Near infrared autofluorescence (NIRAF) can aid in identifying parathyroid glands (PGs) during thyroidectomies. Additionally, surgeons use indocyanine green (ICG) to evaluate PG perfusion. However, there is spectral overlap between PGs and ICG making parathyroid identification challenging after ICG injection. ICG dose adjustment may be needed for quantitative tissue perfusion assessment without interfering with PG NIRAF detection. This work investigated the utility of probe-based detection to determine PG vascularity using ICG doses of 0.25 and 1.25 mg. A mathematical model was also developed to determine the ICG dosage threshold for concurrent vascularity assessment and NIRAF detection of PGs.
Surgeons find it challenging to preserve healthy parathyroid glands (PGs) and confirm removal of diseased PGs during parathyroidectomies, often leading to postoperative complications and costly frozen section analysis (FSA). PTeye™ - a fiber-optic probe-based system that detects near infrared autofluorescence (NIRAF) was FDA-cleared to serve as an intraoperative adjunct device to aid in intraoperative PG identification. We sought to assess the impact of NIRAF detection during parathyroidectomies for the first time through a single-center randomized clinical trial. Our current findings indicate that PTeye™ could improve a surgeon’s confidence in PG identification, while potentially reducing FSAs needed during parathyroidectomies.
Identifying parathyroid glands can be challenging for surgeons during head and neck operations. For the surgeon, it becomes essential to preserve healthy parathyroid glands, while successfully removing diseased parathyroid glands. This study presents PTeye – a commercial fiber probe-based device that was designed for intraoperative parathyroid identification by detecting near infrared autofluorescence. The results of this study demonstrate that PTeye had 95% accuracy in identifying parathyroid glands in 78 patients. The device had an overall detection rate of 97% for healthy and diseased parathyroid glands. PTeye could also quantify parathyroid vascularity in real-time by using indocyanine green during neck surgeries.
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