{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:12:58Z","timestamp":1787026378919,"version":"build-2736575974"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T00:00:00Z","timestamp":1681171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002644","name":"Pukyong National University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002644","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Near-infrared light can penetrate the fat or connective tissues overlying the parathyroid gland (PG), enabling early localization of the PG by near-infrared autofluorescence (NIRAF) imaging. However, the depth at which the PG can be detected has not been reported. In this study, we investigated the detectable depth of unexposed PGs using NIRAF during thyroidectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Fifty-one unexposed PGs from 30 consecutive thyroidectomy patients, mapped by an experienced surgeon (K.D. Lee) with the use of NIRAF imaging, were included. For NIRAF detection of PGs, a lab-built camera imaging system was used. Detectable depths of the unexposed PGs were measured using a Vernier caliper. The NIRAF images were classified as faint or bright depending on whether a novice could successfully interpret the image as showing the PG. Data on variables that may affect detectable depth and NIRAF intensity were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Detectable depth ranged between 0.35 and 3.05 mm, with a mean of 1.23 \u00b1 0.73 mm. The average NIRAF intensity of unexposed PGs was 3.13 au. After dissection of the overlying tissue, the intensity of the exposed PG increased to 4.88 au (p &amp;lt; 0.001). No difference in NIRAF intensity between fat-covered (3.27 \u00b1 0.90 au) and connective tissue-covered PGs (3.00 \u00b1 1.23 au) was observed (p = 0.369). PGs covered by fat tissue (depth: 1.77 \u00b1 0.67 mm) were found at deeper locations than those covered by connective tissue (depth: 0.70 \u00b1 0.21 mm) (p &amp;lt; 0.001). The brightness of images of the faint group (2.14 \u00b1 0.48 au) was on average 1.24 au lower than that of the bright group (3.38 \u00b1 1.04 au) (p = 0.001). A novice successfully localized 80.4% of the unexposed PGs. Other variables did not significantly affect detectable depth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Unexposed PGs could be mapped using NIRAF imaging at a maximum depth of 3.05 mm and an average depth of 1.23 mm. A novice was able to localize the PGs before they were visible to the naked eye at a high rate. These results can be used as reference data for localization of unexposed PGs in thyroid surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2023.1170751","type":"journal-article","created":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T01:40:12Z","timestamp":1681177212000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Detectable depth of unexposed parathyroid glands using near-infrared autofluorescence imaging in thyroid surgery"],"prefix":"10.3389","volume":"14","author":[{"given":"Young Seok","family":"Han","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yikeun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyoung Shin","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeongjoon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeh-Chan","family":"Ahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang Dae","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10843","article-title":"Mortality in patients with permanent hypoparathyroidism after total thyroidectomy","volume":"105","author":"Almquist","year":"2018","journal-title":"Br J Surg"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0709(98)90106-5","article-title":"Parathyroid preservation during thyroid surgery","volume":"19","author":"Shaha","year":"1998","journal-title":"Am J Otolaryngol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1007\/s00268-012-1809-4","article-title":"Risk factors of hypoparathyroidism following total thyroidectomy for thyroid cancer","volume":"37","author":"Paek","year":"2013","journal-title":"World J Surg"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.11106\/cet.2014.7.2.149","article-title":"Preservation of parathyroid glands during thyroid surgery","volume":"7","author":"Park","year":"2014","journal-title":"J Korean Thyroid Assoc"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2022.4421","article-title":"Emerging imaging technologies for parathyroid gland identification and vascular assessment in thyroid surgery: A review from the American head and neck society endocrine surgery section","volume":"149","author":"Silver Karcioglu","year":"2023","journal-title":"JAMA Otolaryngology-Head Neck Surg"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-6364-2","article-title":"Detection of parathyroid autofluorescence using near-infrared imaging: A multicenter analysis of concordance between different surgeons","volume":"25","author":"Kahramangil","year":"2018","journal-title":"Ann Surg Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2017.0102","article-title":"Near-infrared autofluorescence imaging to detect parathyroid glands in thyroid surgery","volume":"100","author":"Ladurner","year":"2017","journal-title":"Ann R Coll Surgeons Engl"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2019.04.072","article-title":"Autofluorescence imaging of parathyroid glands: An assessment of potential indications","volume":"167","author":"Kose","year":"2020","journal-title":"Surgery"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2503","article-title":"Label-free intraoperative parathyroid localization with near-infrared autofluorescence imaging","volume":"99","author":"McWade","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2017.10.015","article-title":"Near-infrared autofluorescence image-guided parathyroid gland mapping in thyroidectomy","volume":"226","author":"Kim","year":"2018","journal-title":"J Am Coll Surgeons"},{"key":"B11","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.surg.2015.06.047","article-title":"Establishing the clinical utility of autofluorescence spectroscopy for parathyroid detection","volume":"159","author":"McWade","year":"2016","journal-title":"Surgery"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2018.04.079","article-title":"Innovative surgical guidance for label-free real-time parathyroid identification","volume":"165","author":"Thomas","year":"2019","journal-title":"Surgery"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-2558","article-title":"Intraoperative real-time localization of normal parathyroid glands with autofluorescence imaging","volume":"101","author":"Kim","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/S1011-1344(00)00082-8","article-title":"Measurement of the penetration depths of red and near infrared light in human \u201cEx vivo\u201d tissues","volume":"57","author":"Stolik","year":"2000","journal-title":"J Photochem Photobiol B: Biol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/jbio.201900017","article-title":"Video-assisted parathyroid gland mapping with autofocusing","volume":"12","author":"Kim","year":"2019","journal-title":"J biophotonics"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2021.0056","article-title":"Near-infrared autofluorescence imaging may reduce temporary hypoparathyroidism in patients undergoing total thyroidectomy and central neck dissection","volume":"31","author":"Kim","year":"2021","journal-title":"Thyroid"},{"key":"B17","doi-asserted-by":"publisher","first-page":"644","DOI":"10.21037\/gs.2017.09.04","article-title":"Comparison of indocyanine green fluorescence and parathyroid autofluorescence imaging in the identification of parathyroid glands during thyroidectomy","volume":"6","author":"Kahramangil","year":"2017","journal-title":"Gland Surg"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1364\/BOE.9.003391","article-title":"Real-time localization of the parathyroid gland in surgical field using raspberry pi during thyroidectomy: A preliminary report","volume":"9","author":"Kim","year":"2018","journal-title":"Biomed optics express"},{"key":"B19","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1016\/j.jamcollsurg.2019.09.003","article-title":"Imaging or fiber probe-based approach? assessing different methods to detect near infrared autofluorescence for intraoperative parathyroid identification","volume":"229","author":"Thomas","year":"2019","journal-title":"J Am Coll Surgeons"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-019-04929-9","article-title":"Autofluorescence in parathyroidectomy: Signal intensity correlates with serum calcium and parathyroid hormone but routine clinical use is not justified","volume":"43","author":"DiMarco","year":"2019","journal-title":"World J Surg"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-016-3571-5","article-title":"Intraoperative near-infrared imaging for parathyroid gland identification by auto-fluorescence: A feasibility study","volume":"40","author":"De Leeuw","year":"2016","journal-title":"World J Surg"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5338-3","article-title":"Intraoperative near-infrared autofluorescence imaging of parathyroid glands","volume":"31","author":"Ladurner","year":"2017","journal-title":"Surg endoscopy"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1109\/3.64354","article-title":"A review of the optical properties of biological tissues","volume":"26","author":"Cheong","year":"1990","journal-title":"IEEE J quantum Electron"},{"key":"B24","doi-asserted-by":"publisher","first-page":"R37","DOI":"10.1088\/0031-9155\/58\/11\/R37","article-title":"Optical properties of biological tissues: A review","volume":"58","author":"Jacques","year":"2013","journal-title":"Phys Med Biol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2021.12.036","article-title":"Is the indocyanine green score an accurate predictor of postoperative parathyroid hormone level","volume":"171","author":"Demarchi","year":"2022","journal-title":"Surgery"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10783","article-title":"Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery","volume":"105","author":"Vidal Fortuny","year":"2018","journal-title":"J Br Surg"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25837","article-title":"Efficacy of indocyanine green fluorescence in predicting parathyroid vascularization during thyroid surgery","volume":"41","author":"Razavi","year":"2019","journal-title":"Head Neck"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-021-06353-4","article-title":"Intraoperative mapping angiograms of the parathyroid glands using indocyanine green during thyroid surgery: Results of the fluogreen study","volume":"46","author":"Benmiloud","year":"2022","journal-title":"World J Surg"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2023.1170751\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T01:40:14Z","timestamp":1681177214000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2023.1170751\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,11]]},"references-count":28,"alternative-id":["10.3389\/fendo.2023.1170751"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2023.1170751","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,11]]},"article-number":"1170751"}}