In Vivo 3-Dimensional Radiopharmaceutical-Excited Fluorescence Tomography

SODL-IR-FISTA: sparse online dictionary learning with iterative reduction FISTA for cone-beam X-ray luminescence computed tomography

Cone beam X-ray luminescence computed tomography (CB-XLCT) is an emerging imaging technique with potential for early 3D tumor detection. However, the reconstruction challenge due to low light absorption and high scattering in tissues makes it a difficult inverse problem. In this study, the online dictionary learning (ODL) method, combined with iterative reduction FISTA (IR-FISTA), has been utilized to achieve high-quality reconstruction. Our method integrates IR-FISTA for efficient and accurate sparse coding, followed by an online stochastic approximation for dictionary updates, effectively capturing the sparse features inherent to the problem. Additionally, a re-sparse step is introduced to enhance the sparsity of the solution, making it better suited for CB-XLCT reconstruction. Numerical simulations and in vivo experiments were conducted to assess the performance of the method. The SODL-IR-FISTA achieved the smallest location error of 0.325 mm in in vivo experiments, which is 58% and 45% of the IVTCG-L 1 (0.562 mm) and OMP-L 0 (0.721 mm), respectively. Additionally, it has the highest DICE similarity coefficient, which is 0.748. The results demonstrate that our approach outperforms traditional methods in terms of localization precision, shape restoration, robustness, and practicality in live subjects.

Sparse reconstruction based on dictionary learning and group structure strategy for cone-beam X-ray luminescence computed tomography

As a dual-modal imaging technology that has emerged in recent years, cone-beam X-ray luminescence computed tomography (CB-XLCT) has exhibited promise as a tool for the early three-dimensional detection of tumors in small animals. However, due to the challenges imposed by the low absorption and high scattering of light in tissues, the CB-XLCT reconstruction problem is a severely ill-conditioned inverse problem, rendering it difficult to obtain satisfactory reconstruction results. In this study, a strategy that utilizes dictionary learning and group structure (DLGS) is proposed to achieve satisfactory CB-XLCT reconstruction performance. The group structure is employed to account for the clustering of nanophosphors in specific regions within the organism, which can enhance the interrelation of elements in the same group. Furthermore, the dictionary learning strategy is implemented to effectively capture sparse features. The performance of the proposed method was evaluated through numerical simulations and in vivo experiments. The experimental results demonstrate that the proposed method achieves superior reconstruction performance in terms of location accuracy, target shape, robustness, dual-source resolution, and in vivo practicability.

Generalized conditional gradient method with adaptive regularization parameters for fluorescence molecular tomography

Fluorescence molecular tomography (FMT) is an optical imaging technology with the ability of visualizing the three-dimensional distribution of fluorescently labelled probes in vivo. However, due to the light scattering effect and ill-posed inverse problems, obtaining satisfactory FMT reconstruction is still a challenging problem. In this work, to improve the performance of FMT reconstruction, we proposed a generalized conditional gradient method with adaptive regularization parameters (GCGM-ARP). In order to make a tradeoff between the sparsity and shape preservation of the reconstruction source, and to maintain its robustness, elastic-net (EN) regularization is introduced. EN regularization combines the advantages of L₁-norm and L₂-norm, and overcomes the shortcomings of traditional L_p-norm regularization, such as over-sparsity, over-smoothness, and non-robustness. Thus, the equivalent optimization formulation of the original problem can be obtained. To further improve the performance of the reconstruction, the L-curve is adopted to adaptively adjust the regularization parameters. Then, the generalized conditional gradient method (GCGM) is used to split the minimization problem based on EN regularization into two simpler sub-problems, which are determining the direction of the gradient and the step size. These sub-problems are addressed efficiently to obtain more sparse solutions. To assess the performance of our proposed method, a series of numerical simulation experiments and in vivo experiments were implemented. The experimental results show that, compared with other mathematical reconstruction methods, GCGM-ARP method has the minimum location error (LE) and relative intensity error (RIE), and the maximum dice coefficient (Dice) in the case of different sources number or shape, or Gaussian noise of 5%-25%. This indicates that GCGM-ARP has superior reconstruction performance in source localization, dual-source resolution, morphology recovery, and robustness. In conclusion, the proposed GCGM-ARP is an effective and robust strategy for FMT reconstruction in biomedical application.

Intraoperative fluorescence molecular imaging accelerates the coming of precision surgery in China

Purpose

China has the largest cancer population globally. Surgery is the main choice for most solid cancer patients. Intraoperative fluorescence molecular imaging (FMI) has shown its great potential in assisting surgeons in achieving precise resection. We summarized the typical applications of intraoperative FMI and several new trends to promote the development of precision surgery.

Methods

The academic database and NIH clinical trial platform were systematically evaluated. We focused on the clinical application of intraoperative FMI in China. Special emphasis was placed on a series of typical studies with new technologies or high-level evidence. The emerging strategy of combining FMI with other modalities was also discussed.

Results

The clinical applications of clinically approved indocyanine green (ICG), methylene blue (MB), or fluorescein are on the rise in different surgical departments. Intraoperative FMI has achieved precise lesion detection, sentinel lymph node mapping, and lymphangiography for many cancers. Nerve imaging is also exploring to reduce iatrogenic injuries. Through different administration routes, these fluorescent imaging agents provided encouraging results in surgical navigation. Meanwhile, designing new cancer-specific fluorescent tracers is expected to be a promising trend to further improve the surgical outcome.

Conclusions

Intraoperative FMI is in a rapid development in China. In-depth understanding of cancer-related molecular mechanisms is necessary to achieve precision surgery. Molecular-targeted fluorescent agents and multi-modal imaging techniques might play crucial roles in the era of precision surgery.

First clinical investigation of near-infrared window IIa/IIb fluorescence imaging for precise surgical resection of gliomas

OBJECTIVE

The near-infrared window II (NIR-II, 1000-1700 nm) imaging, including NIR-IIa (1300-1400 mm) and NIR-IIb (1500-1700 mm), outperforms the near-infrared window I (NIR-I, 700-900 nm) imaging in biological researches. However, the advantages of NIR-IIa/IIb imaging in human study are ambiguous. This study aims to apply the NIR-IIa/IIb imaging to glioma resection and evaluate their performance by using the developed imaging instrument and intraoperative image fusion method.

METHODS

A multispectral fluorescence imaging instrument that integrated NIR-I/II/IIa/IIb fluorescence imaging and an intraoperative image fusion method have been developed. Seven patients with grade III/IV glioma have been enrolled. NIR-I/II images of the tumor and NIR-I/II/IIa/IIb images of cerebral vessels were acquired with the administration of indocyanine green. Images were fused using the specialized fusion method to synchronously provide the distribution of the vessels and the surgical boundaries.

RESULTS

The NIR-IIa/IIb imaging was successfully applied to the clinic. High imaging resolution and contrast have been attained in the NIR-IIa/IIb regions. Besides, capillaries with an apparent diameter as small as 182 m were acquired using NIR-IIb imaging. Tumor-feeding arteries were precisely blocked and tumors were excised to the maximum extent for all patients. The blood loss volume during surgery was significantly reduced compared with the control group.

CONCLUSION

The multispectral fluorescence imaging showed high performance, which led to a significant reduction in blood loss volume.

SIGNIFICANCE

The novel multispectral fluorescence imaging technology can assist surgeons in other vascular surgeries in the future.

X-ray luminescence computed tomography using a hybrid proton propagation model and Lasso-LSQR algorithm

X-ray luminescence computed tomography (XLCT) uses external X-rays for luminescence excitation, which is becoming a promising molecular imaging technique with superb penetration depth and spatial resolution. To achieve the tomographic mapping of luminescence distribution, accurate optical propagation model and suitable reconstruction method are two keys for XLCT, but not satisfied. To overcome the limitation of the single proton propagation model (e.g., DE, SP₃ ), we adopted a hybrid diffusion equation with third order simplified spherical harmonics (DE-SP₃ ) model for XLCT. To enable fast iteration and accurate sparse reconstruction, we also integrated in the inversion optimization, with a novel Least Square QR-factorization based on the Lasso (Lasso-LSQR) algorithm. We first simulated the light propagation in various kinds of organs under DE model and SP₃ model, respectively. By comparison with the Monte Carlo, these tissues can be categorized into two types, namely DE-fitted tissues that include muscle and lung, and SP₃ -fitted tissues including heart, kidney, liver, and stomach. According to the above classification results, we built a hybrid DE-SP₃ model to more accurately describing light transport. Numerical simulations and in vivo experiments illustrated that hybrid DE-SP₃ model achieves superior reconstruction performance in terms of location accuracy, and spatial resolution than DE, and less computational cost than SP₃ . The hybrid DE-SP₃ model materializes a balance between accuracy and efficiency for XLCT.

Detection of the common bile duct in difficult bile duct exploration using indocyanine green fluorescence imaging: A case report

We describe two cases using indocyanine green (ICG) fluorescence imaging for visualization of the common bile duct (CBD) in patients with difficult Bile duct exploration (BDE) due to extensive dense adhesions around the hepatoduodenal ligament. The CBD was rapidly detected under fluorescence guidance without excessive dissection of extensive dense adhesions. It is illustrated that the use of ICG fluorescence imaging is effective and feasible for detecting the CBD and thus we highly recommend this method during difficult BDE.

A robust elastic net-ℓ1ℓ2reconstruction method for x-ray luminescence computed tomography

Objective. X-ray luminescence computed tomography (XLCT) has played a crucial role in pre-clinical research and effective diagnosis of disease. However, due to the ill-posed of the XLCT inverse problem, the generalization of reconstruction methods and the selection of appropriate regularization parameters are still challenging in practical applications. In this research, an robust Elastic net-ℓ₁ℓ₂reconstruction method is proposed aiming to the challenge.Approach. Firstly, our approach consists of ℓ₁and ℓ₂regularization to enhance the sparsity and suppress the smoothness. Secondly, through optimal approximation of the optimization problem, double modification of Landweber algorithm is adopted to solve the Elastic net-ℓ₁ℓ₂regulazation. Thirdly, drawing on the ideal of supervised learning, multi-parameter K-fold cross validation strategy is proposed to determin the optimal parameters adaptively.Main results. To evaluate the performance of the Elastic net-ℓ₁ℓ₂method, numerical simulations, phantom and in vivo experiments were conducted. In these experiments, the Elastic net-ℓ₁ℓ₂method achieved the minimum reconstruction error (with smallest location error, fluorescent yield relative error, normalized root-mean-square error) and the best image reconstruction quality (with largest contrast-to-noise ratio and Dice similarity) among all methods. The results demonstrated that Elastic net-ℓ₁ℓ₂can obtain superior reconstruction performance in terms of location accuracy, dual source resolution, robustness and in vivo practicability.Significance. It is believed that this study will further benefit preclinical applications with a view to provide a more reliable reference for the later researches on XLCT.

The facile preparation of solid-state fluorescent carbon dots with a high fluorescence quantum yield and their application in rapid latent fingerprint detection

Because of direct π-π interactions and excessive energy resonance transfer, it is very challenging to prepare carbon dots (CDs) with a high fluorescence quantum yield (QY) in the solid state. In this study, novel CDs which gave solid-state fluorescence (SSF) with high brightness were successfully prepared via a simple microwave-assisted method. The prepared ScCDs can emit strong blue fluorescence in the solid state, and the absolute QY of this ScCDs powder reaches 51.7%. Such a high QY means that the ScCDs powder could be successfully applied in rapid latent fingerprint (LFP) detection. The LFP detection performance of this ScCDs powder was studied in detail, and the results show that the LFPs developed using the ScCDs powder can be visualized with high definition and contrast under different conditions. This research not only developed a new type of SSF-emitting CDs, but it also proved that the developed CDs have great potential for applications in LFP detection, and this research may also provide inspiration and ideas for the design of new SSF-emitting CDs.

Synthesis and in vitro preliminary evaluation of prostate-specific membrane antigen targeted upconversion nanoparticles as a first step towards radio/fluorescence-guided surgery of prostate cancer

Over the last decade, upconversion nanoparticles (UCNP) have been widely investigated in nanomedicine due to their high potential as imaging agents in the near-infrared (NIR) optical window of biological tissues. Here, we successfully develop active targeted UCNP as potential probes for dual NIR-NIR fluorescence and radioactive-guided surgery of prostate-specific membrane antigen (PSMA)(+) prostate cancers. We designed a one-pot thermolysis synthesis method to obtain oleic acid-coated spherical NaYF4:Yb,Tm@NaYF4 core/shell UCNP with narrow particle size distribution (30.0 ± 0.1 nm, as estimated by SAXS analysis) and efficient upconversion luminescence. Polyethylene glycol (PEG) ligands bearing different anchoring groups (phosphate, bis- and tetra-phosphonate-based) were synthesized and used to hydrophilize the UCNP. DLS studies led to the selection of a tetra-phosphonate PEG(2000) ligand affording water-dispersible UCNP with sustained colloidal stability in several aqueous media. PSMA-targeting ligands (i.e., glutamate-urea-lysine derivatives called KuEs) and fluorescent or radiolabelled prosthetic groups were grafted onto the UCNP surface by strain-promoted azide-alkyne cycloaddition (SPAAC). These UCNP, coated with 10 or 100% surface density of KuE ligands, did not induce cytotoxicity over 24 h incubation in LNCaP-Luc or PC3-Luc prostate cancer cell lines or in human fibroblasts for any of the concentrations evaluated. Competitive binding assays and flow cytometry demonstrated the excellent affinity of UCNP@KuE for PSMA-positive LNCaP-Luc cells compared with non-targeted UCNP@CO2H. Furthermore, the binding of UCNP@KuE to prostate tumour cells was positively correlated with the surface density of PSMA-targeting ligands and maintained after 125I-radiolabelling. Finally, a preliminary biodistribution study in LNCaP-Luc-bearing mice demonstrated the radiochemical stability of non-targeted [125I]UCNP paving the way for future in vivo assessments.

Intraperitoneal Injection of Cyanine-Based Nanomicelles for Enhanced Near-Infrared Fluorescence Imaging and Surgical Navigation in Abdominal Tumors

Fluorescent surgical navigation can effectively aid tumor resection. As one of the most popular near-infrared (NIR) fluorophores, cyanine dye has the outstanding optical ability and the potential to act as a fluorescence probe for tumors. Herein, we report a polyethylene glycol-modified amphiphilic cyanine dye (Cy7-NPC) with an NIR luminescence performance, which can self-assemble to form uniform nanomicelles (Cy7-NPC-S) and which can be applied for the optical imaging of abdominal tumors and for fluorescence imaging-guided precision tumor resection. When applied to biological imaging, Cy7-NPC-S showed high biological safety, strong tissue penetration depth for optical imaging, and high optical imaging resolution. Intraperitoneal administration of Cy7-NPC-S produced remarkable imaging efficacy in abdominal tumors. Compared with intravenous injection, abdominal tumors took up intraperitoneal Cy7-NPC-S faster and in greater quantities, thus enabling Cy7-NPC-S to facilitate accurate recognition and extirpation of abdominal tumors in fluorescence-guided surgery. We believe that metabolizable Cy7-NPC-S with NIR luminescence has promising applications and value in the fields of in vivo imaging and fluorescent surgical navigation.

Radiopharmaceutical and Eu3+ doped gadolinium oxide nanoparticles mediated triple-excited fluorescence imaging and image-guided surgery

Cerenkov luminescence imaging (CLI) is a novel optical imaging technique that has been applied in clinic using various radionuclides and radiopharmaceuticals. However, clinical application of CLI has been limited by weak optical signal and restricted tissue penetration depth. Various fluorescent probes have been combined with radiopharmaceuticals for improved imaging performances. However, as most of these probes only interact with Cerenkov luminescence (CL), the low photon fluence of CL greatly restricted it's interaction with fluorescent probes for in vivo imaging. Therefore, it is important to develop probes that can effectively convert energy beyond CL such as β and γ to the low energy optical signals. In this study, a Eu3+ doped gadolinium oxide (Gd2O3:Eu) was synthesized and combined with radiopharmaceuticals to achieve a red-shifted optical spectrum with less tissue scattering and enhanced optical signal intensity in this study. The interaction between Gd2O3:Eu and radiopharmaceutical were investigated using 18F-fluorodeoxyglucose (18F-FDG). The ex vivo optical signal intensity of the mixture of Gd2O3:Eu and 18F-FDG reached 369 times as high as that of CLI using 18F-FDG alone. To achieve improved biocompatibility, the Gd2O3:Eu nanoparticles were then modified with polyvinyl alcohol (PVA), and the resulted nanoprobe PVA modified Gd2O3:Eu (Gd2O3:Eu@PVA) was applied in intraoperative tumor imaging. Compared with 18F-FDG alone, intraoperative administration of Gd2O3:Eu@PVA and 18F-FDG combination achieved a much higher tumor-to-normal tissue ratio (TNR, 10.24 ± 2.24 vs. 1.87 ± 0.73, P = 0.0030). The use of Gd2O3:Eu@PVA and 18F-FDG also assisted intraoperative detection of tumors that were omitted by preoperative positron emission tomography (PET) imaging. Further experiment of image-guided surgery demonstrated feasibility of image-guided tumor resection using Gd2O3:Eu@PVA and 18F-FDG. In summary, Gd2O3:Eu can achieve significantly optimized imaging property when combined with 18F-FDG in intraoperative tumor imaging and image-guided tumor resection surgery. It is expected that the development of the Gd2O3:Eu nanoparticle will promote investigation and application of novel nanoparticles that can interact with radiopharmaceuticals for improved imaging properties. This work highlighted the impact of the nanoprobe that can be excited by radiopharmaceuticals emitting CL, β, and γ radiation for precisely imaging of tumor and intraoperatively guide tumor resection.

An Optimized Integrin α6-Targeted Magnetic Resonance Probe for Molecular Imaging of Hepatocellular Carcinoma in Mice

Introduction

Integrin α6 is an attractive diagnostic biomarker for molecular imaging of hepatocellular carcinoma (HCC) as it has an extremely high positive rate (approximately 94%) in clinical early-stage HCC. In this study, based on our previously identified integrin α6-targeted peptide, we developed an optimized integrin α6-targeted magnetic resonance (MR) probe dubbed DOTA(Gd)-ANADYWR for MR imaging of HCC in mice.

Materials and Methods

The longitudinal (R₁) relaxivity of DOTA(Gd)-ANADYWR was measured on a 3.0 T MR system . The specific tumor enhancement of the agent was investigated in four distinct mouse models, including subcutaneous, orthotopic, genetically engineered and chemically induced HCC mice.

Results

The R₁ relaxivity value of DOTA(Gd)-ANADYWR is 5.11 mM⁻¹s⁻¹ at 3.0 T, which is similar to that of the nonspecific clinical agent Gadoteridol. DOTA(Gd)-ANADYWR generated superior enhanced MR signal in HCC lesions and provided complementary enhancement MR signals to the clinically available hepatobiliary MR contrast agent gadoxetate disodium (Gd-EOB-DTPA). Importantly, DOTA(Gd)-ANADYWR could efficiently visualize small HCC lesion (approximately 1 mm) which was hardly detected by the clinical Gd-EOB-DTPA.

Conclusion

These findings suggest the potential application of this integrin α6-targeted MR probe for the detection of HCC, particularly for small HCC.

Visualizing Tumors in Real Time: A Highly Sensitive PSMA Probe for NIR-II Imaging and Intraoperative Tumor Resection

Owing to the complex anatomical structure, precise resection of a tumor while maintaining adjacent tissue is a challenge in radical prostatectomy for prostate cancer (PCa). Optical imaging in near-infrared window II (NIR-II) is a promising technology for intraoperative guidance, whereas there is no available probe for PCa yet. In this article, a novel probe (PSMA-1092) bearing two prostate-specific membrane antigen (PSMA) binding motifs was developed, displaying excellent optical properties (λ_max = 1092 nm) and ultrahigh affinity (K_i = 80 pM) toward PSMA. The tumor was visualized with high resolution (tissue-to-normal tissue ratio = 7.62 ± 1.05) and clear margin by NIR-II imaging using PSMA-1092 in a mouse model. During the tumor resection, residual tumors missed by visible inspection were detected by the real-time imaging. Overall, PSMA-1092 displayed excellent performance in delineating the tumor margin and detecting residual tumors, demonstrating promising potential for precise PCa tumor resection in clinical practice.

Preliminary application of indocyanine green fluorescence imaging in postoperative gastrointestinal fistula

We describe a case using indocyanine green (ICG) fluorescence imaging for diagnosis of postoperative gastrointestinal fistula. When the fistula is very large, both indocyanine green and methylene blue can be found in the postoperative drainage. After treatment, when the leak became small, only ICG fluorescence imaging continued to be demonstrated. ICG fluorescence imaging is likely to prove to be a safe and effective method of examination, and one that is very practical and easy to execute for the diagnosis of postoperative gastrointestinal fistula.

Real-time intraoperative glioma diagnosis using fluorescence imaging and deep convolutional neural networks

Purpose

Surgery is the predominant treatment modality of human glioma but suffers difficulty on clearly identifying tumor boundaries in clinic. Conventional practice involves neurosurgeon’s visual evaluation and intraoperative histological examination of dissected tissues using frozen section, which is time-consuming and complex. The aim of this study was to develop fluorescent imaging coupled with artificial intelligence technique to quickly and accurately determine glioma in real-time during surgery.

Methods

Glioma patients (N = 23) were enrolled and injected with indocyanine green for fluorescence image–guided surgery. Tissue samples (N = 1874) were harvested from surgery of these patients, and the second near-infrared window (NIR-II, 1000–1700 nm) fluorescence images were obtained. Deep convolutional neural networks (CNNs) combined with NIR-II fluorescence imaging (named as FL-CNN) were explored to automatically provide pathological diagnosis of glioma in situ in real-time during patient surgery. The pathological examination results were used as the gold standard.

Results

The developed FL-CNN achieved the area under the curve (AUC) of 0.945. Comparing to neurosurgeons’ judgment, with the same level of specificity >80%, FL-CNN achieved a much higher sensitivity (93.8% versus 82.0%, P < 0.001) with zero time overhead. Further experiments demonstrated that FL-CNN corrected >70% of the errors made by neurosurgeons. FL-CNN was also able to rapidly predict grade and Ki-67 level (AUC 0.810 and 0.625) of tumor specimens intraoperatively.

Conclusion

Our study demonstrates that deep CNNs are better at capturing important information from fluorescence images than surgeons’ evaluation during patient surgery. FL-CNN is highly promising to provide pathological diagnosis intraoperatively and assist neurosurgeons to obtain maximum resection safely.

Trial registration

ChiCTR ChiCTR2000029402. Registered 29 January 2020, retrospectively registered

Supplementary Information

The online version contains supplementary material available at 10.1007/s00259-021-05326-y.

Nanoparticles for Cerenkov and Radioluminescent Light Enhancement for Imaging and Radiotherapy

Cerenkov luminescence imaging and Cerenkov photodynamic therapy have been developed in recent years to exploit the Cerenkov radiation (CR) generated by radioisotopes, frequently used in Nuclear Medicine, to diagnose and fight cancer lesions. For in vivo detection, the endpoint energy of the radioisotope and, thus, the total number of the emitted Cerenkov photons, represents a very important variable and explains why, for example, ⁶⁸Ga is better than ¹⁸F. However, it was also found that the scintillation process is an important mechanism for light production. Nanotechnology represents the most important field, providing nanosctructures which are able to shift the UV-blue emission into a more suitable wavelength, with reduced absorption, which is useful especially for in vivo imaging and therapy applications. Nanoparticles can be made, loaded or linked to fluorescent dyes to modify the optical properties of CR radiation. They also represent a useful platform for therapeutic agents, such as photosensitizer drugs for the production of reactive oxygen species (ROS). Generally, NPs can be spaced by CR sources; however, for in vivo imaging applications, NPs bound to or incorporating radioisotopes are the most interesting nanocomplexes thanks to their high degree of mutual colocalization and the reduced problem of false uptake detection. Moreover, the distance between the NPs and CR source is crucial for energy conversion. Here, we review the principal NPs proposed in the literature, discussing their properties and the main results obtained by the proponent experimental groups.

A preliminary study of dual-band confocal laser endomicroscopy combined with image mosaic in the diagnosis of liver cancer

Accurate identification of tumor tissues and their margins are still challenging for conventional clinical imaging methods during liver cancer surgery. In this study, dual-band confocal laser endomicroscopy (CLE) combined with image mosaic was used to guide liver cancer surgery. In the experiments with mice bearing orthotropic liver tumor, CLE can accurately detect the tumors and identify their margins with two excitation wavelengths of 488 nm and 660 nm by clinically available dyes fluorescein sodium (FS) or indocyanine green (ICG). The mosaic CLE images enlarged the imaging field and detected the liver tumor margins more accurately. Normal liver tissues fluorescence intensity of CLE images was significantly higher than that of tumor tissues in the same tumor-bearing mice (P < 0.0001). Overall, dual-band CLE imaging demonstrates to be a promising method to identify liver tumor tissues and margins, which has the prospect of clinical application and helps to achieve intraoperative radical resection.

A novel in vivo Cerenkov luminescence image-guided surgery on primary and metastatic colorectal cancer

Intraoperative Cerenkov luminescence imaging (CLI) can effectively improve the performance of tumor surgery. Nevertheless, the existing approaches are still unsatisfying to the clinical demands of open surgery. This study develops a novel intraoperative in vivo CLI approach to investigate the potential and value of Cerenkov luminescence (CL) image-guided surgery. A system characterized with high sensitivity (19.61 kBq mL^{-1 18} F-FDG) and desirable spatial resolution (88.34 μm) is developed. CL image-guided surgery is performed on colorectal cancer (CRC) models of mice and swine. Tumor surgery is guided by the static CL images, and the resection quality is evaluated quantitatively and contrasted with other imaging modalities exemplified by bioluminescence imaging (BLI). The in vivo results demonstrated the effectiveness of the proposed intraoperative CLI approach for removing primary and metastatic CRC. Safety of performing in vivo CL image-guided surgery is verified as well through radiation measurements of related staffs. Overall, the developed intraoperative in vivo CLI approach can efficiently improve the cancer treatment.

A novel Cerenkov luminescence tomography approach using multilayer fully connected neural network

Cerenkov luminescence tomography (CLT) has been proved as an effective tool for various biomedical applications. Because of the severe scattering of Cerenkov luminescence, the performance of CLT remains unsatisfied. This paper proposed a novel CLT reconstruction approach based on a multilayer fully connected neural network (MFCNN). Monte Carlo simulation data was employed to train the MFCNN, and the complex relationship between the surface signals and the true sources was effectively learned by the network. Both simulation and in vivo experiments were performed to validate the performance of MFCNN CLT, and it was further compared with the typical radiative transfer equation (RTE) based method. The experimental data showed the superiority of MFCNN CLT in terms of accuracy and stability. This promising approach for CLT is expected to improve the performance of optical tomography, and to promote the exploration of machine learning in biomedical applications.

Radiopharmaceuticals and Fluorescein Sodium Mediated Triple-Modality Molecular Imaging Allows Precise Image-Guided Tumor Surgery

Radical resection is the most effective method for malignant tumor treatments. However, conventional imaging cannot fully satisfy the clinical needs of surgical navigation. This study presents a novel triple-modality positron emission tomography (PET)-Cerenkov radiation energy transfer (CRET)-confocal laser endomicroscopy (CLE) imaging strategy for intraoperative tumor imaging and surgical navigation. Using clinical radiopharmaceuticals and fluorescein sodium (FS), this strategy can accurately detect the tumor and guide the tumor surgery. The FS emission property under Cerenkov radiation excitation is investigated using 2-deoxy-2-18F-fluoroglucose and 11C-choline. Performances of the PET-CRET-CLE imaging and the CRET-CLE image-guided surgery are evaluated on mouse models. The CRET signal at 8 mm depth is stronger than the Cerenkov luminescence at 1 mm depth in phantoms. In vivo experiments indicate that 0.5 mL kg-1 of 10% FS generates the strongest CRET signal, which can be observed immediately after FS injection. A surgical navigation study shows that the tumors are precisely detected and resected using intraoperative CRET-CLE. In summary, a PET-CRET-CLE triple-modality imaging strategy is developed. This strategy can detect the tumors and precisely guide the tumor resection using clinical pharmaceuticals. This triple-modality imaging shows high potential in surgical navigation research and clinical translation.

Endoscopic Cerenkov luminescence imaging and image-guided tumor resection on hepatocellular carcinoma-bearing mouse models

Detecting deep tumors inside living subject is still challenging for Cerenkov luminescence imaging (CLI). In this study, a high-sensitivity endoscopic CLI (ECLI) system was developed with a dual-mode deep cooling approach to improve the imaging sensitivity. System was characterized through a series of ex vivo studies. Furthermore, subcutaneous and orthotropic human hepatocellular carcinoma (HCC) mouse models were established for ECLI guided tumor resection in vivo. The results showed that the ECLI system had spatial resolution (62.5 μm) and imaging sensitivity (6.29 × 10^-2 kBq/μl ¹⁸F-FDG). The in vivo experimental data from the HCC mouse models demonstrated that the system was effective to intraoperatively guide the surgery of deep tumors such as liver cancer. Overall, the developed system exhibits promising potential for the applications of tumor precise resection and novel nanoprobe based optical imaging.

Iridium complex nanoparticle mediated radiopharmaceutical-excited phosphorescence imaging

We firstly perpared liposome coated [Ir(pq)₂(bpy)]Cl (Ir@liposome) as a transducer for radiopharmaceutical (¹⁸F-FDG) excited phosphorescence imaging (REPI).

Weight Multispectral Reconstruction Strategy for Enhanced Reconstruction Accuracy and Stability With Cerenkov Luminescence Tomography

Cerenkov luminescence tomography (CLT) provides a novel technique for 3-D noninvasive detection of radiopharmaceuticals in living subjects. However, because of the severe scattering of Cerenkov light, the reconstruction accuracy and stability of CLT is still unsatisfied. In this paper, a modified weight multispectral CLT (wmCLT) reconstruction strategy was developed which split the Cerenkov radiation spectrum into several sub-spectral bands and weighted the sub-spectral results to obtain the final result. To better evaluate the property of the wmCLT reconstruction strategy in terms of accuracy, stability and practicability, several numerical simulation experiments and in vivo experiments were conducted and the results obtained were compared with the traditional multispectral CLT (mCLT) and hybrid-spectral CLT (hCLT) reconstruction strategies. The numerical simulation results indicated that wmCLT strategy significantly improved the accuracy of Cerenkov source localization and intensity quantitation and exhibited good stability in suppressing noise in numerical simulation experiments. And the comparison of the results achieved from different in vivo experiments further indicated significant improvement of the wmCLT strategy in terms of the shape recovery of the bladder and the spatial resolution of imaging xenograft tumors. Overall the strategy reported here will facilitate the development of nuclear and optical molecular tomography in theoretical study.

Nanoparticles as Theranostic Vehicles in Experimental and Clinical Applications-Focus on Prostate and Breast Cancer

Prostate and breast cancer are the second most and most commonly diagnosed cancer in men and women worldwide, respectively. The American Cancer Society estimates that during 2016 in the USA around 430,000 individuals were diagnosed with one of these two types of cancers, and approximately 15% of them will die from the disease. In Europe, the rate of incidences and deaths are similar to those in the USA. Several different more or less successful diagnostic and therapeutic approaches have been developed and evaluated in order to tackle this issue and thereby decrease the death rates. By using nanoparticles as vehicles carrying both diagnostic and therapeutic molecular entities, individualized targeted theranostic nanomedicine has emerged as a promising option to increase the sensitivity and the specificity during diagnosis, as well as the likelihood of survival or prolonged survival after therapy. This article presents and discusses important and promising different kinds of nanoparticles, as well as imaging and therapy options, suitable for theranostic applications. The presentation of different nanoparticles and theranostic applications is quite general, but there is a special focus on prostate cancer. Some references and aspects regarding breast cancer are however also presented and discussed. Finally, the prostate cancer case is presented in more detail regarding diagnosis, staging, recurrence, metastases, and treatment options available today, followed by possible ways to move forward applying theranostics for both prostate and breast cancer based on promising experiments performed until today.

Cerenkov luminescence imaging: physics principles and potential applications in biomedical sciences

Cerenkov luminescence imaging (CLI) is a novel imaging modality to study charged particles with optical methods by detecting the Cerenkov luminescence produced in tissue. This paper first describes the physical processes that govern the production and transport in tissue of Cerenkov luminescence. The detectors used for CLI and their most relevant specifications to optimize the acquisition of the Cerenkov signal are then presented, and CLI is compared with the other optical imaging modalities sharing the same data acquisition and processing methods. Finally, the scientific work related to CLI and the applications for which CLI has been proposed are reviewed. The paper ends with some considerations about further perspectives for this novel imaging modality.