Parathyroid identification during thyroid and parathyroid operations: A pilot study evaluating a novel low cost autofluorescence based device

The aim of this study was to develop a low-cost prototype near-infrared fluorescence device that enables contrast-free, real time, high-resolution intraoperative visualization of normal and pathological parathyroid glands (PGs) by imaging their autofluorescence (AF). A novel near-infrared parathyroid AF (NIR-PAF) imaging device with visible laser PG targeting was developed. The device was evaluated during parathyroid and thyroid operations in a pilot clinical study. Overall, of the 6 parathyroidectomies carried out in the study population a parathyroid adenoma was found to exhibit AF ex vivo in 6/6 (100%) of cases, and in vivo in 3/3 (100%) of these cases. Two of 4 thyroidectomies were evaluated in vivo and all PGs (6 PGs total) were identified by the NIR-PAF device. The NIRPAF device cost less than $1200 Canadian to build. The inexpensive NIR-PAF device that we developed can successfully intraoperatively identify both normal and pathological PGs. •Near-infrared parathyroid autofluoresence (NIR-PAF) assists with parathyroid identification.•A novel prototype NIR-PAF autofluoresence imaging device was developed.•A surgeon and team of engineers designed, built, and tested the device.•The device was able to accurately identify normal parathyroid glands and adenomas in a pilot study.•The NIR-PAF device cost less than $1000 Canadian to build.