Parathyroid gland detection using an intraoperative autofluorescence handheld imager - early feasibility study

IntroductionParathyroid glands may be compromised during thyroid surgery which can lead to hypoparathyroidism and hypocalcemia. Identifying the parathyroid glands relies on the surgeon's experience and the only way to confirm their presence was through tissue biopsy. Near infrared autofluorescence technology offers an opportunity for real-time, non-invasive identification of the parathyroid glands. MethodsWe used a new research prototype (hANDY-I) developed by Optosurgical, LLC. It offers coaxial excitation light and a dual-Red Green Blue/Near Infrared sensor that guides anatomical landmarks and can aid in identification of parathyroid glands by showing a combined autofluorescence and colored image simultaneously. ResultsWe tested the imager during 23 thyroid surgery cases, where initial clinical feasibility data showed that out of 75 parathyroid glands inspected, 71 showed strong autofluorescence signal and were correctly identified (95% accuracy) by the imager. ConclusionsThe hANDY-I prototype demonstrated promising results in this feasibility study by aiding in real-time visualization of the parathyroid glands. However, further testing by conducting randomized clinical trials with a bigger sample size is required to study the effect on levels of hypoparathyroidism and hypocalcemia.

Automated summary

Parathyroid glands can be compromised during thyroid surgery, and identifying their presence traditionally relies on the surgeon's experience and tissue biopsy. Near infrared autofluorescence technology, demonstrated by the hANDY-I prototype, offers a real-time, non-invasive way to identify the parathyroid glands. Initial results showed a 95% accuracy in identifying parathyroid glands in 71 out of 75 cases tested. Further testing with a larger sample size is necessary to study the impact on hypoparathyroidism and hypocalcemia levels.