LAUSR

This study evaluates the effectiveness of near-infrared fluorescence imaging (NIRAFI) during and after parathyroidectomy in patients with primary hyperparathyroidism due to parathyroid adenoma. Forty-six patients who underwent parathyroidectomy due to parathyroid adenoma from June 2022 to September 2024 were enrolled in study. Visual and then autofluorescence identification of parathyroid adenoma were analysed with the effectiveness of the surgery, pre- and postoperative calcium and PTH concentrations, surgery time, application of NIRAFI and visual characteristics of autofluorescence. Autofluorescence identification of parathyroid adenoma prior to resection was observed in 100% of cases compared to visual effective identification in 80,4% of cases. Particularly bright autofluorescence of parathyroid adenomas was found after resection in all cases. Heterogeneous type of autofluorescence was most often observed (63%), much less often homogeneous (37%). The presence of a “cap” in the picture on a parathyroid adenoma was noted in 69,6%. A statistically significant decrease in the average parathormone concentration after surgery was found in the study group from 169.4 pg/ml to 20 pg/ml (p < 0,001). A statistically significant decrease in the average calcium concentration after the surgery from 2,87 mmol/l to 2,27 mmol/l was also observed (p < 0,001). The average duration of the operation was 58 minutes. NIRAFI has proven to be a useful and effective additional method for the identification of parathyroid adenomas both before and after resection during surgery.