Improved intraoperative visualization of nerves through a myelin-binding fluorophore and dual-mode laparoscopic imaging

Victoria E. Cotero, Simon Y. Kimm, Tiberiu M. Siclovan, Rong Zhang, Evgenia M. Kim, Kazuhiro Matsumoto, Tatsuo Gondo, Peter T. Scardino, Siavash Yazdanfar, Vincent P. Laudone, Cristina A. Tan Hehir

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

The ability to visualize and spare nerves during surgery is critical for avoiding chronic morbidity, pain, and loss of function. Visualization of such critical anatomic structures is even more challenging during minimal access procedures because the small incisions limit visibility. In this study, we focus on improving imaging of nerves through the use of a new small molecule fluorophore, GE3126, used in conjunction with our dual-mode (color and fluorescence) laparoscopic imaging instrument. GE3126 has higher aqueous solubility, improved pharmacokinetics, and reduced non-specific adipose tissue fluorescence compared to previous myelin-binding fluorophores. Dosing and kinetics were initially optimized in mice. A non-clinical modified Irwin study in rats, performed to assess the potential of GE3126 to induce nervous system injuries, showed the absence of major adverse reactions. Real-time intraoperative imaging was performed in a porcine model. Compared to white light imaging, nerve visibility was enhanced under fluorescence guidance, especially for small diameter nerves obscured by fascia, blood vessels, or adipose tissue. In the porcine model, nerve visualization was observed rapidly, within 5 to 10 minutes post-intravenous injection and the nerve fluorescence signal was maintained for up to 80 minutes. The use of GE3126, coupled with practical implementation of an imaging instrument may be an important step forward in preventing nerve damage in the operating room.

Original languageEnglish
Article numbere0130276
JournalPLoS One
Volume10
Issue number6
DOIs
Publication statusPublished - 2015 Jun 15
Externally publishedYes

Fingerprint

Fluorophores
fluorescent dyes
myelin sheath
Myelin Sheath
nerve tissue
Visualization
Fluorescence
image analysis
Imaging techniques
Adipose Tissue
Swine
Nervous System Trauma
fluorescence
Visibility
Optical Imaging
Fascia
Operating Rooms
Intravenous Injections
Chronic Pain
Solubility

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Improved intraoperative visualization of nerves through a myelin-binding fluorophore and dual-mode laparoscopic imaging. / Cotero, Victoria E.; Kimm, Simon Y.; Siclovan, Tiberiu M.; Zhang, Rong; Kim, Evgenia M.; Matsumoto, Kazuhiro; Gondo, Tatsuo; Scardino, Peter T.; Yazdanfar, Siavash; Laudone, Vincent P.; Tan Hehir, Cristina A.

In: PLoS One, Vol. 10, No. 6, e0130276, 15.06.2015.

Research output: Contribution to journalArticle

Cotero, VE, Kimm, SY, Siclovan, TM, Zhang, R, Kim, EM, Matsumoto, K, Gondo, T, Scardino, PT, Yazdanfar, S, Laudone, VP & Tan Hehir, CA 2015, 'Improved intraoperative visualization of nerves through a myelin-binding fluorophore and dual-mode laparoscopic imaging', PLoS One, vol. 10, no. 6, e0130276. https://doi.org/10.1371/journal.pone.0130276
Cotero, Victoria E. ; Kimm, Simon Y. ; Siclovan, Tiberiu M. ; Zhang, Rong ; Kim, Evgenia M. ; Matsumoto, Kazuhiro ; Gondo, Tatsuo ; Scardino, Peter T. ; Yazdanfar, Siavash ; Laudone, Vincent P. ; Tan Hehir, Cristina A. / Improved intraoperative visualization of nerves through a myelin-binding fluorophore and dual-mode laparoscopic imaging. In: PLoS One. 2015 ; Vol. 10, No. 6.
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