In this 2024 Update Course Rewind session, pediatric surgeons Dr. Justin Huntington and Dr. Ben Ham explore the emerging use of autofluorescence and ICG angiography during thyroid surgery. These imaging technologies are helping identify and assess parathyroid gland perfusion, with the goal of reducing hypocalcemia and improving long-term outcomes—especially in pediatric patients.

Classified as a Black Diamond (early adopter practice), this approach is still gaining traction in pediatric centers, but adult trials are already showing promise.

Key Highlights:

• What is Autofluorescence? A no-injection technique that uses natural gland fluorescence to locate parathyroids during surgery.
• ICG Angiography: Assessing real-time perfusion of glands to determine viability and reimplantation need.
• Clinical Impact: Reduced rates of post-op hypocalcemia, improved identification of glands in surgical specimens, and more targeted decision-making.
• Challenges in Practice: Equipment bulkiness, variable image quality, and limited adoption in lower-volume pediatric centers.

While further pediatric data are needed, this episode shows how new technologies may shape the future of thyroid surgery—especially in safeguarding parathyroid function.