Label-free tissue NIR-II autofluorescence imaging for visualization of human liver malignancy

Area of Science:

• Biomedical Optics
• Surgical Oncology
• Medical Imaging

Background:

• Accurate intraoperative tumor boundary delineation is crucial for successful surgical resection but remains a clinical challenge.
• Existing imaging tools often lack the required real-time precision for complex cases.

Purpose of the Study:

• To develop and validate a novel label-free imaging technique for real-time visualization of human liver malignancies.
• To leverage endogenous autofluorescence in the second near-infrared window (NIR-II) for enhanced contrast between tumor and healthy tissue.

Main Methods:

• Identification of endogenous substances with intense autofluorescence in the NIR-II window (1,000-1,700 nm) present in liver tissue but absent in tumors.
• Development of tissue autofluorescence NIR-II imaging (TANI), a wide-field imaging approach for visualizing liver malignancies.
• Comparative analysis of TANI performance against conventional imaging and fluorescence-guided surgery.

Main Results:

• TANI achieved high contrast (7.69 ± 0.52), sensitivity (97.8%), and specificity (98.4%) in delineating various liver malignancies.
• The technique accurately visualized hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and liver metastases.
• TANI's performance was robust across different cancer grades/stages and unaffected by blood/bile contamination or benign lesions.

Conclusions:

• TANI is a highly effective, label-free imaging approach for intraoperative visualization of liver malignancies.
• The findings suggest a strong correlation between NIR-II autofluorescence and disease states, offering a promising advance in surgical decision-making.
• Further investigation into the molecular basis of these autofluorescent substances may yield new diagnostic strategies.