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Fluorescent Detection of Rat Parathyroid Glands via 5‐Aminolevulinic Acid
Author(s) -
Asher Scott A.,
Peters Glenn E.,
Pehler Stephen F.,
Zinn Kurt,
Newman J Robert,
Rosenthal Eben L.
Publication year - 2008
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/mlg.0b013e3181671b61
Subject(s) - parathyroid gland , fluorescence , parathyroid hormone , chemistry , medicine , pathology , endocrinology , calcium , physics , quantum mechanics
Objective: Anatomic identification of parathyroid glands during surgery is challenging and time consuming. We sought to determine whether 5‐aminolevulinic acid (5‐ALA) could produce parathyroid gland fluorescence to improve their detection in a preclinical model. Methods: Thirty‐two rats were administered 0 to 700 mg/kg of 5‐ALA by intraperitoneal injection prior to neck exploration under the illumination of a blue light (380–440 nm). Tissue fluorescence was assessed at 1, 2, or 4 hours postinjection and then removed for histologic confirmation of parathyroid tissue. Results: Rat parathyroid glands could not be visualized under ambient light. At dosages of 300 mg/kg or greater, bilateral parathyroid glands were visualized in 18 of 19 rats using blue light illumination. At dosages less than 300 mg/kg, parathyroid gland fluorescence was detected in only 1 of 13 rats. At 2 hours after 5‐ALA administration, the net mean intensity of parathyroid gland fluorescence was optimal with a dose of 500 mg/kg. At both 1 and 4 hours after 5‐ALA injection, the net mean intensity of parathyroid gland fluorescence was optimal at the highest dose (700 mg/kg) and positively correlated with dosage increases. Conclusion: 5‐ALA can be used to selectively detect parathyroid tissue from surrounding tissue in a preclinical model. Our data support the use of this technique in the clinical setting.