{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T23:27:35Z","timestamp":1786750055440,"version":"build-2736575974"},"reference-count":33,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,11,30]],"date-time":"2024-11-30T00:00:00Z","timestamp":1732924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: This study investigates the use of near-infrared fluorescence imaging (NIFI) as an alternative to intraoperative parathyroid hormone (ioPTH) measurement in patients with primary hyperparathyroidism (PHP) due to parathyroid adenoma (PA) with two preoperative imaging examinations in agreement on the position of the altered parathyroid gland. Methods: Fifty patients who underwent minimally invasive parathyroidectomy (MIP) from March 2021 to April 2024 were enrolled. MIPs utilised both NIFI and ioPTH, comparing the time to adenoma excision with NIFI against the total surgical time, including ioPTH measurement wait time. Results: Results showed successful MIPs in all patients, with a mean excision time of 44.7 min (SD \u00b1 25.2) and a total procedure time of 85.5 min (SD \u00b1 37.1). The median of the duration of the surgical procedure until adenoma excision was 35.0 min (IQR 38.8), while the median duration of the entire procedure was 74.5 min (IQR 40.5). This difference in medians is statistically significant using the Wilcoxon non-parametric test for paired samples (p &lt; 0.001). The average wait for ioPTH results post-excision was 37 min (SD \u00b1 12.2). Three fluorescence patterns were identified: \u201ccap\u201d (46%), heterogeneous (30%), and homogeneous (24%). Conclusions: If preoperative imaging confirms PA location, NIFI could replace ioPTH reducing surgical time without compromising success rates.<\/jats:p>","DOI":"10.3390\/cancers16234018","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T04:04:04Z","timestamp":1733198644000},"page":"4018","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Near-Infrared Autofluorescence or Intraoperative Parathyroid Hormone Determination as a Surgical Support Tool in Primary Hyperparathyroidism: Too Close to Call?"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7447-0994","authenticated-orcid":false,"given":"Pietro","family":"Indelicato","sequence":"first","affiliation":[{"name":"Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4702-2090","authenticated-orcid":false,"given":"Emilio","family":"Salerno","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"},{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7260-9126","authenticated-orcid":false,"given":"Alberto","family":"Tettamanti","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"},{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilda Tersilla","family":"Guizzardi","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"},{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2677-8091","authenticated-orcid":false,"given":"Andrea","family":"Galli","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"},{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Frattini","sequence":"additional","affiliation":[{"name":"Division of Surgery, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy"},{"name":"Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9094-4205","authenticated-orcid":false,"given":"Leone","family":"Giordano","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"},{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Bussi","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"},{"name":"School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianlorenzo","family":"Dionigi","sequence":"additional","affiliation":[{"name":"Division of Surgery, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy"},{"name":"Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"16033","DOI":"10.1038\/nrdp.2016.33","article-title":"Primary hyperparathyroidism","volume":"2","author":"Bilezikian","year":"2016","journal-title":"Nat. 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