Intraoperative near-infrared autofluorescence in parathyroidectomy: associations with gland morphology, body mass index, and histopathology

Background: Identifying parathyroid glands during surgery is challenging. Recent studies suggest that near-infrared autofluorescence (NIRAF) detection can improve their recognition. However, the correlation between positive NIRAF detection and clinical features in parathyroidectomy remains unclear. This study aimed to explore correlation between positive NIRAF detection and clinical features in parathyroid surgery, aiming to improve the application of this technology. Methods: Prospective data were collected from patients undergoing parathyroidectomy using handheld NIRAF devices. Data included the ratio of parathyroid NIRAF to baseline, and clinical features such as age, gender, body mass index (BMI), parathyroid gland size, preoperative blood calcium, parathyroid hormone levels, and pathological properties. Factors influencing parathyroid autofluorescence intensity were evaluated. Results: From June 2023 to June 2024, 20 primary and 19 secondary hyperparathyroidism patients with 98 parathyroid lesions were analyzed. NIRAF probe detection showed no significant correlation with age, gender, or preoperative serum calcium. However, it was significantly correlated with parathyroid volume, BMI, and pathological properties. Smaller glands, lower BMI, and diffuse parathyroid hyperplasia were more easily detected by near-infrared probes (P