Abstract: Objective To evaluate the effect of real-time recognition of parathyroid gland(PG) intraoperatively by near-infrared autofluorescence imaging(NIRAF).
Methods The clinical data of 59 patients undergoing thyroid surgery from June 2020 to August 2020 were analyzed.PG was identified by naked eyes and NIRAF imaging respectively during operation.The suspected PG tissues with inconsistent identification results were tested by intraoperative immunocolloidal gold to verify.
Results A total of 79 thyroids were excised in 59 patients and 158 PGs were expected to be identified routinely ignoring uncommon number variation.However,only 144 PGs were finally confirmed,and the detection rate was 91.1%(144/158).In addition,the transplantation rate of PG was 4.4%(7/158).The detection rate of NIRAF imaging and naked eyes was 90.5%(143/158) and 86.7%(137/158) respectively,and the accuracy rate was 98.6%(143/145) and 100%(137/137) respectively,with no significant difference between them.It is worth mentioning that,the detection rate of NIRAF was 55.7%(88/158),significantly higher than naked eyes(31.6%,50/158) before the thyroid capsule anatomy（P＜0.05).
Conclusion The usage of intraoperative NIRAF imaging could significantly increase the recognition rate of PG before thyroid capsule anatomy with good predictability.Moreover,NIRAF imaging can perform intraoperative PG identification,locate PG before and after dissection,and find PG in vitro tissues.It has the advantages of intuitive,real-time,non-invasive,and no contrast agent,etc.,which can be a useful supplement for naked eyes.

Key words: near-infrared autofluorescence imaging, parathyroid gland, thyroid, intraoperative localization of parathyroid