Nerve trauma is a major cause of morbidity associated with surgery and can lead to loss of sensation, chronic postsurgical pain, and erectile dysfunction. Although human nerve anatomy is known, precisely locating tissue- embedded nerves is challenging during surgery due to individual anatomical variation, intricacy, and size. De- spite the use of nerve sparing techniques, the risk of iatrogenic nerve damage remains high in a wide array of prominent open and minimally invasive surgeries, ranging from radical prostatectomy (prostate cancer), coro- nary artery bypass graft (cardiovascular disease), lymph node dissection (breast cancer), and spine surgery. The team proposes to improve intra operative detection of nerves through two complimentary technologies: (1) near infrared fluorescent contrast agents targeting nerves, and (2) dedicated compact and minimally invasive surgical instruments to simultaneously image nerve fluorescence and anatomy in real-time. The ability of these molecular imaging agents and surgical instruments to visualize nerves will be validated in preclinical models. The long-term goal of this study is to provide tools for surgeons to minimize iatrogenic nerve damage, expedite surgical procedures, enhance surgical efficiency, and improve patient outcomes.

Public Health Relevance

Nerve damage during surgery can have a significant deleterious effect on patient quality of life. Unintentional damage to nerves can lead to chronic pain, loss of sensation, and erectile dysfunction. A method to better visualize nerves during surgery would improve patient outcome by reducing the risk of nerve damage.

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Research Project (R01)
Project #
5R01EB011872-02
Application #
8074104
Study Section
Clinical Molecular Imaging and Probe Development (CMIP)
Program Officer
Krosnick, Steven
Project Start
2010-06-01
Project End
2014-03-31
Budget Start
2011-04-01
Budget End
2012-03-31
Support Year
2
Fiscal Year
2011
Total Cost
$930,961
Indirect Cost
Name
General Electric Global Research Center
Department
Type
DUNS #
086188401
City
Niskayuna
State
NY
Country
United States
Zip Code
12309
Siclovan, Tiberiu M; Zhang, Rong; Cotero, Victoria et al. (2016) Fluorescence Phenomena in Nerve-Labeling Styryl-Type Dyes. J Photochem Photobiol A Chem 316:104-116
Cotero, Victoria E; Kimm, Simon Y; Siclovan, Tiberiu M et al. (2015) Improved Intraoperative Visualization of Nerves through a Myelin-Binding Fluorophore and Dual-Mode Laparoscopic Imaging. PLoS One 10:e0130276
Gibbs, Summer L; Xie, Yang; Goodwill, Haley L et al. (2013) Structure-activity relationship of nerve-highlighting fluorophores. PLoS One 8:e73493
Bajaj, Anshika; LaPlante, Nicole E; Cotero, Victoria E et al. (2013) Identification of the protein target of myelin-binding ligands by immunohistochemistry and biochemical analyses. J Histochem Cytochem 61:19-30
Gray, Dan; Kim, Evgenia; Cotero, Victoria et al. (2012) Compact Fluorescence and White Light Imaging System for Intraoperative Visualization of Nerves. Proc SPIE Int Soc Opt Eng 8207:
Cotero, Victoria E; Siclovan, Tiberiu; Zhang, Rong et al. (2012) Intraoperative fluorescence imaging of peripheral and central nerves through a myelin-selective contrast agent. Mol Imaging Biol 14:708-17
Gray, Daniel C; Kim, Evgenia M; Cotero, Victoria E et al. (2012) Dual-mode laparoscopic fluorescence image-guided surgery using a single camera. Biomed Opt Express 3:1880-90
Zavodszky, Maria I; Graf, John F; Tan Hehir, Cristina A (2011) Feasibility of imaging myelin lesions in multiple sclerosis. Int J Biomed Imaging 2011:953806
Gibbs-Strauss, Summer L; Nasr, Khaled A; Fish, Kenneth M et al. (2011) Nerve-highlighting fluorescent contrast agents for image-guided surgery. Mol Imaging 10:91-101