Contrast-Enhanced Multispectral Photoacoustic Imaging for Irregular Hepatectomy Navigation: A Pilot Study

Area of Science:

• Biomedical Engineering
• Medical Imaging
• Oncology

Background:

• Irregular hepatectomy is crucial for treating hepatocellular carcinoma (HCC) with cirrhosis and metastasis.
• Current navigation methods like ultrasound and ICG fluorescence have limited specificity.
• Precise intraoperative tumor delineation is key to achieving negative margins and reducing HCC recurrence.

Purpose of the Study:

• To develop and evaluate a novel multispectral photoacoustic (PA) imaging navigation system for precise irregular hepatectomy.
• To assess the efficacy of a new integrin αvβ3-targeted fluorescent contrast agent, IR820-E[c(RGDfK)]2, for intraoperative tumor visualization.

Main Methods:

• Designed, synthesized, and characterized the targeted fluorescent contrast agent IR820-E[c(RGDfK)]2.
• Conducted in vitro studies for optical/PA properties, affinity, specificity, and biocompatibility.
• Evaluated multispectral PA imaging, optimal contrast, and safety in HCC animal models and patient biospecimens.

Main Results:

• IR820-E[c(RGDfK)]2 demonstrated high affinity and specificity for integrin αvβ3, with good pharmacokinetics and safety.
• Multispectral PA imaging effectively differentiated tumor from normal liver tissue in models and patient samples.
• Successfully guided preoperative localization, intraoperative tumor resection, and postoperative margin assessment in irregular hepatectomy.

Conclusions:

• The developed IR820-E[c(RGDfK)]2 contrast agent and PA imaging system enable precise navigation in irregular hepatectomy.
• This approach shows potential for improving surgical outcomes in HCC patients by ensuring negative margins.
• IR820-E[c(RGDfK)]2 may become an investigational new drug for clinical application in PA imaging-guided liver surgery.