A crew led by Vanderbilt College and Vanderbilt College Medical Heart biomedical engineers and surgeons has printed outcomes of a giant medical trial exhibiting that use of a near-infrared autofluorescence (NIRAF) probe machine improves intraoperative identification of parathyroid glands (PGs).
The biomedical engineers and surgeons printed the outcomes of the primary multicenter, randomized medical trial utilizing this know-how throughout endocrine neck procedures in JAMA Surgical procedure.
Whereas endocrine neck surgical procedure is usually protected with a low fee of issues, inadvertent elimination and injury to PGs could cause hypoparathyroidism, a situation that may result in low ranges of calcium and elevated ranges of phosphorus within the blood.
Lengthy-term hypoparathyroidism issues embrace impaired kidney operate, cardiac arrhythmias and elevated danger of loss of life. Due to this, it’s essential to precisely establish these glands throughout parathyroidectomy and thyroidectomy.
In 2018, the Meals and Drug Administration granted de novo classification and advertising and marketing authorization for a tool to help with detection of parathyroid glands in adults known as the PTeye, which was used on this trial.
The machine was developed by the Vanderbilt Biophotonics Heart, led by Anita Mahadevan-Jansen, Ph.D., the Orrin H. Ingram Professor of Engineering. Its medical implementation was pioneered by a gaggle of VUMC surgeons led by Carmen Solórzano, MD, chair of the Division of Surgical procedure, John L. Sawyers Professor of Surgical Sciences and director of Vanderbilt Endocrine Surgical procedure.
“NIRAF know-how leverages the truth that parathyroid tissue emits a stronger near-infrared autofluorescence sign than different tissues within the neck, so it glows within the surgical discipline when utilizing our machine,” stated Mahadevan-Jansen.
“Our crew has been working diligently for a number of years to take this from idea in our lab to medical follow. It’s gratifying to now have this massive, multicenter medical trial present additional proof of its impression in efficiently and effectively figuring out PGs throughout surgical procedure. It’s our final purpose to enhance the accuracy of endocrine neck surgical procedures, which can result in improved affected person outcomes.”
There are usually 4 parathyroid glands within the human physique. The multisite randomized medical trial confirmed a big improve within the imply variety of PGs recognized throughout thyroidectomies utilizing the probe-based NIRAF—3.3 versus 2.8 with out the machine.
In bilateral parathyroidectomies, there was additionally an enchancment within the imply variety of PGs recognized utilizing the machine (3.5) versus with out (3.2). Utilizing the machine didn’t add worth throughout centered procedures the place a single overactive PG was focused for elimination.
For each the NIRAF and management teams having thyroidectomies, there was no important discount within the charges of transient or long-term hypoparathyroidism.
“PGs can have unpredictable areas and may be discovered wherever within the neck from just under the jaw to the chest, close to the guts,” stated Solórzano.
“Regular PGs are in regards to the dimension of a lentil and appear to be different tissues within the neck, to allow them to be tough to find and establish, even for expert surgeons. Our earlier medical trial at VUMC confirmed an accuracy fee of 97% when utilizing the machine to detect PGs.
“Counting on eyesight alone throughout thyroid or parathyroid procedures may not deliver the very best outcomes, so we’re excited to now have additional proof of the accuracy of this machine and to have it out there to surgeons all through the world.”
The medical trial was carried out at 4 medical facilities between March 2020 and July 2024. It concerned 752 sufferers present process surgical procedure for main hyperthyroidism or thyroid illness, with a six-month follow-up. Along with VUMC, the medical trial was additionally carried out by investigators on the College of Michigan, College of California-San Francisco and the Medical School of Wisconsin-Milwaukee.
Extra info:
Alexandria G. Cousart et al, Close to-Infrared Autofluorescence for Parathyroid Detection Throughout Endocrine Neck Surgical procedure, JAMA Surgical procedure (2025). DOI: 10.1001/jamasurg.2025.2233
Quotation:
Multicenter trial confirms near-infrared autofluorescence will increase detection of parathyroid glands (2025, August 8)
retrieved 10 August 2025
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