Optimization of the enhanced permeability and retention effect for near-infrared imaging of solid tumors with indocyanine green.

Authors

• Jack X Jiang
• Jane J Keating
• Elizabeth M De Jesus
• Ryan P Judy
• Brian Madajewski
• Ollin Venegas
• Olugbenga T Okusanya
• Sunil Singhal

Publication/Presentation Date

1-1-2015

Abstract

Surgery is the most effective method to cure patients with solid tumors. New techniques in near-infrared (NIR) cancer imaging are being used to identify surgical margins and residual tumor cells in the wound. Our goal was to determine the optimal time and dose for imaging solid tumors using Indocyanine Green. Syngeneic murine flank tumor models were used to test NIR imaging of ICG at various doses ranging from 0 to 10 mg/kg. Imaging was performed immediately after injection and up to 72 hours later. Biodistribution in the blood and murine organs were quantified by spectroscopy and fluorescence microscopy. Based on these results, a six patient dose titration study was performed. In murine flank tumors, the tumor-to-background ratio (TBR) for ICG at doses less than 5 mg/kg were less than 2 fold at all time points, and the surgeons could not subjectively identify tissue contrast. However, for doses ranging from 5 mg/kg to 10 mg/kg, the TBR ranged from 2.1 to 8.0. The tumor signal was best appreciated at 24 hours and the background was least pronounced after 24 hours. Biodistribution studies in the blood and murine organs revealed excretion through the biliary tree and gastrointestinal tract, with minimal blood fluorescence at the higher doses. A follow up pilot study confirmed that these findings were applicable to lung cancer patients, and tumor was clearly delineated from surrounding normal tissue by NIR imaging. For non-hepatic solid tumors, we found ICG was optimal when dosed at 5 mg/kg and 24 hours before surgery.

Volume

5

Issue

4

First Page

390

Last Page

400

ISSN

2160-8407

Published In/Presented At

Jiang, J. X., Keating, J. J., Jesus, E. M., Judy, R. P., Madajewski, B., Venegas, O., Okusanya, O. T., & Singhal, S. (2015). Optimization of the enhanced permeability and retention effect for near-infrared imaging of solid tumors with indocyanine green. American journal of nuclear medicine and molecular imaging, 5(4), 390–400.

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

26269776

Department(s)

Administration and Leadership

Document Type

Article