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Nerve Visualization using Phenoxazine-Based Near-Infrared Fluorophores to Guide Prostatectomy
Lei G Wang1,2, Antonio R Montaño1, Anas M Masillati1
1Biomedical Engineering Department, Oregon Health and Science University, Portland, OR, 97201, USA.
Advanced Materials (Deerfield Beach, Fla.)
|August 31, 2023
Summary
New near-infrared (NIR) fluorophores enable precise nerve identification during surgery. This molecular engineering approach integrates with existing systems, potentially reducing nerve injury in prostate cancer patients.
Area of Science:
- Surgical innovation
- Molecular imaging
- Biomedical engineering
Background:
- Fluorescence-guided surgery (FGS) utilizes near-infrared (NIR) fluorophores for enhanced visualization.
- Current NIR systems lack tissue-specific contrast agents, hindering nerve identification during procedures like prostatectomy.
- Identifying nerves is crucial to minimize morbidity in cancer patients.
Purpose of the Study:
- To develop novel NIR fluorophores for intraoperative, nerve-specific imaging.
- To create a library of phenoxazine-based fluorophores using drug-like molecular design.
- To enable seamless integration into current surgical workflows.
Main Methods:
- Synthesized a library of NIR phenoxazine-based fluorophores.
- Employed drug-like molecular design principles.
- Tested lead candidate fluorophore in preclinical models using the da Vinci Surgical System.
Main Results:
- Successfully produced NIR phenoxazine-based fluorophores.
- The lead candidate effectively delineated prostatic nerves in canines.
- Demonstrated visualization of the iliac plexus in swine.
- Confirmed compatibility with the da Vinci Surgical System.
Conclusions:
- Molecular engineering of NIR nerve-binding fluorophores is feasible.
- Developed fluorophores show potential for intraoperative nerve identification.
- This approach facilitates clinical translation to reduce nerve injury during prostatectomy.
