Abstract

Simple SummaryOvarian cancer has a greater mortality rate than all gynecological malignancies combined. While cytoreductive surgery remains the primary therapeutic approach, its success is limited by the inability to visualize all tumor nodules for resection. We developed light activated nano-sized particles derived from red blood cells as potential imaging probes for near infrared fluorescence imaging of tumors during cytoreductive surgery. We present the first demonstration of the use of these nanoparticles in conjunction a spatially-modulated illumination (SMI) modality to image ovarian intraperitoneal tumors in mice. Our findings indicate that, at 24 h post-administration, these nanoparticles accumulated at higher levels in tumors as compared to organs, and that use of SMI enhances the image contrast.Ovarian cancer is the deadliest gynecological cancer. Cytoreductive surgery to remove primary and intraperitoneal tumor deposits remains as the standard therapeutic approach. However, lack of an intraoperative image-guided approach to enable the visualization of all tumors can result in incomplete cytoreduction and recurrence. We engineered nano-sized particles derived from erythrocytes that encapsulate the near infrared (NIR) fluorochrome, indocyanine green, as potential imaging probes for tumor visualization during cytoreductive surgery. Herein, we present the first demonstration of the use of these nanoparticles in conjunction with spatially-modulated illumination (SMI), at spatial frequencies in the range of 0–0.5 mm−1, to fluorescently image intraperitoneal ovarian tumors in mice. Results of our animal studies suggest that the nanoparticles accumulated at higher levels within tumors 24 h post-intraperitoneal injection as compared to various other organs. We demonstrate that, under the imaging specifications reported here, use of these nanoparticles in conjunction with SMI enhances the fluorescence image contrast between intraperitoneal tumors and liver, and between intraperitoneal tumors and spleen by nearly 2.1, and 3.0 times, respectively, at the spatial frequency of 0.2 mm−1 as compared to the contrast values at spatially-uniform (non-modulated) illumination. These results suggest that the combination of erythrocyte-derived NIR nanoparticles and structured illumination provides a promising approach for intraoperative fluorescence imaging of ovarian tumor nodules at enhanced contrast.

Highlights

  • We have previously reported on toxicological evaluation of nRBCs-Indocyanine green (ICG) using blood chemistry and hematological profiling, and histological analysis [41]

  • Future studies will include the optimization of the number concentration of nRBCs-ICG and the imaging time point as methods to further enhance the image contrast

  • We presented the first demonstration of the use of nRBCs-ICG in conjunction with spatially modulated illumination for fluorescence imaging of intraperitoneal ovarian tumors in mice

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Summary

Introduction

Ovarian cancer has the greatest mortality rate than all gynecological malignancies combined [1]. Epithelial ovarian cancer (EOC) arising from the ovarian surface epithelium creativecommons.org/licenses/by/ 4.0/). The 5-year survival rate is relatively high (~92%) if diagnosed at stage I when the cancer is still localized in one or both ovaries or the fallopian tubes, but significantly drops to less than 30% if diagnosed at stage III-IV where the cancer metastasizes beyond the pelvic region [4]. One of the most important factors for improving survival rate is the success of cytoreductive surgery with complete resection of all visible cancer [5,6,7]. Several studies recommend resecting all “visible” lesions, and not just cytoreduction of tumor nodules

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