Aptamer-based NIR II imaging for breast cancer surgical resection

Area of Science:

• Biomedical Engineering
• Surgical Oncology
• Medical Imaging

Background:

• Accurate intraoperative tumor margin assessment remains a critical challenge in breast conserving surgery (BCS).
• Near-infrared-II (NIR-II) fluorescence-guided surgery offers real-time visualization of tumor margins for precise resection.
• Existing methods often struggle with detecting microscopic residual disease.

Purpose of the Study:

• To develop and evaluate an aptamer-conjugated NIR-II fluorescence probe for improved intraoperative tumor margin detection.
• To assess the probe's tumor-targeting capability and efficacy in guiding precise surgical resection.
• To demonstrate the advantages of NIR-II imaging over NIR-I for surgical guidance.

Main Methods:

• Synthesis of an aptamer (SYL3C targeting EpCAM) conjugated with pegylated indocyanine green (PEG-ICG) to create the SYL3C-ICG probe.
• In vitro assessment using human breast cancer cell lines with varying EpCAM expression.
• In vivo evaluation in tumor xenograft models and during segmental excision procedures under NIR-II imaging.

Main Results:

• NIR-II fluorescence imaging demonstrated superior resolution and penetration depth compared to NIR-I.
• The SYL3C-ICG probe selectively accumulated at tumor sites, enabling visualization of EpCAM-expressing cancer cells.
• The probe facilitated the detection of tiny residual malignant lesions not visible to the naked eye.

Conclusions:

• The developed SYL3C-ICG probe effectively targets tumors and enhances intraoperative margin assessment in BCS using NIR-II fluorescence imaging.
• This technology has the potential to improve surgical precision and decrease the postoperative recurrence rate in breast cancer patients.
• NIR-II fluorescence imaging guided by targeted probes represents a significant advancement in surgical oncology.