Surgical excision of an adenomatous or hypercellular parathyroid gland is typically the treatment of choice for primary hyperparathyroidism. Intraoperative identification can be challenging due to potential variable location and indistinct features of these glands. In 115 ex-vivo specimens we evaluated the efficacy of DOCI in identifying hypercellular parathyroid glands. Significant imaging differences were seen between hypercellular vs normal parathyroid glands vs other adjacent healthy tissues across 8 spectral channels (p<0.05). Our classification result (100% sensitivity, 98.8% specificity) using a logistic regression classifier further corroborated that DOCI has the capacity to accurately identify and differentiate parathyroid glands from surrounding tissues. DOCI enables sensitive and specific mapping of parathyroid location, leading to improved accuracy of the surgical procedure, reduced time to successful completion, fewer risks and improved patient outcomes.
Scar formation in tissue is a healing process that inhibits normal tissue function through the deposition of predominantly disorganized type I collagen which is much more rigid than native collagen. Scarring in the vocal fold is especially debilitating as the vocal fold requires flexibility and freedom of movement to produce voicing. Furthermore the vocal fold has a very layered and organized structure with type I collagen in the basement membrane providing organ structural support, while type III collagen is in high concentration in the deep layer of the vocal fold. Using Dynamic Optical Contrast Imaging (DOCI) on unstained histological rabbit vocal fold slides (formalin fixed paraffin embedded tissue, FFPE), we were able to use subtle differences in fluorescence lifetime between native and scarred collagen types to image molecular evolution of scarring following injury. The degree of scarring and the DOCI fluorescence life time shift correlated with molecular and functional evaluations of scarring. Preliminary results demonstrates DOCI could be used as a prognostic tool useful to clinicians by depicting scar damage on vocal folds, (VF) not visible to the unaided eye or with white light endoscopic imaging.
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