Cell-Based Tracers as Trojan Horses for Image-Guided Surgery

• Published in: International journal of molecular sciences Vol. 22; no. 2; p. 755
• Main Authors: Sier, Vincent Q, de Vries, Margreet R, van der Vorst, Joost R, Vahrmeijer, Alexander L, van Kooten, Cornelis, Cruz, Luis J, de Geus-Oei, Lioe-Fee, Ferreira, Valerie, Sier, Cornelis F M, Alves, Frauke, Muthana, Munitta
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 13.01.2021; MDPI
• Subjects: Arteriosclerosis; Atherosclerosis; Cell Tracking - methods; cell-based imaging; Cell-Derived Microparticles - metabolism; Chemokines; Computed tomography; Contrast agents; Contrast Media; Epidermal growth factor; Exosomes; Extracellular vesicles; Fluorescence; Fluorescent indicators; Humans; Immune system; leukocyte; Leukocytes (neutrophilic); Leukocytes - metabolism; Lymphocytes; Lymphocytes T; Macrophages; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Medical imaging; Mesenchymal Stem Cells - metabolism; mesenchymal stromal cell; Mesenchyme; Microorganisms; Monocytes; Nanoparticles; Nanoparticles - chemistry; near-infrared; Neutrophils; nuclear imaging; Peptides; Photon emission; Plaques; Positron emission; Positron emission tomography; Positron-Emission Tomography - methods; Prostate; Review; Single photon emission computed tomography; Stromal cells; Surgery; Surgery, Computer-Assisted - methods; Surgery, Computer-Assisted - standards; Tomography; Tracers; Tumors; Vascular endothelial growth factor; Visualization; magnetic resonance imaging; near-infrared; microorganisms; leukocyte; nanoparticle; cell-based imaging; mesenchymal stromal cell; nuclear imaging; extracellular vesicle; platelets
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms22020755

Surgeons rely almost completely on their own vision and palpation to recognize affected tissues during surgery. Consequently, they are often unable to distinguish between different cells and tissue types. This makes accurate and complete resection cumbersome. Targeted image-guided surgery (IGS) provides a solution by enabling real-time tissue recognition. Most current targeting agents (tracers) consist of antibodies or peptides equipped with a radiolabel for Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT), magnetic resonance imaging (MRI) labels, or a near-infrared fluorescent (NIRF) dye. These tracers are preoperatively administered to patients, home in on targeted cells or tissues, and are visualized in the operating room via dedicated imaging systems. Instead of using these 'passive' tracers, there are other, more 'active' approaches of probe delivery conceivable by using living cells (macrophages/monocytes, neutrophils, T cells, mesenchymal stromal cells), cell(-derived) fragments (platelets, extracellular vesicles (exosomes)), and microorganisms (bacteria, viruses) or, alternatively, 'humanized' nanoparticles. Compared with current tracers, these active contrast agents might be more efficient for the specific targeting of tumors or other pathological tissues (e.g., atherosclerotic plaques). This review provides an overview of the arsenal of possibilities applicable for the concept of cell-based tracers for IGS.