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Figure 5 from Shortwave Infrared Imaging Enables High-Contrast Fluorescence-Guided Surgery in Neuroblastoma

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posted on 2023-06-15, 08:20 authored by Laura Privitera, Dale J. Waterhouse, Alessandra Preziosi, Irene Paraboschi, Olumide Ogunlade, Chiara Da Pieve, Marta Barisa, Olumide Ogunbiyi, Gregory Weitsman, J. Ciaran Hutchinson, Kate Cross, Lorenzo Biassoni, Danail Stoyanov, Neil Sebire, Paul Beard, Paolo De Coppi, Gabriela Kramer-Marek, John Anderson, Stefano Giuliani

In vitro multispectral NIR-I/SWIR fluorescence imaging of anti–GD2-IR800 and anti–GD2-IR12 A. Schematic representation of selected cell lines (left) and number of cells used (right) to assess the camera sensitivity. Cells were stained with 100 nmol/L of anti–GD2-IR800 and anti–GD2-IR12 and prepared as pellets in microcentrifuge tubes [tubes 1–4, GD2-positive; tubes 5–8, SUPT1-WT (GD2-negative)]. B, Multispectral NIR-I/SWIR images were acquired. Images are shown for 1,050-nm LP filter LAN-1 cells (tubes 1–4) and SUPT1- WT cells (tubes 5–8) with anti–GD2-IR800 and anti–GD2-IR12 on the same fluorescence intensity scale. Yellow dotted lines show the approximate positions of Eppendorf tubes. C, The SBR was calculated as the MFI of each cell pellet divided by the MFI of the control cell pellets for the corresponding cell line and dye. Data are shown for the 850-nm long-pass filter. Error bars are derived from the SEs within the signal and background ROIs. D, MFI of anti–GD2-IR800 and anti–GD2-IR12 decrease towards longer wavelengths. The shaded region represents SE over pixels in ROI. Exposure time = 25 ms.

Funding

NIHR Great Ormond Street Hospital Biomedical Research Centre (BRC)

research into childhood cancer

GOSHCC Cancer infrastructure award

Royal Academy of Engineering chair in emerging Technologies Scheme

Medical Research Council (MRC)

Wellcome Trust (WT)

University College London Wellcome/EPSRC Centre for Interventional and Surgical Sciences

Engineering and Physical Sciences Research Council (EPSRC)

Cancer Research UK (CRUK)

European Research Council (ERC)

History

ARTICLE ABSTRACT

Fluorescence-guided surgery is set to play a pivotal role in the intraoperative management of pediatric tumors. Shortwave infrared imaging (SWIR) has advantages over conventional near-infrared I (NIR-I) imaging with reduced tissue scattering and autofluorescence. Here, two NIR-I dyes (IRDye800CW and IR12), with long tails emitting in the SWIR range, were conjugated with a clinical-grade anti-GD2 monoclonal antibody (dinutuximab-beta) to compare NIR-I and SWIR imaging for neuroblastoma surgery. A first-of-its-kind multispectral NIR-I/SWIR fluorescence imaging device was constructed to allow an objective comparison between the two imaging windows. Conjugates were first characterized in vitro. Tissue-mimicking phantoms, imaging specimens of known geometric and material composition, were used to assess the sensitivity and depth penetration of the NIR-I/SWIR device, showing a minimum detectable volume of ∼0.9 mm3 and depth penetration up to 3 mm. In vivo, fluorescence imaging using the NIR-I/SWIR device showed a high tumor-to-background ratio (TBR) for both dyes, with anti–GD2-IR800 being significantly brighter than anti–GD2-IR12. Crucially, the system enabled higher TBR at SWIR wavelengths than at NIR-I wavelengths, verifying SWIR imaging enables high-contrast delineation of tumor margins. This work demonstrates that by combining the high specificity of anti-GD2 antibodies with the availability and translatability of existing NIR-I dyes, along with the advantages of SWIR in terms of depth and tumor signal-to-background ratio, GD2-targeted NIR-I/SWIR-guided surgery could improve the treatment of patients with neuroblastoma, warranting investigation in future clinical trials. Multispectral near-infrared I/shortwave infrared fluorescence imaging is a versatile system enabling high tumor-to-background signal for safer and more complete resection of pediatric tumors during surgery.

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