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Symposium: Nanotechnology for Cancer Detection and Treatment

Near-infrared fluorescent quantum dots for image-guided surgery.

Beth Israel Deaconess Medical Center, Boston, MA

Abstract

SY19-01

Our research is focused on the application of imaging technology to clinical medicine. Human surgery is presently performed "blindly," without the ability to see tissue pathology with high sensitivity and high resolution in the operating room. For example, cancer resection is performed without real-time assessment of margin status and sentinel lymph node mapping is performed without real-time image guidance. Near-infrared (NIR; typically 700–900 nm) wavelengths of light are invisible to the human eye, but penetrate relatively deeply into living tissue due to absorbance and scatter that are much lower than visible wavelengths (reviewed in (1–3)). By introducing an exogenous NIR fluorophore into the surgical field, one can use invisible NIR fluorescence to guide surgery. We have developed an intraoperative imaging system that permits anatomy (color video) and function (NIR fluorescence) to be acquired and displayed simultaneously, and in real-time (4, 5). Spatial resolution varies from 125–650 micrometers depending on the selected field-of-view, and all image windows are refreshed at up to 15 Hz. In collaboration with the laboratory of Moungi G. Bawendi, Ph.D., at the Massachusetts Institute of Technology, we have developed several families of contrast agents for intraoperative use, including inorganic/organic hybrid NIR fluorescent quantum dots (6, 7). This talk will focus on the application of nanotechnology, including near-infrared and infrared (IR) fluorescent quantum dots, to important problems in human surgery. Basic physiology, including biodistribution and clearance of quantum dots as a function of organic coating and hydrodynamic diameter will be reviewed. Data from the pre-clinical validation of quantum dots in small and large animal model systems will be presented, including sentinel lymph node mapping of the skin (6), stomach (8), esophagus (9), stomach (8), colon (8), and pleural space (10). Newer formulations of ultra-small NIR fluorescent quantum dots will also be presented.