# US 12,178,595 B2 · Methods and apparatus for intraoperative assessment of parathyroid gland vascularity using laser speckle contrast imaging and applications of same

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- Number: US 12,178,595 B2
- Document ID: US12178595B2
- Status: Granted
- Kind: B2
- Application number: 18/377,867
- Filed: 2023-10-09
- Published: 2024-02-01
- Granted: 2024-12-31
- Earliest claimed: 2016-12-27
- Assignees: Vanderbilt University
- Applicants: Vanderbilt University
- Inventors: Emmanuel A. Mannoh; Anita Mahadevan-Jansen
- Web page: https://patentgrep.com/patent/US12178595B2

## CPC

- A61B 5/415: {the glands, e.g. tonsils, adenoids or thymus}
- A61B 5/0071: {by measuring fluorescence emission}
- A61B 5/0075: {by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy (A61B5/0071 takes precedence)}
- A61B 5/0077: {Devices for viewing the surface of the body, e.g. camera, magnifying lens}
- A61B 5/0086: {using infrared radiation}
- A61B 5/418: {lymph vessels, ducts or nodes}
- A61B 5/4227: {endocrine glands, i.e. thyroid, adrenals, hypothalamic, pituitary}
- A61B 5/742: {using visual displays (displays for heart-related electrical signals, e.g. ECG, A61B5/339)}
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- G01N 21/6456: {Spatial resolved fluorescence measurements; Imaging}
- G01N 21/65: Raman scattering
- A61B 90/361: {Image-producing devices, e.g. surgical cameras}
- A61B 2034/2055: {Optical tracking systems}
- A61B 2505/05: Surgical care
- G01N 21/35: using infrared light (G01N21/39 takes precedence)
- G01N 2021/479: {Speckle}
- G01N 2021/6439: {with indicators, stains, dyes, tags, labels, marks}
- G01N 2201/0221: Portable; cableless; compact; hand-held
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G01N: INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES (measuring or testing apparatus or processes other than immunoassay, involving enzymes or microorganisms C12M, C12Q)

## Abstract

One aspect of the invention relates to a method for intraoperative detection of parathyroid gland viability in a surgery, comprising obtaining speckle contrast images of a parathyroid gland of a patent; and displaying the speckle contrast images of the parathyroid gland in real-time.

## Claims

### Claim 1

A method for intraoperatively providing anatomical guidance in an endocrine surgery, comprising:
obtaining speckle contrast images of a parathyroid gland of a patient; and
displaying the speckle contrast images of the parathyroid gland in real-time,
wherein said obtaining the speckle contrast images of the parathyroid gland of the patient comprises:
diffusing a beam of light onto a tissue surface of a parathyroid gland of the patient to illuminate the tissue surface;
acquiring images of the illuminated tissue surface, wherein each of the acquired images comprises a speckle pattern; and
processing the acquired images to obtain speckle contrast images, wherein said processing the acquired images comprises calculating a plurality of speckle contrasts from the acquired images of the parathyroid gland to obtain a resultant speckle contrast image, wherein the resultant speckle contrast image has values that range from 0 to 1 with values closer to 0 representing regions of greater motion (perfusion) and 1 representing regions with no motion.

### Claim 2 (depends on 1)

The method of claim 1, wherein in the speckle contrast images, a perfused parathyroid gland has low speckle contrast, and a devascularized parathyroid gland has high speckle contrast.

### Claim 3 (depends on 1)

The method of claim 1, wherein said calculating the plurality of speckle contrasts comprises:
defining a window with a number of pixels over which a speckle contrast is to be calculated;
moving the window across the acquired image of the speckle pattern; and
at each location, calculating the speckle contrast as a standard deviation of pixel intensity values σs within the window divided by a mean intensity value (l) as follows:
K
s
=
σ
s
〈
I
〉
.

### Claim 4

An apparatus for intraoperatively providing anatomical guidance in an endocrine surgery, comprising:
a means for obtaining speckle contrast images of a parathyroid gland of a patient; and
a display for displaying the speckle contrast images of the parathyroid gland in real-time,
wherein said means for obtaining the speckle contrast images comprises:
a light source for emitting a beam of light that is diffused onto a tissue surface of the parathyroid gland of the patient to illuminate the tissue surface;
a detector for acquiring images of the illuminated tissue surface; and
a controller arranged to operate the detector to acquire the images of the illuminated tissue surface, receive the acquired images from the detector, and process the acquired images to obtain the speckle contrast images;
wherein said processing the acquired images comprises calculating a plurality of speckle contrasts from the acquired images of the parathyroid gland to obtain a resultant speckle contrast image, wherein the resultant speckle contrast image has values that range from 0 to 1 with values closer to 0 representing regions of greater motion (perfusion) and 1 representing regions with no motion.

### Claim 5 (depends on 4)

The apparatus of claim 4, wherein the light source comprises an infrared laser.

### Claim 6 (depends on 4)

The apparatus of claim 4, wherein the beam of light is diffused onto the tissue surface of the parathyroid gland by a diffuser including a biconvex lens.

### Claim 7 (depends on 4)

The apparatus of claim 4, wherein the detector comprises a camera.

### Claim 8 (depends on 7)

The apparatus of claim 7, wherein the camera comprises an infrared camera or a near-infrared camera.

### Claim 9 (depends on 7)

The apparatus of claim 7, wherein the detector further comprises a focus tunable lens attached to the front end of the camera.

### Claim 10 (depends on 4)

The apparatus of claim 4, wherein in the speckle contrast images, perfused parathyroid gland has low speckle contrast, and a devascularized parathyroid gland has high speckle contrast.