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Intraoperative use of optical coherence tomography to differentiate normal and diseased thyroid and parathyroid tissues from lymph node and fat

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Abstract

The purpose of this study is twofold: (1) to determine the feasibility of optical coherence tomography (OCT) to differentiate normal and diseased tissue of the neck region intraoperatively and (2) to evaluate how accurately a cohort of test subjects can identify various tissue types when shown a sample set of OCT images. In this in vivo, prospective, single institutional study, an OCT imaging system (Niris, Imalux, Cleveland, OH) was used to image parathyroid, thyroid, lymph node, and fat tissue in 76 patients during neck surgery. Biopsies were performed for comparison of OCT images with histology in select cases (n = 20). Finally, a group of either surgeons or scientists familiar with OCT (n = 17) were shown a sample of OCT images and asked to identify the tissue. A total of 437 OCT images were analyzed, and characteristic features of each tissue type were identified. OCT demonstrated distinct differences in structural architecture and signal intensity that allows differentiation between thyroid and parathyroid tissues, lymph nodes, and fat. OCT images were also compared with histology with good correlation. There was no difference in correctly identifying OCT-imaged tissue type between surgeons and scientists. This study is the first in vivo OCT imaging study to evaluate both normal and diseased tissues that may be encountered during neck surgery. OCT has the potential to become a valuable intraoperative tool to differentiate diseased and normal thyroid tissue intraoperatively to obtain an “optical biopsy” in real time without fixation, staining, or tissue resection.

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Funding

This work was supported by the National Institutes of Health (DC 006026, CA 91717, EB 00293, RR 01192, RR00827), Flight Attendant Medical Research Institute (32456), State of California Tobacco Related Disease Research Program (12RT-0113), Air Force Office of Scientific Research (F49620_00_1_0371), and the Arnold and Mabel Beckman Foundation.

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Author notes

  1. Marc Rubinstein and Allison C. Hu contributed equally to this work should be considered co-first authors

Authors and Affiliations

  1. Departement of Otolaryngology – Head and Neck Surgery, University of California Irvine, Orange, CA, USA

    Marc Rubinstein, Allison C. Hu, Jason H. Kim, Paul Schalch, William B. Armstrong & Brian J. F. Wong

  2. Beckman Laser Institute and Medical Clinic, University of California Irvine, 1002 Health Sciences Rd, Irvine, CA, 92617, USA

    Marc Rubinstein, Allison C. Hu & Brian J. F. Wong

  3. Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA

    Allison C. Hu & Brian J. F. Wong

  4. Beckman Laser Institute Korea, Dankook University, Cheonan, South Korea

    Phil-Sang Chung

  5. Department of Otolaryngology – Head and Neck Surgery, College of Medicine, Dankook University, Cheonan, South Korea

    Phil-Sang Chung

  6. Department of Medicine, University of California Irvine, Orange, CA, USA

    Kathryn E. Osann

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  1. Marc Rubinstein
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Correspondence to Brian J. F. Wong.

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Rubinstein, M., Hu, A.C., Chung, PS. et al. Intraoperative use of optical coherence tomography to differentiate normal and diseased thyroid and parathyroid tissues from lymph node and fat. Lasers Med Sci 36, 269–278 (2021). https://doi.org/10.1007/s10103-020-03024-z

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  • DOI: https://doi.org/10.1007/s10103-020-03024-z

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