Letter to the Editor “Application and Evaluation of Indocyanine Green Fluorescence Imaging in Pediatric Testicular Torsion Surgery”

jpedsurg.org

We read with great interest the recent article “Application and Evaluation of Indocyanine Green Fluorescence Imaging in Pediatric Testicular Torsion Surgery” by Dai et al., [1]. The study highlights the importance to introduce ICG-NIRF imaging into the challenging setting of pediatric testicular torsion, where intraoperative decision-making remains highly subjective. However, we would like to raise a few important points for consideration. Experimental data have shown that irreversible germ cell necrosis can occur as early as 6 to 8 hours after ischemia, even when reperfusion signals remain detectable.

jpedsurg.org shows its articles on its own site.

Read the article on jpedsurg.org ↗

Article · Sep 2025 · 1 min read

In brief

This letter discusses the application of ICG near-infrared fluorescence imaging for assessing testicular viability during pediatric torsion surgery. The authors emphasize that while ICG imaging shows promise for intraoperative decision-making, irreversible germ cell damage may occur within 6-8 hours despite detectable reperfusion signals, highlighting limitations in current viability assessment methods.

ICG-NIRF imaging shows promise for objective assessment of testicular viability during torsion surgery in pediatric patients.
Irreversible germ cell necrosis can occur within 6-8 hours of ischemia, even when reperfusion signals are still detectable.
Intraoperative decision-making in testicular torsion remains subjective; fluorescence imaging may improve but not eliminate clinical judgment.
Detectable reperfusion on ICG imaging does not guarantee testicular salvage due to potential microscopic germ cell damage.
Time to surgical intervention remains critical; imaging adjuncts complement but cannot replace urgent operative management.

Written by the GCMD Library team from the article.

Read it at the source ↗