Fluorecence imaging – a game-changer for endocrine surgery in German university hospital

The Fluoptics technology enables the combined use of autofluorescence and fluorescence imaging with indocyanine green (ICG) in real time. This allows surgeons to accurately visualize both the location and perfusion of the parathyroid glands, and provides intraoperative guidance to significantly increase parathyroid gland identification rates.

“We were one of the first centers in the German-speaking region to use fluorescence imaging, and we now apply it routinely in thyroid and parathyroid surgery, performing approximately 500 procedures per year. The patients benefit from the technology, because every parathyroid gland that can be preserved is a success,” explains Prof. Dr. Kerstin Lorenz, Head of Endocrine Surgery and Deputy Director of the Department of Visceral, Vascular and Endocrine Surgery at Halle University Hospital.

Up to 31% of thyroidectomies result in the accidental removal of parathyroid glands. Even though the resulting hypoparathyroidism usually is temporary, it may have a significant impact on patients' quality of life if it becomes permanent.

“Health consequences include chronic hypoparathyroidism, which may lead to disrupted calcium metabolism, tissue calcification, and significantly reduced resilience. In worst case, these effects can contribute to increased mortality,” Prof. Dr. Kerstin Lorenz says.

A major advantage of NIR imaging is that it helps surgeons make more confident decisions about preserving healthy-looking thyroid tissue in cases of benign thyroid disease.

“We use autofluorescence to identify patterns that help us assess the severity of hyperparathyroidism and choose the best surgical strategy. Diseased glands generally fluoresce less than healthy ones and exhibit an irregular pattern. In oncology, these fluorescence patterns also help distinguish typical parathyroid adenomas from atypical or malignant lesions,” Prof. Dr. Kerstin Lorenz explains.

Even when a gland is accidentally removed, autofluorescence imaging still allows for intraoperative identification on the back table in the sterile field – so that the tissue can be auto transplanted.

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