Photoacoustic and Fluorescence Image-Guided Surgery Using a Multifunctional Targeted Nanoprobe

• Type of Material: Article
• Authors: Lei Xi, University of Florida; Guangyin Zhou, University of Florida; Ning Gao, Emory University; Lily Yang, Emory University; David A. Gonzalo, University of Florida; Steven J. Hughes, University of Florida; Huabei Jiang, University of Florida
• Language: English
• Date: 2014-05-01
• Publisher: Springer Verlag (Germany)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 Society of Surgical Oncology.
• Final Published Version (URL): http://dx.doi.org/10.1245/s10434-014-3541-9
• Title of Journal or Parent Work: Annals of Surgical Oncology
• ISSN: 1068-9265
• Volume: 21
• Issue: 5
• Start Page: 1602
• End Page: 1609
• Grant/Funding Information: This research project was supported by the following National Institutes of Health (NIH) Grants: NIH R21CA 161384 (Huabei Jiang) and R01CA133722 (Lily Yang).
• Keywords: SCANNING-MIRROR; ONCOLOGY; BREAST-TUMOR MARGINS; Life Sciences & Biomedicine; CANCER; SENTINEL LYMPH-NODES; IN-VIVO; PARTIAL MASTECTOMY; OPTICAL CONTRAST; Science & Technology; SURGERY; SURGICAL MARGIN STATUS; Surgery; SYSTEM; TOMOGRAPHY; Oncology
• Research Categories: Engineering, Biomedical; Health Sciences, Medicine and Surgery; Health Sciences, Pathology

Abstract

Purpose: A complete surgical excision with negative tumor margins is the single most important factor in the prediction of long-term survival for most cancer patients with solid tumors. We hypothesized that image-guided surgery using nanoparticle-enhanced photoacoustic and fluorescence imaging could significantly reduce the rate of local recurrence. Methods: A murine model of invasive mammary carcinoma was utilized. Three experimental groups were included: (1) control; (2) tumor-bearing mice injected with non-targeted nanoprobe; and (3) tumor-bearing mice injected with targeted nanoprobe. The surgeon removed the primary tumor following the guidance of photoacoustic imaging (PAI), then inspected the surgical wound and removed the suspicious tissue using intraoperative near-infrared (NIR) fluorescence imaging. The mice were followed with bioluminescence imaging weekly to quantify local recurrence. Results: Nanoprobe-enhanced photoacoustic contrast enabled PAI to map the volumetric tumor margins up to a depth of 31 mm. The targeted nanoparticles provided significantly greater enhancement than non-targeted nanoparticles. Seven mice in the group injected with the targeted nanoprobes underwent additional resections based upon NIR fluorescence imaging. Pathological analysis confirmed residual cancer cells in the re-resected specimens in 5/7 mice. Image-guided resection resulted in a significant reduction in local recurrence; 8.7 and 33.3 % of the mice in the targeted and control groups suffered recurrence, respectively. Conclusions: These results suggest that photoacoustic and NIR intraoperative imaging can effectively assist a surgeon to locate primary tumors and to identify residual disease in real-time. This technology has promise to overcome current clinical challenges that result in the need for second surgical procedures.