Real-time near infrared fluorescence (NIRF) intra-operative imaging in ovarian cancer using an αvβ3-integrin targeted agent

BackgroundIn ovarian cancer, optimal cytoreductive surgery is of the utmost importance for long-term survival. The ability to visualize minuscule tumor deposits is important to ensure complete resection of the tumor. The purpose of our study was to estimate the in vivo sensitivity, specificity and diagnostic accuracy of an intra-operative fluorescence imaging system combined with an αvβ3-integrin targeted near-infrared fluorescent probe.MethodTumor bearing mice were injected intravenously with a fluorescent probe targeting αvβ3 integrins. Fluorescent spots and non-fluorescent tissue were identified and resected. Standard histopathology and fluorescence microscopy were used as gold-standard for tumor detection.ResultsFifty-eight samples excised with support of intra-operative image-guided surgery were analyzed. The mean target to background ratio was 2.2 (SD 0.5). The calculated sensitivity of the imaging system was 95%, and the specificity was 88% with a diagnostic accuracy of 96.5%.ConclusionNear-infrared image-guided surgery in this model has a high diagnostic accuracy and a fair target to background ratio that supports the development towards clinical translation of αvβ3-integrin targeted imaging.

► Near infrared fluorescence imaging with targeted probes enables tumor visualization.
► By using an avb3 integrin targeted fluorescent probe, tumor tissue can be detected with high accuracy.
► Near infrared fluorescence imaging combined with targeted probes can in may shift the paradigm of surgical oncology.