Table 2. Published studies using AF (without ICG) in vivo for thyroidectomy and parathyroidectomy.
| Reference | Device used | Study group | Study question | Result |
|---|---|---|---|---|
| DiMarco et al. 2019 (24) | Fluobeam800 | 269 thyroidectomies | Does AF prevent inadvertent parathyroidectomy? | 2 inadvertent parathyroid excisions prevented but not significant (P=0.08) |
| Kose et al. 2019 (33) | Fluobeam800 | 310 patients: 173 thyroidectomy & 137 parathyroidectomy | Do PTGs reliably show AF and is AF more sensitive than surgeon identification? | 98% PTGs AF but only 23% identified before the surgeon |
| DiMarco et al. 2019 (23) | Fluobeam800 | 96 parathyroidectomy patients/284 glands | Clinical correlates of PTG AF | 90.5% PTGs detectable with AF. Correlation with serum CA and PTH |
| Thomas et al. 2019 (34) | PT-Eye +/− overlay imaging (OTIS) | 41 patients thyroidectomy & parathyroidectomy | Sensitivity of AF for PTG—pathological and normal/added value of OTIS | 98% PTG AF, no difference for normal vs. pathological tissue. Enhanced sensitivity with OTIS (98% vs. 100%) |
| Thomas et al. 2019 (35) | Comparison of lab-built device vs. PT-Eye | 162 patients thyroidectomy & parathyroidectomy | Accuracy of PTG identification with lab device vs. PT-Eye | 92.5% for lab device vs. 96.1% PT-Eye |
| Kim et al. 2018 (21) | Raspberry-Pi | Pilot study of lab-built device 3 patients undergoing thyroidectomy | Feasibility/accuracy | 100% accuracy of PTG identification |
| Kahramangil et al. 2018 (36) | Fluobeam800 | Multicentre study of 210 patients thyroidectomy & parathyroidectomy | Accuracy for AF and ability to detect before the surgeon | 98% accuracy/detection before the surgeon in 37–67% cases |
| Kahramangil et al. 2017 (37) | Fluobeam for AF/Pinpoint for ICG | 44 patients thyroidectomy: 22 AF vs. 22 ICG | Comparison of accuracy and ability to detect before the surgeon | Accuracy 98% vs. 95%. Early detection with AF |
| Kim et al. 2018 (38) | Raspberry-Pi (21) | 38 patients, 70 glands, thyroidectomy for PTC | Ability of AF to detect PTG before surgical exposure/after/at removal | 92.8% detection before surgical dissection |
| Benmiloud et al. 2018 (39) | Fluobeam800 | 513 patients: 93 with NIR and 180 controls in period 1 vs. 153 without NIR and 87 controls in period 2 | Hypocalcaemia and inadvertent parathyroidectomy with and without NIR-AF | 5.2% vs. 20.9% post op hypocalcaemia. Increase in median number of PTGs visualised NIR+ vs. NIR− |
| Ladurner et al. 2018 (40) | Karl Storz | 41 PTGs in 20 patients undergoing thyroidectomy | Ability of AF to identify PTGs | 37/41 accuracy (90.2%) |
| Kim et al. 2016 (41) | Group’s own lab device | 8 patients/16 PTGs. Thyroidectomy for PTC | Feasibility of AF for PTG identification | 100% positive predictive value |
| McWade et al. 2016 (42) | Group’s own lab device | 137 patients/264 glands | Accuracy of PTG identification/clinical factors affecting AF | 97% accuracy of PTG identification. AF correlation with BMI, serum Ca, serum vitamin D. Secondary HPT confounder |
NIR-AF, near-infrared autofluorescence; ICG, indocyanine green; PTGs, parathyroid glands; PTC, papillary thyroid carcinoma; HPT, hyperparathyroidism.