Feasibility of indocyanine green fluorescence imaging for intraoperative identification of parathyroid glands during thyroid surgery

Head Neck. 2019 Feb;41(2):340-348. doi: 10.1002/hed.25451. Epub 2018 Dec 11.


Background: This study assessed the feasibility of near-infrared fluorescence imaging with indocyanine green (ICG) to identify the parathyroid glands (PGs) intraoperatively and to assess their perfusion after thyroid resection.

Methods: Patients undergoing elective thyroidectomy were enrolled in this prospective study. An intravenous bolus of 7.5 mg ICG was administered twice: the first bolus to identify the PGs before resection of the thyroid and the second to assess vascularization of the PGs after resection.

Results: A total of 30 operations in 26 patients were included. In 17 surgeries (56.7%), fluorescence imaging was of added value, especially to confirm the presence of a suspected PG. No intraoperative or postoperative complications occurred because of the use of ICG.

Conclusion: Near-infrared fluorescence imaging with the use of ICG for intraoperative identification of the PGs and the assessment of its vascularization is feasible and safe and can provide more certainty about the location of the PGs.

Keywords: NIRF; indocyanine green; near-infrared fluorescence imaging; parathyroid gland; thyroidectomy.

MeSH terms

  • Adult
  • Aged
  • Coloring Agents*
  • Feasibility Studies
  • Female
  • Humans
  • Indocyanine Green*
  • Intraoperative Care
  • Male
  • Middle Aged
  • Optical Imaging*
  • Parathyroid Glands / blood supply
  • Parathyroid Glands / diagnostic imaging*
  • Prospective Studies
  • Thyroid Diseases / diagnostic imaging
  • Thyroid Diseases / surgery*
  • Thyroidectomy*


  • Coloring Agents
  • Indocyanine Green