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We present a novel label\u2010free approach that uses near\u2010infrared autofluorescence (NIRAF) detection, which demonstrates potential for enhanced intraoperative AG visualization and efficient tumor resection during adrenalectomies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients undergoing adrenalectomy or nephrectomy were enrolled for this feasibility study. NIRAF emitted beyond 800\u00a0nm was detected in vivo from AGs and surrounding tissues during open adrenalectomies or nephrectomies. NIRAF was also measured ex vivo in excised AGs following robotic adrenalectomies. NIRAF images of tissues were captured using near\u2010infrared (NIR) camera systems, whereas NIRAF intensities were recorded concurrently using fiber\u2010optic probe\u2010based NIR devices. Normalized NIRAF intensities (expressed as mean\u2009\u00b1\u2009standard error) were analyzed and compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 55 enrolled patients, NIRAF intensity was elevated significantly for AGs versus retroperitoneal fat and other structures. NIR images of AGs also revealed a distinct demarcation of NIRAF between adrenal cortex and other periadrenal structures. NIRAF intensity in AGs was decreased markedly in malignant adrenal tumors, while benign adrenal cortical tumors and healthy adrenal cortex exhibited the strongest NIRAF levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our preliminary findings indicate that NIRAF detection could be a promising label\u2010free technology to enhance intraoperative AG visualization and holds immense potential for effective tumor demarcation during cortical\u2010sparing adrenalectomies or adrenal\u2010conserving surgeries.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06755-y","type":"journal-article","created":{"date-parts":[[2022,10,2]],"date-time":"2022-10-02T22:02:21Z","timestamp":1664748141000},"page":"350-360","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Label\u2010Free Enhancement of Adrenal Gland Visualization Using Near\u2010Infrared Autofluorescence for Surgical 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