Use of invisible near infrared light fluorescence with indocyanine green and methylene blue in urology. Part 2

INTRODUCTION: In the second part of this paper, concerning the use of invisible near infrared light (NIR) fluorescence with indocyanine green (ICG) and methylene blue (MB) in urology, other possible uses of this new technique will be presented. In kidney transplantation, this concerns allograft perfusion and real time NIR–guided angiography; moreover, perfusion angiography of tissue flaps, NIRF visualization of ureters, NIR–guided visualization of urinary calcifications, NIRF in male infertility and semen quality assessment. In this part, we have also analysed cancer targeting and imaging fluorophores as well as cost benefits associated with the use of these new techniques. MATERIAL AND METHODS: PubMed and Medline databases were searched for ICG and MB use in urological settings, along with data published in abstracts of urological conferences. RESULTS: Although NIR–guided ICG and MB are still in their initial phases, there have been significant developments in a few more major domains of urology, including 1) kidney transplantation: kidney allograft perfusion and vessel reconstruction; 2) angiography perfusion of tissue flaps; 3) visualization of ureters; 4) visualization of urinary calcifications; and 5) NIRF in male infertility and semen quality assessment. CONCLUSIONS: Near infrared technology in urology is at its early stages. More studies are needed to assess the true potential and limitations of the technology. Initial studies show that this pioneering tool may influence various aspects of urology.