CClinicalTrials.gg
CompletedNCT05022641Updated Aug 27, 2025Results posted

Evaluating Impact of Near Infrared Autofluorescence (NIRAF) Detection for Identifying Parathyroid Glands During Parathyroidectomy

An interventional study of PTeye and Standard of Care in Parathyroid Adenoma, Parathyroid Neoplasms and Parathyroid Cancer, sponsored by University of Michigan. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-08-27.

Sponsored by University of Michigan · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
160
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study will see if the use of near infrared autofluorescence (NIRAF) detection with an FDA-cleared device 'Parathyroid Eye (PTeye)' for identifying parathyroid glands (PGs) during parathyroidectomy (PTx) procedures is better than a surgeon's detection alone. It compares risk-benefits and outcomes in PTx patients where NIRAF detection with PTeye for parathyroid identification is either used or not used.

Parathyroidectomy - look at application of the technology to see if it assists during a parathyroidectomy.

Read the detailed description

Prior to data collection, it was determined some additional outcome measures collected by the primary site would not be relevant to the trial for participating sites such as this site. Those outcomes were removed from this record.

02

Conditions studied

  • Parathyroid Adenoma
  • Parathyroid Neoplasms
  • Parathyroid Cancer
  • Hypercalcemia
  • Primary Hyperparathyroidism

Keywords

  • Parathyroidectomy
  • Intraoperative Parathyroid Identification
  • Near Infrared Autofluorescence
  • Persistent Hyperparathyroidism
  • Persistent Hypercalcemia
  • Failed Parathyroidectomy
  • Repeat Parathyroidectomy
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Primary hyperparathyroidism who will be undergoing parathyroid surgery
  • Persistent primary hyperparathyroidism after having undergone a failed prior parathyroid surgery who will be undergoing repeat parathyroid surgery

Exclusion criteria

Exclusion Criteria:

  • Pregnant women (Those patients who could potentially will receive preoperative pregnancy testing, as is standard before general anesthesia. Any patients with positive pregnancy test results will not be included in the study.)
  • Patients with concurrent parathyroid and thyroid disease that require total thyroidectomy
  • Patients with secondary or tertiary hyperparathyroidism
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
160 participants (actual)

Study arms

  • Experimental
    PTeye

    The surgeon will use the PTeye as an intraoperative tool to identify if a suspect tissue is a parathyroid or not, during the parathyroid surgery.

    Device: PTeye

  • Other
    Standard of Care

    The surgeon will rely solely on her/his surgical experience in identifying the parathyroid glands during the operations.

    Other: Standard of Care

Interventions

  • DevicePTeye

    The surgeon will first take 5 baseline NIRAF measurements on the thyroid gland (or neck muscle, if thyroid is absent) using the disposable sterile fiber probe that is connected to the PTeye console (see Figure 1), as per device functionality requirements.

  • OtherStandard of Care

    The surgeon will rely solely on her/his surgical experience in identifying the parathyroid glands during the operations.

05

What researchers measure

Primary outcomes

  1. Average Number of Parathyroid Glands Identified

    Average number of parathyroid glands identified between the Experimental Group: Glands identified with naked eye + NIRAF vs. the Control Group: Glands identified with naked eye.

    Time frame: Measured within the procedure, generally not more than 2 hours

Secondary outcomes

  1. Parathyroid Hormone (PTH) Levels 5-14 Days After Surgery

    Parathyroid hormone (PTH) levels 5-14 days after surgery. Higher levels could indicate failure of operation. Low levels could indicate temporary or permanent parathyroid damage.

    Time frame: 5-14 days after surgery

  2. Appropriate Intraoperative Parathyroid Hormone Drop

    \>50% drop from baseline at 10 minutes post-resection

    Time frame: baseline to 10 minutes

  3. Duration of Surgery

    Surgery duration in minutes

    Time frame: Measured within the procedure, generally not more than 2 hours

  4. Number of Nights Spent in the Hospital After Parathyroidectomy

    Number of nights spent for postoperative recovery in the hospital after the surgical procedure.

    Time frame: 0-72 hours after PTx procedure.

  5. Number of Frozen Sections

    Total number of frozen sections conducted for patients undergoing repeat surgery or bilateral neck explorations. Frozen sections were conducted to confirm that the parathyroid tissue for the targeted over-acting parathyroid was removed. Results reflect whether participants had a frozen section conducted.

    Time frame: Immediate

06

Results

Posted Aug 27, 2025
Limitations and caveats
The relatively small sample size may miss rare events such as operative failure. Additionally, inter-variability amongst the two surgeons and their surgical approaches adds more complexity. Lastly, these findings may only be generalizable to higher volume centers with more experienced surgeons.

Participant flow

Participant flow — Overall Study
MilestonePTeyeStandard of Care
Started8179
Completed8179
Not completed00

Outcome measures

PrimaryAverage Number of Parathyroid Glands Identified

Average number of parathyroid glands identified between the Experimental Group: Glands identified with naked eye + NIRAF vs. the Control Group: Glands identified with naked eye.

Time frame:
Measured within the procedure, generally not more than 2 hours
Reported as:
Mean · parathyroid glands per patient
Average Number of Parathyroid Glands Identified
parathyroid glands per patientPTeyeStandard of Care
Average Number of Parathyroid Glands Identified2.7 (2.4 to 2.9)2.6 (2.3 to 2.8)
Statistical analysis
  • PTeye vs Standard of Care · t-test, 2 sided · p = .6
SecondaryParathyroid Hormone (PTH) Levels 5-14 Days After Surgery

Parathyroid hormone (PTH) levels 5-14 days after surgery. Higher levels could indicate failure of operation. Low levels could indicate temporary or permanent parathyroid damage.

Time frame:
5-14 days after surgery
Reported as:
Mean · pg/mL
Parathyroid Hormone (PTH) Levels 5-14 Days After Surgery
pg/mLPTeyeStandard of Care
Parathyroid Hormone (PTH) Levels 5-14 Days After Surgery23 ± 26.925.3 ± 23.4
Statistical analysis
  • PTeye vs Standard of Care · t-test, 2 sided · p = .65
SecondaryAppropriate Intraoperative Parathyroid Hormone Drop

\>50% drop from baseline at 10 minutes post-resection

Time frame:
baseline to 10 minutes
Reported as:
Count of participants · Participants
Appropriate Intraoperative Parathyroid Hormone Drop
ParticipantsPTeyeStandard of Care
Yes4556
No3519
Statistical analysis
  • PTeye vs Standard of Care · Chi-squared · p = .02
SecondaryDuration of Surgery

Surgery duration in minutes

Time frame:
Measured within the procedure, generally not more than 2 hours
Reported as:
Mean · minutes
Duration of Surgery
minutesPTeyeStandard of Care
Duration of Surgery92.3 ± 40.288.8 ± 42.3
Statistical analysis
  • PTeye vs Standard of Care · t-test, 2 sided · p = 0.6
SecondaryNumber of Nights Spent in the Hospital After Parathyroidectomy

Number of nights spent for postoperative recovery in the hospital after the surgical procedure.

Time frame:
0-72 hours after PTx procedure.
Reported as:
Count of participants · Participants
Number of Nights Spent in the Hospital After Parathyroidectomy
ParticipantsPTeyeStandard of Care
0 nights7776
1 night43
SecondaryNumber of Frozen Sections

Total number of frozen sections conducted for patients undergoing repeat surgery or bilateral neck explorations. Frozen sections were conducted to confirm that the parathyroid tissue for the targeted over-acting parathyroid was removed. Results reflect whether participants had a frozen section conducted.

Time frame:
Immediate
Reported as:
Count of participants · Participants
Number of Frozen Sections
ParticipantsPTeyeStandard of Care
0 frozen sections taken4947
1 or more frozen sections taken3232
Statistical analysis
  • PTeye vs Standard of Care · Chi-squared · p = .6

Adverse events

Collected over Up to 6-months after surgery.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
PTeye0/81 (0%)0/81 (0%)0/81 (0%)
Standard of Care0/79 (0%)0/79 (0%)0/79 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)PTeyeStandard of CareTotal
Mean61.3 ± 15.261.1 ± 15.561.2 ± 15.3
Sex: Female, Male
Sex: Female, Male(Participants)PTeyeStandard of CareTotal
Female5965124
Male221436
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)PTeyeStandard of CareTotal
Hispanic or Latino011
Not Hispanic or Latino8178159
Unknown or Not Reported000
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)PTeyeStandard of CareTotal
White7669145
Black369
Asian134
Other112
Region of Enrollment
Region of Enrollment(participants)PTeyeStandard of CareTotal
United States8179160
Final Diagnosis
Final Diagnosis(Participants)PTeyeStandard of CareTotal
Primary sporadic hyperparathyroidism7877155
Recurrent/persistent hyperparathyroidism303
Other022
Preoperative PTH (pg/mL)
Preoperative PTH (pg/mL)(pg/mL)PTeyeStandard of CareTotal
Mean125.9 ± 78124.1 ± 66.4125 ± 72.3
Preoperative calcium (pg/dL)
Preoperative calcium (pg/dL)(pg/dL)PTeyeStandard of CareTotal
Mean11.5 ± 4.410.8 ± 0.611.2 ± 3.2

1 further baseline measures are reported on the registry.

07

Study locations

1 site
  • The University of Michigan
    Ann Arbor, Michigan 48109, United States
08

References and documents

Publications

  • Cousart AG, Kiernan CM, Willmon PA, Thomas G, Wang TS, Gauger PG, Duh QY, Underwood HJ, Jackson A, Patel A, Mahadevan-Jansen A, Solorzano CC. Near-Infrared Autofluorescence for Parathyroid Detection During Endocrine Neck Surgery: A Randomized Clinical Trial. JAMA Surg. 2025 Sep 1;160(9):936-944. doi: 10.1001/jamasurg.2025.2233. PubMed 40668552 ↗

Study documents

  • Protocol and statistical analysis plan · May 5, 2021
  • Informed consent form · May 5, 2021

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT05022641
Lead sponsor
University of Michigan
Collaborators
National Cancer Institute (NCI), Vanderbilt University
Responsible party
Paul Gauger (Ambulatory Care Clinical Chief, William J Fry Professor of Surgery and Professor of Surgery, Medical School, University of Michigan) — Principal investigator
First posted
Aug 26, 2021
Start date
Dec 1, 2021
Primary completion
May 31, 2024
Completion
May 31, 2024
Results posted
Aug 27, 2025
Last update
Aug 27, 2025

Study contacts

Paul Gauger
principal investigator · University of Michigan

Oversight

FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Aug 2025. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion