Usefulness of autofluorescence detection of the parathyroid glands with PTeye system. Scope review

Introduction and ObjectiveNear-infrared (NIR) fluorescence is used to visualize anatomical structures and physiological activities in real time. The objective is to synthesize the advantages and disadvantages of the PTeye system in the identification of parathyroid glands during thyroid and parathyroid surgery. MethodA literature review of the scope of primary research articles in databases such as PubMed, WoS and Cochrane was carried out, using the search strategy "(autofluorescence AND (parathyroid glands)) AND PTeye" until January 27, 2025. We included studies with any methodology that evaluated the identification of parathyroid glands with autofluorescence in thyroid or parathyroid surgery with PTeye technology. Review articles, editorials, and individual clinical cases were excluded. ResultsWe included 8 studies that met the inclusion criteria. The results showed that PTeye has high accuracy in identifying parathyroid glands, with identification rates above 90%. The use of PTeye reduced the need for additional tests such as freeze biopsies and increased the surgeons confidence in identifying parathyroid tissue. However, some false positives were identified, including thyroid nodules and lymph nodes. The device proved to be easy to use and provided real-time feedback. ConclusionsPTeye is a useful tool to improve the identification of parathyroid glands during surgery, increasing surgeon confidence and reducing the rate of postoperative hypocalcemia. Although it has some disadvantages, such as the possibility of false positives and the need for a learning curve, its benefits outweigh these limitations. More studies are needed to confirm these findings and assess their long-term impact.