Nicholas E Wojtynek1,2, Madeline T Olson1,2, Timothy A Bielecki1,2, Wei An1, Aaqib M Bhat1,3, Hamid Band1,2,3,4,5,6, Scott R Lauer2,5, Edibaldo Silva-Lopez2,7, Aaron M Mohs8,9,10,11. 1. Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, USA. 2. Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA. 3. Department of Genetics, Cell Biology, and Anatomy, University of Nebraska Medical Center, Omaha, NE, USA. 4. Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE, USA. 5. Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA. 6. Center for Drug Delivery and Nanomedicine, University of Nebraska Medical Center, Omaha, NE, USA. 7. Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA. 8. Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA. aaron.mohs@unmc.edu. 9. Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE, USA. aaron.mohs@unmc.edu. 10. Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, USA. aaron.mohs@unmc.edu. 11. Center for Drug Delivery and Nanomedicine, University of Nebraska Medical Center, Omaha, NE, USA. aaron.mohs@unmc.edu.
Abstract
PURPOSE: Negative surgical margins (NSMs) have favorable prognostic implications in breast tumor resection surgery. Fluorescence image-guided surgery (FIGS) has the ability to delineate surgical margins in real time, potentially improving the completeness of tumor resection. We have recently developed indocyanine green (ICG)-loaded self-assembled hyaluronic acid (HA) nanoparticles (NanoICG) for solid tumor imaging, which were shown to enhance intraoperative contrast. PROCEDURES: This study sought to assess the efficacy of NanoICG on completeness of breast tumor resection and post-surgical survival. BALB/c mice bearing iRFP+/luciferase+ 4T1 syngeneic breast tumors were administered NanoICG or ICG, underwent FIGS, and were compared to bright light surgery (BLS) and sham controls. RESULTS: NanoICG increased the number of complete resections and improved tumor-free survival. This was a product of improved intraoperative contrast enhancement and the identification of a greater number of small, occult lesions than ICG and BLS. Additionally, NanoICG identified chest wall invasion and predicted recurrence in a model of late-stage breast cancer. CONCLUSIONS: NanoICG is an efficacious intraoperative contrast agent and could potentially improve surgical outcomes in breast cancer.
PURPOSE: Negative surgical margins (NSMs) have favorable prognostic implications in breast tumor resection surgery. Fluorescence image-guided surgery (FIGS) has the ability to delineate surgical margins in real time, potentially improving the completeness of tumor resection. We have recently developed indocyanine green (ICG)-loaded self-assembled hyaluronic acid (HA) nanoparticles (NanoICG) for solid tumor imaging, which were shown to enhance intraoperative contrast. PROCEDURES: This study sought to assess the efficacy of NanoICG on completeness of breast tumor resection and post-surgical survival. BALB/c mice bearing iRFP+/luciferase+ 4T1 syngeneic breast tumors were administered NanoICG or ICG, underwent FIGS, and were compared to bright light surgery (BLS) and sham controls. RESULTS:NanoICG increased the number of complete resections and improved tumor-free survival. This was a product of improved intraoperative contrast enhancement and the identification of a greater number of small, occult lesions than ICG and BLS. Additionally, NanoICG identified chest wall invasion and predicted recurrence in a model of late-stage breast cancer. CONCLUSIONS:NanoICG is an efficacious intraoperative contrast agent and could potentially improve surgical outcomes in breast cancer.
Entities:
Keywords:
Breast Cancer; Fluorescence image-guided surgery; Hyaluronic acid; Indocyanine green; Nanoparticle; Near infrared fluorescence
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