Clear margins (no tumor on the surface of the resected tissues) is essential to minimize tumor recurrence and prolong survival for wide local... Show moreClear margins (no tumor on the surface of the resected tissues) is essential to minimize tumor recurrence and prolong survival for wide local excision cancer surgeries. However, standard methods of margin assessment cannot be carried out within the time frame of surgery (meaning patients with positive margins are suggested to undergo call-back surgeries). Intraoperative molecular imaging of cell surface receptors can offer a solution; however, substantial nonspecific diffusion and retention of imaging agents in resected tissues remains a significant challenge to identifying cancer reliably. Recently, “paired-agent” methods—which employ co-administration of a control-imaging agent with a targeting agent—have been applied to thick-sample staining and rinsing applications to account for background staining. This dissertation aimed to optimize paired-agent molecular imaging tumor-to-healthy tissue discrimination through mathematical modeling.Two simplified mathematical models—the rinsing paired-agent model (RPAM) and the serial staining model (SSM)—were derived and tested in accurate simulation models (also developed as a component of this dissertation,) and in preclinical cancer models. More specifically, RPAM was demonstrated to be capable of providing more accurate estimates of receptor concentration than more standard “ratiometric” methods (essentially dividing the targeted agent signal by the control agent signal), and the model was insensitive to the variability of rinsing time from one image to the next. Though it was noted in experiments, that regardless of the approach taken, a very large fraction of signal was removed upon the first rinse, leading to large “gaps” in the data that would be available to RPAM. The SSM, on the other hand, provided a model that could be applied to serial staining data, which yielded a more gradual change in signal between imaging.Considering the multidimensional complexity of paired-agent topical tissue molecular imaging (with diffusion, imaging agent chemical/binding properties, tissue staining, rinsing, imaging, and data analysis protocols all being subject to alteration), thorough optimization margin analysis imaging protocols is untractable using experiments alone. Therefore, a salient feature of this dissertation was the development and validation of a “forward” mathematical diffusion and binding model for in silico testing of proposed paired-agent staining and rinsing protocols in thick tissue. Show less
