Feasibility of combined near infrared autofluorescence and indocyanine green fluorescence imaging in the management of parathyroid glands.

BACKGROUND: Autofluorescence (AF) imaging helps identify parathyroid glands (PGs), while indocyanine green (ICG) imaging demonstrates perfusion. No device has historically provided both types of imaging interchangeably. Aim of this study is to assess the efficacy of a new device that provides both functions. METHODS: This prospective study evaluated efficacy of a new fluorescence device that provides AF and ICG imaging in a combined fashion. RESULTS: 16 patients with 44 PGs were assessed. AF imaging after ICG injection was feasible in 98% of the time. While a satisfactory angiogragm was obtained in 78% of the time with ICG injection, a visual recognition of increase in fluorescence by the surgeon was challenging due to the grayscale imaging involved. CONCLUSIONS: Concurrent AF and ICG fluorescence imaging is possible with advances in optical engineering. However, perfusion assessment using the device based on human eye perception was challenging, suggesting the need for quantification.