Determination of Parathyroid Function by Fluorescence With Indocyanine Green (ICG) After Total Thyroidectomy

NCT ID: NCT04012476

Last Updated: 2019-07-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-11-30

Study Completion Date

2020-10-31

Brief Summary

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The intensity of parathyroid fluorescence that occurs after intravenous injection of indocyanine green during the performance of a total thyroidectomy correlates with postoperative parathyroid function and could be used as a diagnostic marker of postoperative hypoparathyroidism and hypocalcemia.

Detailed Description

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The main objective of the study is to compare the intensity of parathyroid fluorescence among patients who present post-thyroidectomy hypocalcemia with that of patients who do not have it. Therefore, the following points will be studied:

* To study the correlation between parathyroid vascularization (intraoperative fluorescence intensity) and postoperative glandular function (serum calcium and parathormone levels).
* To compare the surgeon's subjective assessment of parathyroid fluorescence in the groups of patients with and without postoperative hypocalcemia.
* To compare the objective assessment of parathyroid fluorescence, by using specific computer software developed ad hoc, in the groups of patients with and without postoperative hypocalcemia.

Conditions

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Hypocalcemia Total Thyroidectomy Hypoparathyroidism Postprocedural

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Single group: patients undergoing total thyroidectomy with intraoperative infusion of intravenous indocyanine green A prospective unicentric and open clinical trial in which the fluorescence intensity of the parathyroid glands after indocyanine administration will be compared between two groups of patients: those with post-thyroidectomy hypocalcemia and patients who do not present it.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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ICG

Patients undergoing total thyroidectomy with visualization of the parathyroid glands under infrared light after intraoperative intravenous injection of 5 mg of indocyanine green

Group Type EXPERIMENTAL

Indocyanine Green

Intervention Type DRUG

Administration of 5 mg of intravenous indocyanine green after total thyroidectomy for measurement of parathyroid fluorescence under infrared light

Interventions

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Indocyanine Green

Administration of 5 mg of intravenous indocyanine green after total thyroidectomy for measurement of parathyroid fluorescence under infrared light

Intervention Type DRUG

Other Intervention Names

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ICG

Eligibility Criteria

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Inclusion Criteria

* Patients who are going to undergo total thyroidectomy, with or without cervical lymph node dissection.
* Visualization of 2 or more parathyroid glands during the surgical act.
* Normal renal and hepatic functions.
* Absence of a history of hypersensitivity reactions to iodine or indocyanine green.
* Able to understand the nature and protocol of the study and its procedures
* Willingness to participate with the subsequent signing of informed consent.

Exclusion Criteria

* Age \<18 years
* Hepatic or renal insufficiency
* Hypersensitivity to iodine or to indocyanine green.
* Pregnancy or lactation
* Inability to understand the nature and procedures of the study.
* Patients with known preoperative hyperparathyroidism.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universitat de les Illes Balears

OTHER

Sponsor Role collaborator

Hospital Son Espases

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Hospital Universitari Son Espases

Palma de Mallorca, Balearic Islands, Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Jaime Bonnín Pascual, MD

Role: CONTACT

871205959

Facility Contacts

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Jaime Bonnín Pascual, MD

Role: primary

871205959

References

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Vidal Fortuny J, Belfontali V, Sadowski SM, Karenovics W, Guigard S, Triponez F. Parathyroid gland angiography with indocyanine green fluorescence to predict parathyroid function after thyroid surgery. Br J Surg. 2016 Apr;103(5):537-43. doi: 10.1002/bjs.10101. Epub 2016 Feb 11.

Reference Type BACKGROUND
PMID: 26864909 (View on PubMed)

Vidal Fortuny J, Sadowski SM, Belfontali V, Guigard S, Poncet A, Ris F, Karenovics W, Triponez F. Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery. Br J Surg. 2018 Mar;105(4):350-357. doi: 10.1002/bjs.10783. Epub 2018 Feb 6.

Reference Type BACKGROUND
PMID: 29405252 (View on PubMed)

Lang BH, Wong CK, Hung HT, Wong KP, Mak KL, Au KB. Indocyanine green fluorescence angiography for quantitative evaluation of in situ parathyroid gland perfusion and function after total thyroidectomy. Surgery. 2017 Jan;161(1):87-95. doi: 10.1016/j.surg.2016.03.037. Epub 2016 Nov 10.

Reference Type BACKGROUND
PMID: 27839936 (View on PubMed)

Zaidi N, Bucak E, Yazici P, Soundararajan S, Okoh A, Yigitbas H, Dural C, Berber E. The feasibility of indocyanine green fluorescence imaging for identifying and assessing the perfusion of parathyroid glands during total thyroidectomy. J Surg Oncol. 2016 Jun;113(7):775-8. doi: 10.1002/jso.24237. Epub 2016 Apr 4.

Reference Type BACKGROUND
PMID: 27041628 (View on PubMed)

Galvez-Pastor S, Torregrosa NM, Rios A, Febrero B, Gonzalez-Costea R, Garcia-Lopez MA, Balsalobre MD, Pastor-Perez P, Moreno P, Vazquez-Rojas JL, Rodriguez JM. Prediction of hypocalcemia after total thyroidectomy using indocyanine green angiography of parathyroid glands: A simple quantitative scoring system. Am J Surg. 2019 Nov;218(5):993-999. doi: 10.1016/j.amjsurg.2018.12.074. Epub 2019 Jan 4.

Reference Type BACKGROUND
PMID: 30665612 (View on PubMed)

Rudin AV, McKenzie TJ, Thompson GB, Farley DR, Lyden ML. Evaluation of Parathyroid Glands with Indocyanine Green Fluorescence Angiography After Thyroidectomy. World J Surg. 2019 Jun;43(6):1538-1543. doi: 10.1007/s00268-019-04909-z.

Reference Type BACKGROUND
PMID: 30659346 (View on PubMed)

Bonnin-Pascual J, Alvarez-Segurado C, Jimenez-Segovia M, Bianchi A, Bonnin-Pascual F, Molina-Romero FX, Gonzalez-Argente FX. Contributions of fluorescence to endocrine surgery. Cir Esp (Engl Ed). 2018 Nov;96(9):529-536. doi: 10.1016/j.ciresp.2018.09.005. Epub 2018 Oct 14. English, Spanish.

Reference Type RESULT
PMID: 30327136 (View on PubMed)

Other Identifiers

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ICG-Parathyroid

Identifier Type: -

Identifier Source: org_study_id

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