Abstract

Approximately 8 million people lose their lives due to cancer each year. Metastatic disease is responsible for ~90% of those cancer-related deaths. Only viable circulating tumor cells (CTCs) that can survive in the blood circulation can create secondary tumors. Thus, real-time enumeration of CTCs and assessment of their viability in vivo has great biological significance. However, little progress has been made in this field. Conventional flow cytometry is the current technique being used for the assessment of cell viability, but there are many limitations to this technique: 1) cell properties may be altered during the extraction and processing method; 2) collection of cells from blood prevents the long-term study of individual cells in their natural biological environment; and 3) there are time-consuming preparation procedures. Whether it be for the assessment of antitumor drugs, where induction of apoptosis or necrosis is the preferred event, or the identification of nanoparticle-induced toxicity during nanotherapeutic treatment, it is clear that new approaches for assessment of the viability circulating blood cells and CTCs are urgently needed. We have developed a novel high speed, multicolor in vivo flow cytometry (FC) platform that integrates photoacoustic (PA) and fluorescence FC (PAFFC) and demonstrate its ability to enumerate rare circulating normal and abnormal (e.g. tumor) cells and assess their viability (e.g. apoptotic and necrotic) in a mouse model.

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