Assessment of a Liposomal CT/Optical Contrast Agent for Image-Guided Head and Neck Surgery

Abstract Background This study evaluates a long-acting liposomal fluorescence / CT dual-modality contrast agent (CF800) in head and neck cancer to enhance intraoperative tumor demarcation with fluorescence imaging and cone-beam computed tomography (CBCT). Methods CF800 was administered to 12 buccal cancer-bearing rabbits. Imaging was acquired at regular timepoints to quantify time-dependent contrast enhancement. Surgery was performed 5–7 days after, with intraoperative near-infrared fluorescence endoscopy and CBCT, followed by histological and ex-vivo fluorescence assessment. Results Tumor enhancement on CT was significant at 24, 96 and 120 hours. Volumetric analysis of tumor segmentation showed high correlation between CBCT and micro-CT. Fluorescence signal was apparent in both ex-vivo and in-vivo imaging. Histological correlation showed [100%] specificity for primary tumor. Sensitivity and specificity of CF800 in detecting nodal involvement require further investigation. Conclusion CF800 is long acting and has dual function for CT and fluorescence contrast, making it an excellent candidate for image-guided surgery.