","sequence":"additional","affiliation":[{"name":"Laserlab Amsterdam, Department of Physics, Faculty of Science Vrije Universiteit Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. F.","family":"Engelsman","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam University Medical Centres, Cancer Center Amsterdam, Location VUmc  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"volume-title":"Operaties in het ziekenhuis; soort opname, leeftijd en geslacht, 1995\u20132010","year":"2014","author":"Centraal Bureau voor de Statistiek","key":"e_1_2_9_2_1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2018.11.003"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2021.2475"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10843"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrac102"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs\u201020\u2010486"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.701253"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478\u2010199805000\u201000003"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27538"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428\u2010008\u20100674\u2010x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbio.201800297"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbio.202300079"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1364\/boe.7.001889"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201015423\u2010z"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1916\u20100216\u201042\u201056"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0716"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/molecules24142560"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.28146","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T02:33:09Z","timestamp":1752719589000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.28146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,27]]},"references-count":17,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/hed.28146"],"URL":"https:\/\/doi.org\/10.1002\/hed.28146","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"type":"print","value":"1043-3074"},{"type":"electronic","value":"1097-0347"}],"subject":[],"published":{"date-parts":[[2025,3,27]]},"assertion":[{"value":"2024-12-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}