[Clinical exploration of near-infrared autofluorescence imaging for parathyroid gland preservation in thyroid cancer surgery].

What was studied

This randomised trial tested a camera method in thyroid cancer surgery. It is near-infrared autofluorescence (NIRAF) imaging. It helps find the parathyroid glands during surgery. The team looked at how well it finds the inferior glands, which vary in position. They also looked at permanent hypoparathyroidism. The trial had 96 patients with thyroid cancer. They had total thyroidectomy and central neck dissection. Surgery ran from January 2023 to June 2024. 44 patients were in the NIRAF group and 52 in the control group. NIRAF used a device with 785 nm light. A fluorescence ratio of 1.4 or more marked a gland. Controls had visual inspection with carbon nanoparticle staining. Gland function was followed for 6 months.

What they found

Pairs below give the NIRAF group, then the control group. Inferior glands were found more often with NIRAF, at 92.0 and 58.7. Overall gland identification was also higher, at 94.3 and 73.1. Accidental removal was lower, at 1.1 and 7.2. All these gaps were significant. Permanent hypoparathyroidism showed a decreasing trend with NIRAF, at 0 and 5.8. This was not significant, with P = 0.155. Transient hypoparathyroidism was lower too, at 9.1 and 23.1. Operative time did not differ significantly.

What it means for patients

The authors say NIRAF identifies inferior parathyroid glands efficiently and accurately. They say it improves gland preservation. They say it lowers transient hypoparathyroidism. They say permanent hypoparathyroidism showed a decreasing trend.

Why it is not certain yet

The drop in permanent hypoparathyroidism was not significant. The trial had 96 patients. The abstract gives no other limits. A single trial can only show so much.

Source

[Clinical exploration of near-infrared autofluorescence imaging for parathyroid gland preservation in thyroid cancer surgery].

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