Near-Infrared Autofluorescence or Intraoperative Parathyroid Hormone Determination as a Surgical Support Tool in Primary Hyperparathyroidism: Too Close to Call?

This study evaluates the effectiveness of near-infrared fluorescence imaging (NIFI) as a replacement for intraoperative parathyroid hormone (ioPTH) measurement during minimally invasive parathyroidectomy (MIP) in patients with primary hyperparathyroidism due to parathyroid adenoma. Fifty patients participated, undergoing preoperative imaging to locate the adenoma. The results indicated that MIP was successful in all cases, with a mean time to excision of the adenoma of 44.7 min and a total surgical duration of 85.5 min. The study also identified three distinct fluorescence patterns of the adenomas. Notably, when preoperative imaging confirms adenoma location, NIFI may reduce surgical time without compromising outcomes, suggesting a potential shift in surgical practice for PHP treatment