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Updated: Jun 1, 2025
Establishment of a Simple and Effective Rat Model for Intraoperative Parathyroid Gland Imaging
Published on: August 17, 2022
Will the autofluorescence take over inadvertent parathyroidectomy? Results from a multicentre cohort study
Diego Barbieri1,2, Pietro Indelicato1,2, Simone De Leo3
1Division of Head and Neck, San Raffaele Scientific Institute IRCCS (Istituto Di Ricovero E Cura a Carattere Scientifico), Otorhinolaryngology Unit, Milan, Italy.
Background:
Recently, several devices exploiting the near-infrared autofluorescence (NIR-AF) of parathyroid glands (PGs) have been developed. Nevertheless, their impact on both preserving PGs from inadvertent surgical dissection and on post-surgical hypoparathyroidism (hypoPTH) is controversial.
Methods:
A retrospective study of 845 patients undergoing thyroid surgery in 2 academic tertiary centres was conducted. In 291 patients, a NIR-AF device was used during surgery to identify PGs. The characteristics of the cohort were examined. The number of PGs identified during surgery, missed PGs, auto-transplants, inadvertent parathyroidectomies, as well as the occurrence of transient and permanent hypoPTH, were analysed.
Results:
The use of NIR-AF device resulted in a higher identification of PGs (92% versus 88%, p = 0.0008), and a significant reduction in the number of PGs inadvertently removed and detected on histopathological examination (4.7% versus 6.5%, p = 0.045). An increase in PG auto-transplantations was observed in the NIR-AF + group (10.4% versus 3.5%, p < 0.0001). The use of NIRAF did not significantly impact the occurrence of either transient or permanent hypoPTH.
Conclusion:
Intraoperative NIR-AF detection is a promising technology to reduce incidental parathyroidectomies in thyroid surgery. The impact of this technology on the occurrence of post-surgical hypoPTH needs to be furtherly investigated.
