A tremendous amount of scientific effort has been placed in recent years towards the generation of multifunctional nanoparticles for early detection of cancer, targeted drug delivery to tumors and for monitoring of cancer therapy. Nanomedicine has the ability to overcome the limitations of traditional imaging and therapeutic agents and to potentially integrate diagnostic and therapeutic applications in oncology [
3-
5]. Functionalization of nanocarriers with tumor-targeting moieties provides the ability to selectively deliver anticancer agents at optimal concentrations to tumor sites [
5]. In addition, the inclusion of imaging agents enables real time, non-invasive assessment of tumor physiology, drug delivery and therapeutic response [
3-
5].
The objective of the present study was to develop and characterize a nanoparticle-based platform for dual modality imaging of HNSCC. Here we report the utility of phospholipid-PEG based polymeric nanomicelles encapsulating a NIR phosphorescent dye, and surface conjugated with gadolinium, as an imaging probe for combined MRI and optical imaging. Our results demonstrate that Pt(TPNP)-Gd nanomicelles exhibit a high degree of tumor-avidity and favorable imaging properties that allowed for combined MRI and optical imaging of head and neck tumors.
The polymeric nanoplatform utilized in our study provides several benefits over conventional imaging agents which include prolonged circulation time, improved tumor selective targeting and reduced antigenicity. The nanomicelles are made of biocompatible copolymers and exploit the EPR effect commonly observed in tumors making them ideal carriers for delivery of anticancer drugs, fluorophores and biomolecules selectively to tumors [
8,
9]. Several preclinical studies have previously demonstrated the usefulness of polymeric micelles as drug carriers [
8,
9]. A number of polymeric conjugates, micellar and liposomal formulations of drugs are also currently being evaluated in clinical trials [
9]. To minimize opsonization, the surface of the nanoparticles was conjugated with polyethylene glycol (PEG), a relatively inert hydrophilic polymer that provides good steric hindrance for preventing protein binding. The net negative charge on the surface of the Pt(TPNP)-Gd nanomicelles should have a pronounced effect on the adsorption of different physiological lipoproteins in systemic circulation, playing a critical role in the clearance of the nanoparticles from the body [
10].
The development of a dual modality imaging agent for combined MRI and optical imaging is attractive, given the complementary nature of these two imaging modalities. Optical imaging methods provide a high degree of sensitivity for bioimaging and are relatively inexpensive and easy to use. Traditionally, clinical application of optical imaging has been limited by tissue penetration of visible light. The use of NIR probes for
in vivo imaging allows for imaging of deeper tissues and reduces the background autofluorescence, providing higher contrast [
8,
11], but does not fully overcome the drawback of optical imaging related to limited depth of light propagation in biological tissues. In contrast to optical imaging methods, MRI suffers from limited sensitivity and lacks resolution for imaging at the cellular level, but does not have limitation of depth and provides excellent soft tissue contrast. Thus, a nanoplatform that allows for combined MR-NIR imaging could potentially bridge the gaps in sensitivity/resolution and depth of imaging. Indeed, such nanoparticle based approaches for combined MR-optical imaging of tumors has been previously reported [
12-
14]. These approaches have typically utilized NIR fluorescent dyes, e.g., Cy5.5, in combination with iron oxide or gadolinium for MR contrast. PAMAM-dendrimer based nanoparticles and gadolinium-labeled photoluminescent quantum dots have been examined for their potential for targeted molecular imaging of lymph nodes and tumor vasculature [
12-
16]. Dual modality MR-optical imaging approaches have also been utilized for sentinel lymph node mapping in mice [
16]. Optical tracers have also been studied for diagnostic and therapeutic applications in head and neck cancers [
17,
18].
We have previously demonstrated that phospholipid-based NIR phosphorescent polymeric nanomicelles exhibit superior optical imaging properties
in vivo [
7]. In the same study, using histologic analyses we have shown that Pt(TPNP) nanomicelles can be safely administered to animals without any associated short-term toxicities. The
in vitro and
in vivo results from the present study demonstrate the potential of Gd-labeled phosphorescent nanomicelles as MR contrast agents (Figure , and ). Although Gd
3+ based agents (Gd-DTPA; Gd-DOTA) have been approved for clinical use and are routinely used in human studies, these agents are associated with considerable limitations. A majority of the clinically approved low molecular weight contrast agents are non-specific in nature and do not contain any targeting moieties. Due to their non-targeted nature, these contrast agents undergo rapid extravasation and plasma clearance (in the order of minutes) resulting in a very narrow imaging window. In this regard, the development of 'targeted' MR contrast agents associated with longer tissue retention times would offer a broader imaging window in which high-resolution images can be acquired. Secondly, the most commonly used Gd-containing compounds have relatively low relaxivities and can be toxic. In particular, at high concentrations of the Gd-containing MRI contrast agents, a significant amount of Gd
3+ ions are released and circulate in a free, uncomplexed state. These free Gd
3+ ions have been shown to result in severe toxicities leading to nephrogenic systemic fibrosis in patients with compromised renal function [
19]. The results of our
in vitro MR relaxometry studies showed that Gd-containing polymeric nanomicelles exhibit superior MR properties (higher T1 relaxivity) compared to clinically approved Gd-based contrast agents (e.g., Gd-DTPA). The higher relaxivity of Gd-containing nanomicelle formulations could therefore potentially allow reduction in the amount of injected dose of contrast agent, without compromising image contrast. The combination of optical and MR imaging probes also facilitated tracking of the biodistribution and tumor accumulation of the nanoparticles over time.
With increasing interest in the development of novel targeted therapies for management of head and neck cancers, nanomedicine is likely to play a significant role in the diagnostic evaluation, therapy and tumor response assessment to such targeted therapies in patients [
20].