Table 7:

Advantages and pitfalls when utilizing probe-based NIRAF detection system – PTeye™ in thyroid and parathyroid operative procedures (PG, parathyroid gland; FSA, frozen section analyses; PTH, parathyroid hormone).

	Advantages	Possible pitfalls
PTeye™ utilization in neck endocrine operative procedures	Real-time intraoperative feedback on whether tissue is PG or not. May reduce the use of FSA for PG tissue confirmation or before autotransplantation May reduce the use of tissue aspirate for PTH level analysis. Improves surgeon confidence at all levels of surgeon experience. Can serve as a real-time intraoperative educational tool for trainees. May expedite OR time by avoiding FSA or improving confidence on the identification of PG tissue.	Failure in setting up PTeye™: Probe not properly connected or error arising from inaccurate baseline (FP or FN). False positives: thyroid cancer, thyroid nodule, lymph nodes, and brown fat. Baseline set up to be lower than what it should be. False negatives: Baseline set up to be higher than what it should be. The adenomatous region of a diseased gland may have low ratios due to heterogeneity of NIRAF typically observed in diseased PGs - leads to low and high ratios in the same gland. PTeye™ does not assess parathyroid perfusion/viability. Recurring costs per probe as the sterile probe is meant to be disposed after each patient and is not reusable.