In this work we highlight the preclinical optimization of targeted tumor fluorophores for delineation. We utilize shortwave infrared fluorescence imaging (SWIRFI) under non-gated or filtered ambient lighting conditions to achieve a symbiotic fluorescence guided surgery ecosystem for unprecedented tumor contrast. With two commercially available targeted dyes we readily achieved tumor to muscle ratios in the ranges of 40 to 80, with exposure times as low as 1 ms within ANSI limited laser exposures. We highlight the metrics which can be used to quantify this contrast and signal, and further highlight the need for standardized metrics in academic and industry settings.
The advantages of shortwave infrared (SWIR, 900-1700 nm) imaging over NIR (650-900 nm) include reduced tissue optical aberrations, increased depth penetration along with improved resolution and contrast. Preclinical SWIR imaging has focused on system development and novel fluorophore development with a goal of targeted tumor resection for clinical translation. Clinical SWIR imaging has focused on indocyanine green (ICG) and the enhanced permeability and retention effect for resection with significant advantages. In this work we preclinically validate the pH low insertion peptide (pHLIP) conjugated to ICG (pHLIP ICG, currently in clinical trials) as a suitable cancer targeted fluorophore for cancer resection.
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