Methods and system for image guided cell ablation with microscopic resolution

1. An in vivo method of treating a subject with a tumor comprising:

(a) administering a composition comprising a molecular imaging probe to the subject, wherein the imaging probe is a clearance differential probe including a fluorescent label with optical properties in the visible spectrum of 350-670 nm attached to a pharmacokinetic modifier that results in the molecular imaging probe clearing preferentially from healthy tissue leaving tumor cells labeled;

(b) permitting the molecular imaging probe to clear preferentially from healthy tissue leaving tumor cells labeled;

(c) performing initial resection surgery to remove cancer cells from the subject thereby creating a resection bed;

(d) treating the resection bed with light energy and obtaining an in situ image of the bed using an imaging system, wherein the image allows for the detection of the tumor cells, if present in the resection bed; and

(e) if tumor cells are detected in (d), performing further resection surgery to remove labeled tumor cells.

2. The method of claim 1 , wherein the composition is administered systemically to said subject or applied to the surface of said tissue.

3. The method of claim 1 wherein the molecular imaging probe is imaged at between 12 and 36 hours after administration.

4. The method of claim 1 , wherein the pharmacokinetic modifier has a molecular weight of between 20,000 g/mol and 40,000 g/mol.

5. The method of claim 1 , wherein the pharmacokinetic modifier is selected from the group consisting of polyethylene glycol (PEG), dextran, polyethylene oxide (PEO), polyoxyethylene (POE), methoxypolyethylene glycol (MPEG), methoxypolypropylene glycol, polyethylene glycol-diacid, polyethylene glycol monoamine, MPEG monoamine, MPEG hydrazide, MPEG imidazole, copolymers of polyethylene glycol and monoxypolypropylene glycol, branched polypropylene glycol, polypropylene glycol, and polylacic-polyglycolic acid.

6. The method of claim 1 , wherein the molecular imaging probe comprises a polyethylene glycol (PEG) having a molecular weight of between 20,000 g/mol and 40,000 g/mol.

7. The method of claim 1 , wherein the fluorescent label is selected from the group consisting of Cy3, Cy3.5, Cy5, Alexa 568, Alexa 546, Alexa 610, Alexa 647, ROX, TAMRA, Bodipy 576, Bodipy 581, Bodipy TR, Bodipy 630, VivoTag 645, and Texas Red.

8. The method of claim 1 , wherein the image allows for selective detection of one or more tumor cells within about 1 cm from the surface of the tissue resection bed and excludes deep tissue emission.

9. The method of claim 1 , wherein the subject is a human.

10. The method of claim 1 , wherein the resolution imaging system comprises: (a) a light source; (b) an optical receptor configured to receive the light from the object; and (c) an image processor.

11. The method of claim 1 , wherein the image processor comprises a field of view (FOV) greater than a diameter of a cell of the object and an analysis resolution matched to the diameter of a cell of the object and configured to receive and analyze the light corresponding to each cell in the FOV.

12. The method of claim 1 , wherein the imaging probe clears preferentially from healthy tissue leaving both tumor cells and tumor associated inflammation cells labeled.

13. The method of claim 1 , wherein the imaging system is a single-cell resolution imaging system.