On the use of fluorescein-based contrast agents as analogs to MRI-gadolinium agents for imaging brain tumors

Magnetic resonance imaging (MRI) of gadolinium (Gd)-based contrast agents plays a central role in managing the treatment of intracranial tumors. These images are involved in diagnosis, surgical planning, surgical navigation, and postoperative assessment of extent of resection. Replicating the information from Gd-MRI in the visual surgical field using fluorescent agents that behave similar to gadolinium in vivo would represent a major advance for surgical intervention of these tumors, and could provide robust compensation information to update pre-operative MRI images during surgery. In this paper, we examine the uptake of a Gd-based contrast agent in orthotopic tumor models and compare this behavior to two fluorescein-based contrast agents; specifically, clinical-grade sodium fluorescein (NaFl) and a 900 Da pegylated form of fluorescein. We show that the pegylated form of fluorescein is a more promising Gd-analog candidate.