Fluorescent contrast agents for tumor surgery (Review)

Abstract

Cancer is a leading cause of cases of mortality worldwide. The most effective method to cure solid tumors is surgery. Every year, >50% of cancer patients receive surgery to remove solid tumors. Surgery may increase the cure rate of most solid tumors by 4–11 fold. Surgery has many challenges, including identifying small lesions, locating metastases and confirming complete tumor removal. Fluorescence guidance describes a new approach to improve surgical accuracy. Near-infrared fluorescence imaging allows for real-time early diagnosis and intraoperative imaging of lesion tissue. The results of previous preclinical studies in the field of near-infrared fluorescence imaging are promising. This review provides examples introducing the three kinds of fluorescent dyes: The passive fluorescent dye indocyanine green, which has been approved by the Food and Drug Administration for clinical use in the USA, the fluorescent prodrug 5-aminolevulinic acid, a porphyrin precursor in the heme synthesis, and biomarker-targeted fluorescent dyes, which allow conjugation to different target sites.

Indocyanine Green Fluorescent Cholangiography During Laparoscopic Cholecystectomy, Ain-Shams University and Egypt’s Initial Experience - A Case Report

“…4 Indocyanine Green is a water-soluble, tricarbocyanine dye, formulated by Kodak Laboratories in 1955 to be used in photography. 5 A few years later, ICG was approved to be used in the medical field. Each vial of ICG contains 25 mg of ICG as a sterile lyophilized powder with no more than 5% sodium iodide.…”

“…Each vial of ICG contains 25 mg of ICG as a sterile lyophilized powder with no more than 5% sodium iodide. 5 It undergoes no significant extrahepatic or enterohepatic circulation; negligible renal, peripheral, lung or cerebrospinal fluid uptake. It is taken up exclusively by the hepatic parenchymal cells from the plasma and is secreted entirely into the bile.…”

DNA Photocleavage in the Near-Infrared Wavelength Range by 2-Quinolinium Dicarbocyanine Dyes

“…Near infrared excitation wavelengths from 700 to 900 nm are particularly attractive for biological applications because they are efficiently transmitted through biological tissue [10]. Low cellular toxicity coupled with the ability to absorb and emit near-infrared light has led to the development of indocyanine green (ICG; λex = 800 nm; λem = 810 nm) and other cyanines as biological agents in the diagnosis and imaging of cancer [1,[11][12][13][14]. The fluorophore ICG, approved by the United States Food and Drug Administration in 1956, is routinely used in medical diagnostics to monitor blood flow, and is now under investigation as a tumor-imaging agent.…”

Next-generation laser-based photodynamic endoscopic diagnosis using 5-aminolevulinic acid for early gastric adenocarcinoma and gastric adenoma

“…5-ALA is a natural amino acid that has been used in the photodynamic diagnosis (PDD) of several tumors, such as brain glioma [9] and bladder cancer [10,11]. The 5-ALA is metabolized into protoporphyrin IX (PpIX) in the heme biosynthesis pathway, and PpIX is synthesized in mitochondria and tends to accumulate in cancer cells, emitting red fluorescence (635 nm light) when irradiated by blue wavelength light (375-440 nm) [12,13]. LPDED, a 5-ALA-based PDD, is an optical imaging technology based on the fundamental biological features of porphyrin metabolism in cancer cells [14].…”