Preclinical study on new parathyroid recognition technology in thyroid surgery

Background: The parathyroid gland is the smallest organ in the organism, with an important function of regulating blood calcium in the human body. The accidental resection of the parathyroid gland during thyroid surgery cannot be ignored, so attention should be paid to the identification of the parathyroid gland.

Methods: 

1. Iron oxide nanoparticles were locally injected into the thyroid gland. Since iron oxide nanoparticles are black, they can stain the thyroid gland and lymph nodes black, while the parathyroid gland is not stained, thus achieving negative imaging of the parathyroid gland.

2. Antibody-coupled fluorescence technology was applied. A fluorescent probe was prepared by linking fluorescence to the calcium-sensing receptor, which was then injected intravenously. The parathyroid gland specifically expresses the calcium-sensing receptor; through antigen-antibody binding, the fluorescence is delivered to the parathyroid gland, realizing positive imaging of the parathyroid gland.

Results: Iron oxide nanoparticles could achieve negative imaging of the parathyroid gland in rat and New Zealand rabbit models with little surrounding contamination. In the rat model, positive imaging of the parathyroid gland was observed using the calcium-sensing receptor-linked fluorescence. 

Conclusion: The negative and positive imaging technologies for the parathyroid gland play a role in identifying the parathyroid gland during thyroid surgery and are worthy of further clinical research.

Zheng Weihui is a clinical doctor who has long been engaged in thyroid surgery. She holds a Doctor of Medicine degree, has completed postdoctoral research, and serves as a master's supervisor and a specially-appointed associate researcher. She is a young health talent in Zhejiang Province and a visiting scholar at A-Star (Agency for Science, Technology and Research) in Singapore. Specializing in surgeries of the thyroid and parathyroid glands, she is committed to solving practical problems related to surgery, with a focus on the intraoperative protection of the recurrent laryngeal nerve and research on parathyroid identification.