# Intraoperative Parathyroid Localization Using DOCI

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2020 · $481,521

## Abstract

Project Abstract
Primary hyperparathyroidism, often caused by a single adenoma (80-85%) or four-gland hyperplasia (10-15%),
can lead to elevated parathyroid hormone (PTH) levels and resultant hypercalcemia. Surgical excision of
offending lesions is the standard of care, as the removal of pathologic adenomas reduces PTH and calcium
values to baseline and avoids the risk of associated morbidities like insulin resistance, dyslipidemia, low
mineral bone density, and nephrolithiasis. The small size, variable location, and indistinct external features of
parathyroid glands can make their identification quite challenging intraoperatively. Distinguishing them from
adjacent fat, lymph tissue, or thymus tissue may be complicated further in previously operated necks. Patient
prognosis depends heavily on complete resection of the involved parathyroid glands. The inability to accurately
localize the parathyroid glands during parathyroidectomy and thyroidectomy procedures can prevent patients
from achieving postoperative normocalcemia. There is a critical need for an improved intraoperative method for
real-time parathyroid localization. The goal of this proposal is to develop new optical methods based on
Dynamic Optical Contrast Imaging (DOCI) characterized by speed, low cost, and improved sensitivity and
specificity, for enhancing intraoperative parathyroid localization. The imaging system leverages a novel
realization of temporally dependent measurements of tissue autofluorescence that allow the acquisition of
specific tissue properties over a large field of view. This system is optimized such that it can be used by
surgeons at the time of resection surgery to localize parathyroid tissue and has been extensively validated in
ex vivo samples. Companion histology has verified the sensitivity and specificity of the technique. In the
proposed work we will reconfigure the imaging system for a large field of view (FOV), then pursue an
intraoperative study using DOCI to localize parathyroid tissue. Companion visible imagery and histology will be
analyzed at all stages of the work ensuring statistical diagnostic power of the technique. The goal of these
surgeries is to remove the diseased thyroid or parathyroid tissues while minimizing risks to surrounding nerves
and vessels. Noninvasive, real-time imaging methods that can accurately and efficiently identify parathyroid
gland tissue in vivo and differentiate it from surrounding neck tissues would be transformative in gland
localization. We hypothesize that the accuracy and efficiency of parathyroid resection will improve significantly
when aided by our optical imaging technology. This intraoperative instrument would be the first of its kind,
giving us the potential to significantly improve the rapid localization of parathyroid tissue, thus enabling the
surgeon to preserve healthy tissue and improve patient outcomes.

## Key facts

- **NIH application ID:** 9825385
- **Project number:** 5R01CA205051-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Maie A. St. John
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $481,521
- **Award type:** 5
- **Project period:** 2016-12-05 → 2021-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9825385

## Citation

> US National Institutes of Health, RePORTER application 9825385, Intraoperative Parathyroid Localization Using DOCI (5R01CA205051-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9825385. Licensed CC0.

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