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CompletedNCT05022667Updated Aug 8, 2025Results posted

Assessing Benefits of Near Infrared Autofluorescence (NIRAF) Detection for Identifying Parathyroid Glands During Total Thyroidectomy

An interventional study of PTeye in Thyroid Neoplasms, Thyroid Diseases and Hypoparathyroidism, 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 2025-08-08.

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

Phase
Not applicable
Study type
Interventional
Enrollment
114
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 a 'Parathyroid Eye (PTeye)' for identifying parathyroid glands (PGs) during total thyroidectomy (TTx) is better than surgeon's detection alone. It compares risk, benefits and outcomes in TTx patients where NIRAF detection with PTeye for parathyroid identification is either used or not used.

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

  • Thyroid Neoplasms
  • Thyroid Diseases
  • Hypoparathyroidism
  • Endocrine System Diseases
  • Endocrine Gland Neoplasms
  • Neoplasms by Site
  • Neoplasms
  • Head and Neck Neoplasms
  • Parathyroid Diseases

Keywords

  • Total Thyroidectomy
  • Intraoperative Parathyroid Identification
  • Near Infrared Autofluorescence
  • Postoperative Hypocalcemia
  • Postoperative Hypoparathyroidism
03

Who can participate

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

Inclusion criteria

  • Patients with thyroid disease who will be undergoing total thyroidectomy (includes patients who have undergone a prior neck exploration for parathyroid disease or other but have an intact thyroid gland).
  • Patients with persisting thyroid disease and will be undergoing re-operative or completion thyroidectomy.

Exclusion criteria

Exclusion Criteria:

  • Pregnant women
  • Patients with concurrent parathyroid and thyroid disease
  • Patients with incidental enlarged parathyroid discovered during thyroidectomy procedure.
  • Patients undergoing thyroid lobectomy or partial thyroidectomy
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
114 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 total thyroidectomy procedure.

    Device: PTeye

  • No intervention
    Standard of Care

    The surgeon will not use the PTeye and will proceed with the total thyroidectomy as usual, while relying solely on her/his surgical experience in identifying the parathyroid glands during the operations.

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, as per device functionality requirements.

05

What researchers measure

Primary outcomes

  1. The Average Number of Parathyroid Glands Identified (Experimental Group: Glands Identified With Naked Eye + NIRAF; Control Group: Glands Identified With Naked Eye) Per Patient

    Overall number of parathyroid glands identified (Experimental Group: Glands identified with naked eye + NIRAF; Control Group: Glands identified with naked eye)

    Time frame: Immediate (During total thyroidectomy procedure)

Secondary outcomes

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

    Blood parathyroid hormone (PTH) levels at 5-14 days post-op

    Time frame: 5-14 days after surgery

  2. Blood Parathyroid Hormone (PTH) Levels at 24-48 Hours After Surgery

    Blood parathyroid hormone (PTH) levels at 24-48 hours after surgery

    Time frame: Within 24-48 hours after surgery

  3. Blood Calcium Levels 24-48 Hours After Surgery

    Blood calcium levels 24-48 hours after surgery

    Time frame: Within 24-48 hours after surgery

  4. Duration in Minutes of Surgery

    Duration of surgery (minutes)

    Time frame: Collected immediately following surgery

  5. Number of Frozen Section Analysis Performed.

    Number of frozen section analysis performed. Samples of a suspected piece of parathyroid tissue were removed and analyzed to confirm whether they were actually parathyroid tissue. Results reflect the participants who were determined to have had a frozen section conducted.

    Time frame: Collected immediately following surgery

  6. Number of Auto-transplanted Parathyroid Glands

    Number of auto-transplanted parathyroid glands if the parathyroid gland was accidentally excised/devascularized.

    Time frame: Immediate. During total thyroidectomy procedure

  7. Number of Nights Spent in the Hospital After Total Thyroidectomy

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

    Time frame: 0 - 4 nights after total thyroidectomy

  8. Number of Inadvertently Resected Parathyroid Glands

    Number of inadvertently resected parathyroid glands when parathyroid tissue is found in the resected thyroid specimens. Results reflect the participants who had an inadvertently resected parathyroid gland.

    Time frame: Immediate (intraoperative) to 7-10 days after total thyroidectomy (as presented in the pathology report)

06

Results

Posted Aug 8, 2025
Limitations and caveats
The median follow-up time of participants was 5-14 days post-operation. Therefore, we lack long-term follow-up (\> 6 months) for the majority of the participants.

Participant flow

Participant flow — Overall Study
MilestonePTeyeStandard of Care
Started5757
Completed5757
Not completed00

Outcome measures

PrimaryThe Average Number of Parathyroid Glands Identified (Experimental Group: Glands Identified With Naked Eye + NIRAF; Control Group: Glands Identified With Naked Eye) Per Patient

Overall number of parathyroid glands identified (Experimental Group: Glands identified with naked eye + NIRAF; Control Group: Glands identified with naked eye)

Time frame:
Immediate (During total thyroidectomy procedure)
Reported as:
Mean · parathyroid glands per patient
The Average Number of Parathyroid Glands Identified (Experimental Group: Glands Identified With Naked Eye + NIRAF; Control Group: Glands Identified With Naked Eye) Per Patient
parathyroid glands per patientPTeyeStandard of Care
The Average Number of Parathyroid Glands Identified (Experimental Group: Glands Identified With Naked Eye + NIRAF; Control Group: Glands Identified With Naked Eye) Per Patient3.1 (2.8 to 3.3)2.9 (2.6 to 3.2)
Statistical analysis
  • PTeye vs Standard of Care · t-test, 2 sided · p = 0.3
SecondaryBlood Parathyroid Hormone (PTH) Levels at 5-14 Days After Surgery

Blood parathyroid hormone (PTH) levels at 5-14 days post-op

Time frame:
5-14 days after surgery
Reported as:
Mean · pg/mL
Blood Parathyroid Hormone (PTH) Levels at 5-14 Days After Surgery
pg/mLPTeyeStandard of Care
Blood Parathyroid Hormone (PTH) Levels at 5-14 Days After Surgery35.6 ± 25.341 ± 34.7
Statistical analysis
  • PTeye vs Standard of Care · t-test, 2 sided · p = .5
SecondaryBlood Parathyroid Hormone (PTH) Levels at 24-48 Hours After Surgery

Blood parathyroid hormone (PTH) levels at 24-48 hours after surgery

Time frame:
Within 24-48 hours after surgery
Reported as:
Mean · pg/mL
Blood Parathyroid Hormone (PTH) Levels at 24-48 Hours After Surgery
pg/mLPTeyeStandard of Care
Blood Parathyroid Hormone (PTH) Levels at 24-48 Hours After Surgery20.7 ± 11.624.3 ± 16.6
Statistical analysis
  • PTeye vs Standard of Care · t-test, 2 sided · p = .2
SecondaryBlood Calcium Levels 24-48 Hours After Surgery

Blood calcium levels 24-48 hours after surgery

Time frame:
Within 24-48 hours after surgery
Reported as:
Mean · pg/dL
Blood Calcium Levels 24-48 Hours After Surgery
pg/dLPTeyeStandard of Care
Blood Calcium Levels 24-48 Hours After Surgery9.4 ± .59.3 ± .5
Statistical analysis
  • PTeye vs Standard of Care · t-test, 2 sided · p = 0.3
SecondaryDuration in Minutes of Surgery

Duration of surgery (minutes)

Time frame:
Collected immediately following surgery
Reported as:
Mean · minutes
Duration in Minutes of Surgery
minutesPTeyeStandard of Care
Duration in Minutes of Surgery126.2 ± 39.6120.3 ± 34.7
Statistical analysis
  • PTeye vs Standard of Care · t-test, 2 sided · p = .4
SecondaryNumber of Frozen Section Analysis Performed.

Number of frozen section analysis performed. Samples of a suspected piece of parathyroid tissue were removed and analyzed to confirm whether they were actually parathyroid tissue. Results reflect the participants who were determined to have had a frozen section conducted.

Time frame:
Collected immediately following surgery
Reported as:
Count of participants · Participants
Number of Frozen Section Analysis Performed.
ParticipantsPTeyeStandard of Care
05555
1 or more22
SecondaryNumber of Auto-transplanted Parathyroid Glands

Number of auto-transplanted parathyroid glands if the parathyroid gland was accidentally excised/devascularized.

Time frame:
Immediate. During total thyroidectomy procedure
Reported as:
Count of participants · Participants
Number of Auto-transplanted Parathyroid Glands
ParticipantsPTeyeStandard of Care
04146
11610
2 or more01
Statistical analysis
  • PTeye vs Standard of Care · Chi-squared · p = .3
SecondaryNumber of Nights Spent in the Hospital After Total Thyroidectomy

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

Time frame:
0 - 4 nights after total thyroidectomy
Reported as:
Count of participants · Participants
Number of Nights Spent in the Hospital After Total Thyroidectomy
ParticipantsPTeyeStandard of Care
0 nights00
1 night5757
> 1 night00
SecondaryNumber of Inadvertently Resected Parathyroid Glands

Number of inadvertently resected parathyroid glands when parathyroid tissue is found in the resected thyroid specimens. Results reflect the participants who had an inadvertently resected parathyroid gland.

Time frame:
Immediate (intraoperative) to 7-10 days after total thyroidectomy (as presented in the pathology report)
Reported as:
Count of participants · Participants
Number of Inadvertently Resected Parathyroid Glands
ParticipantsPTeyeStandard of Care
Number of Inadvertently Resected Parathyroid Glands55

Adverse events

Collected over Adverse event data was collected up to 6-months after surgery.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
PTeye0/57 (0%)0/57 (0%)0/57 (0%)
Standard of Care0/57 (0%)0/57 (0%)0/57 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)PTeyeStandard of CareTotal
Mean51.2 ± 16.952.6 ± 1651.9 ± 16.4
Sex: Female, Male
Sex: Female, Male(Participants)PTeyeStandard of CareTotal
Female444387
Male131427
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)PTeyeStandard of CareTotal
Hispanic or Latino325
Not Hispanic or Latino5455109
Unknown or Not Reported000
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)PTeyeStandard of CareTotal
White474996
Black437
Asian347
Other314
Region of Enrollment
Region of Enrollment(Participants)PTeyeStandard of CareTotal
United States5757114
Preoperative calcium (pg/dL)
Preoperative calcium (pg/dL)((pg/dL))PTeyeStandard of CareTotal
Mean9.4 ± 0.59.5 ± 0.49.5 ± 0.5
Preoperative PTH (pg/mL)
Preoperative PTH (pg/mL)((pg/mL))PTeyeStandard of CareTotal
Mean48.2 ± 22.478.3 ± 2564.6 ± 27.9
Preoperative vitamin D (mcg)
Preoperative vitamin D (mcg)(mcg)PTeyeStandard of CareTotal
Mean33 ± 13.629.3 ± 1130.9 ± 12

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 · Jun 24, 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
NCT05022667
Lead sponsor
University of Michigan
Collaborators
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 8, 2025
Last update
Aug 8, 2025

Study contacts

Paul Gauger, MD
principal investigator · University of Michigan

Oversight

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

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