Abstract
PURPOSE: To evaluate the clinical utility of endoscopic laser speckle contrast imaging (eLSCI) for intraoperative assessment of parathyroid gland (PTG) perfusion and functional preservation. METHODS: Fifteen patients undergoing unilateral/bilateral thyroidectomy at The Affiliated Lihuili Hospital of Ningbo University (November 2024 to April 2025) were prospectively enrolled. PTG perfusion was quantified using eLSCI by recording blood flow index (BFI) before and after thyroid resection. Serum parathyroid hormone (PTH) and calcium levels were measured preoperatively, at 15-min post-resection, and 24-h postoperatively. Pearson correlation analysis was used to assess the linear association between perfusion and functional parameters, while Spearman's rank correlation test was concurrently performed to verify the robustness. RESULTS: A significant correlation existed between the BFI change ratio and PTH change ratio at 15-min post-resection (r = 0.672, p = 0.006) and 24-h postoperatively (r = 0.671, p = 0.006). No significant correlation was observed between BFI change ratio and serum calcium change ratio at either timepoint (p > 0.05). CONCLUSION: The eLSCI system enables real-time quantitative assessment of intraoperative parathyroid perfusion and demonstrates feasibility in predicting postoperative parathyroid function, holding significant potential for clinical application.