Improved Intraoperative Visualization of Nerves through a Myelin-Binding Fluorophore and Dual-Mode Laparoscopic Imaging.
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, w...
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doaj-edb0532a397d49e391e46e42d7d191602020-11-25T01:00:25ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01106e013027610.1371/journal.pone.0130276Improved Intraoperative Visualization of Nerves through a Myelin-Binding Fluorophore and Dual-Mode Laparoscopic Imaging.Victoria E CoteroSimon Y KimmTiberiu M SiclovanRong ZhangEvgenia M KimKazuhiro MatsumotoTatsuo GondoPeter T ScardinoSiavash YazdanfarVincent P LaudoneCristina A Tan HehirThe 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.http://europepmc.org/articles/PMC4468247?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
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 |
spellingShingle |
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 Improved Intraoperative Visualization of Nerves through a Myelin-Binding Fluorophore and Dual-Mode Laparoscopic Imaging. PLoS ONE |
author_facet |
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 |
author_sort |
Victoria E Cotero |
title |
Improved Intraoperative Visualization of Nerves through a Myelin-Binding Fluorophore and Dual-Mode Laparoscopic Imaging. |
title_short |
Improved Intraoperative Visualization of Nerves through a Myelin-Binding Fluorophore and Dual-Mode Laparoscopic Imaging. |
title_full |
Improved Intraoperative Visualization of Nerves through a Myelin-Binding Fluorophore and Dual-Mode Laparoscopic Imaging. |
title_fullStr |
Improved Intraoperative Visualization of Nerves through a Myelin-Binding Fluorophore and Dual-Mode Laparoscopic Imaging. |
title_full_unstemmed |
Improved Intraoperative Visualization of Nerves through a Myelin-Binding Fluorophore and Dual-Mode Laparoscopic Imaging. |
title_sort |
improved intraoperative visualization of nerves through a myelin-binding fluorophore and dual-mode laparoscopic imaging. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2015-01-01 |
description |
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. |
url |
http://europepmc.org/articles/PMC4468247?pdf=render |
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