New technique created for imaging cells and tissues under the skin

A team of scientists has developed the first technique for viewing cells and tissues in three dimensions under the skin. The work could improve diagnosis and treatment for some forms of cancer and blindness.

- By Amy Adams

Gold nanorods within the blood vessels of a mouse ear appear green. The lower right shows vessels within a tumor that lies under the skin.
De la Zerda lab

Scientists can look through microscopes and see incredible detail, including cells and molecules, in preserved tissue. They also can use imaging technology to peer into a living body in three dimensions, and in real time, but without the high-resolution detail.

What they haven’t had is a way to do both: create a three-dimensional, real-time image of individual cells, or even molecules, in a living animal.

Now, Stanford scientists have provided the first glimpse under the skin of a living animal that reveals intricate, real-time details in three dimensions.

The technique, called MOZART, for MOlecular imaging and characteriZation of tissue noninvasively At cellular ResoluTion, could one day allow scientists to detect tumors in the skin, colon or esophagus, or even to see the abnormal blood vessels that appear in the earliest stages of macular degeneration, a leading cause of blindness. The work was published March 18 in Scientific Reports.

“We’ve been trying to look into the living body and see information at the level of the single cell,” said Adam de la Zerda, an assistant professor of structural biology and senior author of the paper. “Until now there has been no way do that.”

De la Zerda, who is also a member of Stanford Bio-X, said the technique could allow doctors to monitor how an otherwise invisible tumor under the skin is responding to treatment, or to understand how individual cells break free from a tumor and travel to distant sites.

Adam de la Zerda

Going for gold

A technique exists for peeking into living tissue several millimeters under the skin, revealing a landscape of cells, tissues and vessels. But that technique, called optical coherence tomography, or OCT, isn’t sensitive or specific enough to see the individual cells or the molecules that the cells are producing, which is what interests de la Zerda.

A major issue has been finding a way to differentiate among types of cells or tissues — for example, to identify the cancerous cells beginning to multiply within overall healthy tissue. In other forms of microscopy, scientists have created tags that latch onto molecules or structures of interest to illuminate those structures and provide a detailed view of where they are in the cell or body.

No such beacons existed for OCT, though de la Zerda knew that tiny particles called gold nanorods had some of the properties he was looking for. The problem was that the commercially available nanorods didn’t produce nearly enough signal to be detected in a tissue.

What the team needed were nanorods — but big ones. Nanorods are analogous to organ pipes, said graduate student Elliott SoRelle, because longer pipes produce lower frequencies, creating a deep, low sound. Likewise, longer nanorods resonate at lower frequencies, or wavelengths, of light. Those vibrations scatter the light, which the microscope detects.

If all the other tissues are resonating in a white noise of higher frequencies, longer nanorods would stand out like low organ notes in a room of high-pitched babble.

SoRelle’s challenge was to manufacture longer nanorods that were nontoxic, stable and very bright, which turned out to be a lot to ask. “My background was biochemistry, and this turned out to be a problem of materials science and surface chemistry,” said SoRelle, who was co-first author of the paper. He has since learned to make nontoxic nanorods in various sizes that all vibrate at unique and identifiable frequencies.

Eliminating noise

The next challenge was filtering out the nanorods’ frequency from the surrounding tissue.

To do that, electrical engineering graduate student and Bowes Bio-X Fellow Orly Liba developed computer algorithms that could separate out the frequencies of light scattered by nanorods of various lengths and differentiate those from surrounding tissue.

I thought it would be really fun to see if we can make it work and see cells talking to each other in real time.

With SoRelle’s large nanorods and Liba’s sensitive algorithms, de la Zerda and his team had solved the initial problem of detecting specific structures in three-dimensional images of living tissues. The resulting three-dimensional, high-resolution images were so big — on the order of gigapixels — that the team needed to develop additional algorithms for analyzing and storing such large images.

The team tested their technology in the ear of a living mouse, where they were able to watch, via OCT, as the nanorods were injected into the ear and taken up into the lymph system, then transported through a network of valves. They were able to distinguish between two different size nanorods that resonated at different wavelengths in separate lymph vessels, and they could distinguish between those two nanorods in the lymph system and the blood vessels. In one case, they could watch individual valves within the lymph vessels open and close to control the flow of fluid in a single direction.

“Nobody has shown that level of detail before,” said Liba, who was the other co-first author on the paper.

Impossible goal

This detailed imaging was de la Zerda’s initial goal when he started his lab in 2012, though he was frequently told it would be impossible. “I’m in a small department, but with very accomplished faculty,” he said. “One faculty member told me his own life story of taking big risks, and that encouraged me. I thought it would be really fun to see if we can make it work and see cells talking to each other in real time.”

His gamble got off the ground primarily with a seed grant from Stanford Bio-X, which supports early-stage interdisciplinary research. “That grant allowed us to take a big risk in a direction that was completely unproven,” de la Zerda said.

Having shown that the gold nanorods can be seen in living tissue, the next step is to show that those nanorods can bind to specific kinds of cells, like skin cancer or abnormal vessels in early stage macular degeneration. Then, the technique could be used to learn more about how those diseases progress at the molecular level and also evaluate treatments in individual patients, something that previously hasn’t been possible.

Debasish Sen, PhD, a research associate at Stanford, is also a co-author of the paper.

The work was funded by the U.S. Air Force, the National Institutes of Health Director's Office, the National Science Foundation, the Damon Runyon Cancer Research Foundation, the Susan G. Komen Breast Cancer Foundation, the Mary Kay Foundation, the Donald E. and Delia B. Baxter Foundation, the Center for Cancer Nanotechnology Excellence and Translation, the Arnold and Mabel Beckman Initiative for Macular Research, the Pew Charitable Trusts and the Alexander and Margaret Stewart Trust, the Skippy Frank Foundation, the Claire Giannini Fund and Stanford Bio-X.

Stanford’s Department of Structural Biology also supported the work.

About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu.

2023 ISSUE 3

Exploring ways AI is applied to health care