Pressure- enhanced sensing of tissue oxygenation via endogenous porphyrin: Implications for dynamic visualization of cancer in surgery
成果类型：
Article
署名作者：
Petusseau, Arthur F.; Ochoa, Marien; Reed, Matthew; Doyley, Marvin M.; Hasan, Tayyaba; Bruza, Petr; Pogue, Brian W.
署名单位：
Dartmouth College; University of Wisconsin System; University of Wisconsin Madison; University of Rochester; Harvard University; Harvard University Medical Affiliates; Massachusetts General Hospital; Harvard University; Harvard Medical School
刊物名称：
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
ISSN/ISSBN：
0027-9514
DOI：
10.1073/pnas.2405628121
发表日期：
2024-08-20
关键词：
interstitial fluid pressure
fluorescence-guided surgery
tumor hypoxia
5-aminolevulinic acid
delayed fluorescence
transient hypoxia
actinic keratosis
breast cancers
therapy
tension
摘要：
Fluorescence guidance is routinely used in surgery to enhance perfusion contrast in multiple cence is a technique extensively analyzed here, that uses an FDA- approved human precursor molecule, 5- aminolevulinic acid (ALA), to stimulate a unique delayed fluorescence signal that is representative of tissue hypoxia. The ALA precontrast agent is metabolized in most tissues into a red fluorescent molecule, protoporphyrin IX (PpIX), which has both prompt fluorescence, indicative of the concentration, and a delayed fluorescence, that is amplified in low tissue oxygen situations. Applied pressure from palpation induces transient capillary stasis and a resulting transient PRESTO contrast, dominant when there is near hypoxia. This study examined the kinetics and behavior of this effect in both normal and tumor tissues, with a prolonged high PRESTO contrast (contrast to background of 7.3) across 5 tumor models, due to sluggish capillaries and inhibited vasodynamics. This tissue function imaging approach is a fundamentally unique tool for real- time palpation- induced tissue response in vivo, relevant for chronic hypoxia, such as vascular diseases or oncologic surgery.