Probe-Based Near-Infrared Autofluorescence for Parathyroid Identification During Thyroid Surgery: Clinical Outcomes, Surgeon Confidence, and Autofluorescence Thresholds
In brief
A near-infrared probe confirmed 42% of glands surgeons viewed uncertainly
In this retrospective comparison of 84 probe-assisted and 103 historical thyroid surgeries, 42% of glands detected with the probe had initially been seen with low or moderate surgeon confidence. Fewer patients had parathyroid tissue found incidentally on pathology, but hypoparathyroidism rates did not differ; the probe's value for improving patient outcomes remains unclear.
- Journal
- Head & neck (Q1)
- Published
- 11 October 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Anthony Y Cheung, Bo Wang, Yoshiyuki Saito, Marika D Russell, Justin M Soffer, Okenwa C Okose, et al.
- PMID
- 42860718
- DOI
- 10.1002/hed.70503
Why clinicians should know about it
- Picked for Breast and Endocrine Surgery (paper of the day, 14 October 2026): PTeye improves parathyroid identification confidence and reduces incidental histology rates
Abstract
BACKGROUND: We evaluated experience with probe-based near-infrared autofluorescence (NIRAF) system (PTeye) in parathyroid gland (PTG) identification during total thyroidectomy. METHODS: In this retrospective study, patients undergoing total thyroidectomy using PTeye (2020-2022; n = 84) were compared with a historical visual-identification cohort (2018-2019; n = 103). RESULTS: PTG identification rates were comparable, although 42% of PTGs detected with PTeye were initially visualized with low or moderate confidence. Significantly fewer patients in the PTeye cohort had PTGs incidentally identified on histology (4.8% vs. 16.5%, p = 0.018), but there was no difference in the incidence of autotransplanted PTGs or total inadvertent parathyroidectomy. Postoperative calcium was higher with PTeye (median 9.2 vs. 9.0 mg/dL, p < 0.001). Postoperative PTH, transient, and permanent hypoparathyroidism did not differ. An autofluorescence ratio cutoff of 2.5 improved specificity compared with the manufacturer-recommended cutoff of 1.2. CONCLUSIONS: PTeye provides adjunctive confirmation of suspected parathyroid tissue, including glands initially identified with low or moderate visual confidence.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.