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2.4.1.2 Imaging

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There is a vast range of medical imaging techniques with various purposes and advantages. Many (e.g. ultrasound scanning) are not enhanced by inorganic nanomaterials, so will not be discussed further in this section. Some (such as positron emission tomography (PET)) are starting to benefit from enhancement with nanoparticles, but expand into the science of radioisotopes, which again is beyond the scope of this section (see [20] for the development of PET with nanoparticles). Nanomaterials can act as a visualisation probe (highlighting an area of interest) in many microscopy and tomography techniques (see chapter 3 for techniques), or enhance the signal for a specific area, because of its nanoproperties such as nanomagnetism in magnetic resonance imaging (MRI) and magnetic particle imaging (MPI). The nanomaterials become diagnostic probes by being decorated with biomarkers such as antibodies that will target individual diseases, thus specifically detecting and emphasising these areas.

Probes for microscopy can be used both in vitro and in vivo. Gold nanoparticles have been used extensively on both accounts. Gold can be decorated effectively (e.g. with antibodies) by taking advantage of the strong gold–sulphur bond using a cysteine residue which contains a sulphur. Thus, gold nanoparticles coated with cancer-targeting antibodies (e.g. anti-EGFR (epidermal growth factor receptor)) can be used to visualise cancerous cells with optical microscopy in vitro (figure 2.9(Bi)) [12]. Similar optical microscopy can be used to visualise targeted quantum dots using confocal microscopy [6]. The density of gold nanoparticles can also be utilised as a probe for TEM imaging in what is commonly referred to as immune gold staining, where gold nanoparticles can be targeted to a specific biological site. TEM analysis will then identify structures decorated with dense gold dots, distinguishing them from the other biological tissue (figure 2.9(Bii)). Recently, a combined approach of both gold and CdSe quantum dots have been used to image a cell, highlighting different aspects (the gold to the nucleus, and the quantum dot to the insulin granules) offering multimodal enhanced imaging (figures 2.9(Biii), (Biv)) [14]. In vitro imaging applications are considered mainly to conduct scientific research and cross over into the area of nanosensing (section 2.4.1.5). In vivo imaging is where the real medical applicability lies. Again, gold nanoparticles have been used in diagnostic imaging, using their SPR properties in optical coherent tomography (OCT) [15]. This non-invasive, high resolution optical technique relies on reflective interference between emitted and backscatter light (akin to an optical ultrasound), so can penetrate biological tissue making it applicable in vivo. Gold nanoparticles of various morphologies (tuned so the SPR lies within the emitted light source) make ideal contrast agents for OCT as the gold nanoparticles absorb this specific light wavelength, enhancing the image at this location. Hollow nanocages have proved to be the best contrast enhancing agent, as they offer the strongest absorption in the near infrared. Figure 2.9(Bv) shows a phantom with and without enhancement with gold 30 nm nanocages [15].


Figure 2.9. Summary of some inorganic nanoparticle uses in nanomedicine. (A) Schematic of and key attributes of a generic biomedical nanoparticle. (B) Some examples of how nanoparticles have been used for imaging. (i) Light scattering image of malignant epithelial cells labelled with antibody (anti-EGFR) coated gold nanoparticles (reproduced with permission from [12], copyright 2005 American Chemical Society). (ii) TEM image of human deep posterior lingual gland selectively labeled with immunogold nanoparticles. Scale bar 1 μm (reproduced from [13], copyright 2006 with permission of Elsevier). (iii) and (iv) Targeted labelling of the nucleus of a cell with gold nanoparticles (red) and insulin granules with quantum dots (green/blue) (scale bar 2 μm) (reproduced from [14]). (v) Spectroscopic optical coherence tomography (SOCT) images of a phantom (top intensity and bottom spectroscopic image) showing contrast due to nanocages (reproduced with permission from [15], copyright The Optical Society). (vi) MPI of a mouse with a lower right flank tumour 9 h after injection with 5 mg kg−1 of (superparamagnetic iron-oxide nanoparticle) SPION tracer. A CT scan of the skeleton is overlaid (reproduced with permission from [16], copyright 2017 American Chemical Society) and (C) shows some examples of how nanoparticles are being researched for therapeutic use. (i) Schematic showing the formation of the DOX-loaded SPION@HP core@shell system, and the sustained release at a steady rate of DOX by diffusing through the polymeric matrix as the HP shell degraded. Reproduced from [17]. (ii) An in vivo experiment of the treatment of a tumour with magnetosomes and a SPION control. (a) Shows the experimental setup in the alternating field coil, (b) shows the shrinkages of the tumour with treatment of magnetosome chains compared to (c) treatment with SPIONs, and (d) shows the cancer cell with magnetosome chains after 24 h (reproduced from [18] with permission from Taylor & Francis Ltd). (Di) Schematic of a multifunctional combined imaging and therapeutic nanoparticle termed a theragnostic nanoparticle. (ii) Schematic representing the dual function of Fe@Si–DOX–CD–PEG nanoparticles having both MRI contrast agents and for SMART targeted drug release. Fe@Si cores are magnetite nanoparticles coated with nanoporous silica shown in the TEM image on the right. DOX is the anticancer drug doxorubicin located in the silica pores. CD is cyclodextrin which can release the DOX when exposed to glutathione (GSH) which is present in high concentrations in cancer cells (adapted from [19]).

Magnetic resonance imaging (MRI) is a non-invasive technique which has been used internationally since the 1970s. The technique makes use of the massive number of protons in the body. In basic terms, when a magnetic field is applied to the body (in an MRI scanner) the net magnetisation of protons in the body aligns with the direction of the field. A radio frequency is then applied giving the protons energy. When the radio frequency is removed the protons then relax back, and this relaxation can be measured. Using gradient magnets of varying strength allows the targeting of specific areas for imaging of all three dimensions. Magnetic nanoparticles have great potential as MRI contrast agents, as the interaction of the particle’s local magnetic field with the surrounding protons can significantly enhance contrast in vivo, by increasing relaxation time, resulting in the darkening of this area of the image, without the toxicity of gadolinium-based agents. The size of the MNPs greatly affects the MRI signal, offering tunable contrast modalities [21].

Magnetic particle imaging (MPI) is a new non-invasive imaging technique that images the magnetic signal from superparamagnetic iron-oxide nanoparticles (SPIONs). Utilising the inherent magnetic properties (from the electrons) results in far greater (×22 million) intensity compared to MRI (which utilises the nuclear moment). SPIONs are targeted to a site in the body then imaged by applying a saturating magnetic field, then rostering an excitation field, which causes the SPIONs to flip, which can be detected at this location in 3D. It has been used to successfully locate and image cancer tumours (figure 2.9(Bvi)) [16] but its sensitivity means it could be used for a range of more subtle diagnostics too.

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