Table 2.
Recent studies that evaluate the benefits of indocyanine green angiography (ICGA) in thyroid surgery.
| Author | Year | Nb pt | Intervention | Key Points | Conclusions |
|---|---|---|---|---|---|
| Lang et al. [37] | 2017 | 70 | TT | Greatest ICG correlated with postoperative normal PTH. | ICGA is a promising operative adjunct in determining residual parathyroid gland function and predicting postoperative hypocalcemia risk after total thyroidectomy. |
| Rudin et al. [34] | 2019 | 210 | TT | At least two vascularized glands on ICGA may predict postoperative parathyroid gland function. | ICGA is a novel technique that may improve the assessment of parathyroid gland blood supply compared to visual inspection. |
| Razavi et al. [38] | 2019 | 111 | TT | No significant difference in mean PTH changes at the end of surgery, symptomatic hypocalcemia, or length of stay between surgeries performed with and without ICG. | Low-flow ICG patterns are not associated with postoperative PTH changes or transient hypocalcemia and may lead to unnecessary parathyroid auto transplantation. |
| Gálvez-Pastor et al. [39] | 2019 | 39 | TT | Patients with postoperative hypocalcemia had a lower 4-ICG score. The 4-ICG score showed good discrimination in terms of predicting postoperative hypocalcemia. | The 4-ICG score predicts postoperative hypocalcemia and correlates well with postoperative parathyroid function in patients undergoing total thyroidectomy for multinodular goiter. |
| Jin et al. [40] | 2019 | 26 | TT | In patients with at least one parathyroid gland with an ICG score of 2 postoperative PTH levels were in the normal range. | Fluorescence imaging system applied with indocyanine green is a safe, easy, and effective method for protecting the parathyroid glnd and predicting postoperative hypoparathyroidism. |
| Vidal Fortuny et al. [33] | 2018 | 196 | TT | One well perfused parathyroid gland using ICGA is a reliable way of predicting the absence of postoperative hypoparathyroidism. | ICGA reliably predicts the vascularization of the parathyroid glands and obviates the need for the postoperative measurement of calcium and PTH. |
| Alesina et al. [41] | 2018 | 5 | TT/PHPT | Postoperative day 1 PTH was normal. | Superiority of combined AF/ICG vs. simple visualization to reduce the rate of postop HPOPT has not been demonstrated. |
Nb pt, number of patients; ICG, indocyanine green; TT, total thyroidectomy; PTH, parathyroid hormone; PHPT, primary hyperparathyroidism; AF, auto fluorescence; HPOPT, hypoparathyroidism.