Shortwave infrared fluorescence in vivo imaging of nerves for minimizing the risk of intraoperative nerve injury
Surgical procedures are often associated with the development of iatrogenic peripheral nerve injuries, and nerve preservation is the unavoidable problem during surgeries. Unfortunately, there is no effective method to avoid this problem in clinic. Here, we present a novel nerve imaging tool for preventing intraoperative nerve injuries, which mainly relies on the excellent SWIR fluorescence capability of lead sulfide quantum dots and the unique nerve targeting abilities of NP-41. In our study, the peripheral nerves (PNs) of mice (size≧2 mm) could be observed specifically by shortwave infrared (SWIR) fluorescence imaging starting ~1.5 hrs after intravenous administration and lasting for ~2.0 hrs in both nude and C57bl/6 mice. Furthermore, an iatrogenic nerve injury with ~6 mm left was able to be defected with negligible non-specific signal interference, and nerve suturing was then performed to recover continuity by using a transected resutured PN mice model. Finally, the long-term survival of mice (100 days) after our products’post-injection without significant abnormalities on behavior tests compared to control groups suggests our product has negligible nerve toxicity. Overall, this novel imaging approach not only provides real-time and long-time images to intraoperatively identify nerves, but can also markedly minimize the risk of iatrogenic nerve injuries during surgeries.