Real-time detection of parathyroid glands during surgery using a highly sensitive autofluorescence-based system

The question of how to quickly and accurately identify and localize living parathyroid tissue, protect its functional integrity, and reduce the risk of intraoperative parathyroid function damage is a great challenge for clinicians and a technical challenge for researchers in the healthcare field.

This prospective basic research designed a laser-induced fluorescence detection system that utilizes the intrinsic fluorescence of tissues and conducted a single-center clinical validation study from 28 May 2025 to 2 July 2025 which was registered with ISRCTN. The parathyroid gland detection data were obtained. A total of 106 patients aged between 18 and 99 representing different racial and gender backgrounds participated in this study. All the participating patients signed the informed consent form. This study mainly determines whether the tissue is a parathyroid gland by measuring the fluorescence intensity values of the relevant human tissues during surgery under the laser-induced fluorescence detection system.

The fluorescence detection module designed employs an innovative algorithm, which can effectively overcome the interference from complex environmental light sources such as shadowless surgical lights, thereby significantly improving the accuracy of fluorescence imaging of tissue contrast agents. System performance was evaluated using serial dilutions of indocyanine green (ICG) to simulate PG autofluorescence, achieving a minimum detectable concentration of 8 × 10-1⁰ mol/L and a limit of detection (LoD) of 1.24 × 10-1⁰ mol/L. The clinical verification of over 100 cases of in situ PG detection showed that the detection accuracy rate was 98.3% (higher than 96% of the PTeye system and the naked eye recognition of clinicians respectively), confirming its reliability in surgical environments.

This parathyroid gland detection system can accurately identify parathyroid glands, providing an effective solution for the real-time localization of intraoperative PG, which may improve intraoperative decision making and patient prognosis.