Detection of pancreatic cancer by indocyanine green‐assisted fluorescence imaging in the first and second near‐infrared windows

Abstract

Dear Editor,In the United States, pancreatic cancer is considered the fourth most common reason for cancer-related deaths; over 53% of patients are diagnosed at end-stage with a 5year survival rate of less than 3% [1]. Incomplete removal of all cancerous cells generally leads to local recurrence of pancreatic cancer [2]. Thus, the detection of tumor margin status plays an essential role in the complete resection of pancreatic cancer. Most of the existing imaging modalities, like computed tomography and magnetic resonance imaging, are primarily used for preoperative planning; these modalities also have issues of bulky equipment, radiation concerns, and slow imaging speed [2]. Thus, these modalities can neither provide an intraoperative diagnosis of cancer with high sensitivity and specificity nor be used to define tumor margins [3].Indocyanine green (ICG), a clinically approved fluorescent dye, has become a popular choice in various clinical applications, e.g., dental imaging [4,5]. Many studies suggested that ICG could become an ideal fluorescent agent to enhance the imaging contrast between normal tissues and certain tumors, such as breast cancer, gastric cancer, head and neck cancer, and pancreatic tumor [6]. However, most of the existing studies using ICG performed the imaging in the first near-infrared window (NIR-I, 700-1000 nm) [6]. Compared to traditional NIR-I, imaging in the second NIR window (NIR-II, 1000-1700 nm) could achieve a deeper tissue penetration depth and acquire good imaging quality because of its low autofluorescence and photon scattering[7], especially with ICG [8]. Existing studies reported ICG-assisted NIR fluorescence imaging in NIR-II (ICG-NIRF-II) for the detection of thoracic malignancy[9] and

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“…To investigate the biodistribution of ICPs@PDA:CuO 2 NPs in vivo , they were labeled with the widely used fluorescence dye indocyanine green (ICG). − Tumor-bearing mice were intravenously injected with either free ICG or ICG-labeled ICPs@PDA:CuO 2 NPs and the images were acquired and are shown in Figure A (excitation ∼740 nm, emission ∼790 nm). The results showed that free ICG was rapidly distributed throughout the body within the first hour, with fluorescence intensity decreasing quickly at the tumor sites due to the small size of the ICG molecules.…”

Sensory Ion Channel Candidates Inform on the Clinical Course of Pancreatic Cancer and Present Potential Targets for Repurposing of FDA-Approved Agents

“…First, TRPC3 seems to be able to interact with indocyanine green (ICG), a clinically established dye for intraoperative fluorescence discrimination of target tissue during hepatocellular surgery. Recent clinical reports promote the use of ICG to detect pancreatic cancer lesions [ 32 , 33 ]. Our prediction data suggests a novel possible contributing factor for a mechanistic explanation to establish fluorescence-guided pancreatic surgery.…”

Activity-Based Fluorescence Diagnostics for Cancer

“…Intravenously administered ICG binds to blood proteins such as albumin and tends to accumulate in certain types of cancer due to the overexpression of ICG-related transporters (Figure ). − Due to this characteristic behavior, ICG has been used for the visualization of malignancies such as liver, pancreatic, stomach and colon cancers. − It is also used for the identification of sentinel lymph nodes during breast cancer surgery. , …”