151
|
Jin CS, Wada H, Anayama T, McVeigh PZ, Hu HP, Hirohashi K, Nakajima T, Kato T, Keshavjee S, Hwang D, Wilson BC, Zheng G, Yasufuku K. An Integrated Nanotechnology-Enabled Transbronchial Image-Guided Intervention Strategy for Peripheral Lung Cancer. Cancer Res 2016; 76:5870-5880. [PMID: 27543602 DOI: 10.1158/0008-5472.can-15-3196] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 06/07/2016] [Indexed: 12/25/2022]
Abstract
Early detection and efficient treatment modality of early-stage peripheral lung cancer is essential. Current nonsurgical treatments for peripheral lung cancer show critical limitations associated with various complications, requiring alternative minimally invasive therapeutics. Porphysome nanoparticle-enabled fluorescence-guided transbronchial photothermal therapy (PTT) of peripheral lung cancer was developed and demonstrated in preclinical animal models. Systemically administered porphysomes accumulated in lung tumors with significantly enhanced disease-to-normal tissue contrast, as confirmed in three subtypes of orthotopic human lung cancer xenografts (A549, H460, and H520) in mice and in an orthotopic VX2 tumor in rabbits. An in-house prototype fluorescence bronchoscope demonstrated the capability of porphysomes for in vivo imaging of lung tumors in the mucosal/submucosal layers, providing real-time fluorescence guidance for transbronchial PTT. Porphysomes also enhanced the efficacy of transbronchial PTT significantly and resulted in selective and efficient tumor tissue ablation in the rabbit model. A clinically used cylindrical diffuser fiber successfully achieved tumor-specific thermal ablation, showing promising evidence for the clinical translation of this novel platform to impact upon nonsurgical treatment of early-stage peripheral lung cancer. Cancer Res; 76(19); 5870-80. ©2016 AACR.
Collapse
Affiliation(s)
- Cheng S Jin
- Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada. Institute of Biomaterial and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada. Princess Margaret Cancer Centre and TECHNA Institute, University Health Network, Toronto, Ontario, Canada
| | - Hironobu Wada
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Takashi Anayama
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Patrick Z McVeigh
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Hsin Pei Hu
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Kentaro Hirohashi
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Takahiro Nakajima
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Tatsuya Kato
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Shaf Keshavjee
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - David Hwang
- Division of Experimental Therapeutics, Respiratory & Critical Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Brian C Wilson
- Princess Margaret Cancer Centre and TECHNA Institute, University Health Network, Toronto, Ontario, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Gang Zheng
- Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada. Institute of Biomaterial and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada. Princess Margaret Cancer Centre and TECHNA Institute, University Health Network, Toronto, Ontario, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
| | - Kazuhiro Yasufuku
- Princess Margaret Cancer Centre and TECHNA Institute, University Health Network, Toronto, Ontario, Canada. Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
| |
Collapse
|
152
|
A review of radiofrequency ablation: Large target tissue necrosis and mathematical modelling. Phys Med 2016; 32:961-71. [PMID: 27461969 DOI: 10.1016/j.ejmp.2016.07.092] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 06/06/2016] [Accepted: 07/18/2016] [Indexed: 12/15/2022] Open
Abstract
Radiofrequency ablation (RFA) is an effective clinical method for tumour ablation with minimum intrusiveness. However, the use of RFA is mostly restricted to small tumours, especially those <3cm in diameter. This paper discusses the state-of-the-art of RFA, drawn from experimental and clinical results, for large tumours (i.e. ⩾3cm in diameter). In particular, the paper analyses clinical results related to target tissue necrosis (TTN) and mathematical modelling of the RFA procedure to understand the mechanism whereby the TTN is limited to under 3cm with RFA. This paper also discusses a strategy of controlling of the temperature of target tissue in the RFA procedure with the state-of-art device, which has the potential to increase the size of TTN. This paper ends with a discussion of some future ideas to solve the so-called 3-cm problem with RFA.
Collapse
|
153
|
Pimentel-Domínguez R, Moreno-Álvarez P, Hautefeuille M, Chavarría A, Hernández-Cordero J. Photothermal lesions in soft tissue induced by optical fiber microheaters. BIOMEDICAL OPTICS EXPRESS 2016; 7:1138-1148. [PMID: 27446642 PMCID: PMC4929627 DOI: 10.1364/boe.7.001138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/22/2016] [Accepted: 02/23/2016] [Indexed: 06/01/2023]
Abstract
Photothermal therapy has shown to be a promising technique for local treatment of tumors. However, the main challenge for this technique is the availability of localized heat sources to minimize thermal damage in the surrounding healthy tissue. In this work, we demonstrate the use of optical fiber microheaters for inducing thermal lesions in soft tissue. The proposed devices incorporate carbon nanotubes or gold nanolayers on the tips of optical fibers for enhanced photothermal effects and heating of ex vivo biological tissues. We report preliminary results of small size photothermal lesions induced on mice liver tissues. The morphology of the resulting lesions shows that optical fiber microheaters may render useful for delivering highly localized heat for photothermal therapy.
Collapse
Affiliation(s)
- Reinher Pimentel-Domínguez
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de Mexico, Circuito Exterior, Ciudad Universitaria, Coyoacán D.F. 04510, Mexico
- Posgrado de Ciencias Biológicas, Universidad Nacional Autónoma de México, Circuito Exterior, Ciudad Universitaria, Coyoacán D.F. 04510, Mexico
| | - Paola Moreno-Álvarez
- Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, Circuito Exterior, Ciudad Universitaria, Coyoacán D.F. 04510, Mexico
| | - Mathieu Hautefeuille
- Facultad de Ciencias, Universidad Nacional Autónoma de México, Circuito Exterior, Ciudad Universitaria, Coyoacán D.F. 04510, Mexico
| | - Anahí Chavarría
- Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán D.F. 04510, Mexico
| | - Juan Hernández-Cordero
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de Mexico, Circuito Exterior, Ciudad Universitaria, Coyoacán D.F. 04510, Mexico
| |
Collapse
|
154
|
Thermal Ablative Therapies and Immune Checkpoint Modulation: Can Locoregional Approaches Effect a Systemic Response? Gastroenterol Res Pract 2016; 2016:9251375. [PMID: 27051417 PMCID: PMC4802022 DOI: 10.1155/2016/9251375] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 02/16/2016] [Indexed: 02/08/2023] Open
Abstract
Percutaneous image-guided ablation is an increasingly common treatment for a multitude of solid organ malignancies. While historically these techniques have been restricted to the management of small, unresectable tumors, there is an expanding appreciation for the systemic effects these locoregional interventions can cause. In this review, we summarize the mechanisms of action for the most common thermal ablation modalities and highlight the key advances in knowledge regarding the interactions between thermal ablation and the immune system.
Collapse
|
155
|
Dewhirst MW, Lee CT, Ashcraft KA. The future of biology in driving the field of hyperthermia. Int J Hyperthermia 2016; 32:4-13. [DOI: 10.3109/02656736.2015.1091093] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
|
156
|
Tagliamonte M, Petrizzo A, Tornesello ML, Ciliberto G, Buonaguro FM, Buonaguro L. Combinatorial immunotherapy strategies for hepatocellular carcinoma. Curr Opin Immunol 2016; 39:103-13. [PMID: 26851637 DOI: 10.1016/j.coi.2016.01.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 01/12/2016] [Accepted: 01/12/2016] [Indexed: 12/18/2022]
Abstract
Hepatocellular carcinoma (HCC) is the most common liver malignancy. The prognosis for HCC patients greatly varies according to the stage at diagnosis. Overall it is poor, with a 5-year survival rate of approximately 5-6%. Immunotherapeutic interventions represent a novel and effective therapeutic tool. However, only few immunotherapy trials for HCC have been conducted so far with contrasting results, suggesting that significant improvements are needed. Indeed, the liver is characterized by a strong intrinsic immune suppressive microenvironment which needs to be counterbalanced with immune stimulatory approaches. Therefore, the implementation of combinatorial protocols combining immune stimulatory strategies with specific immunotherapy approaches could result in a dramatic improvement of efficacy and clinical outcome in HCC patients. The present review aims at describing the state of the art in immunotherapy strategies for HCC and future perspectives.
Collapse
Affiliation(s)
- Maria Tagliamonte
- Lab of Molecular Biology & Viral Oncology, Dept Experimental Oncology
| | | | | | - Gennaro Ciliberto
- Scientific Direction, Istituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione Pascale" - IRCCS, Naples, Italy
| | | | - Luigi Buonaguro
- Lab of Molecular Biology & Viral Oncology, Dept Experimental Oncology.
| |
Collapse
|
157
|
Gardiner RE, Jahangeer S, Forde P, Ariffin AB, Bird B, Soden D, Hinchion J. Low immunogenicity in non-small cell lung cancer; do new developments and novel treatments have a role? Cancer Metastasis Rev 2016; 34:129-44. [PMID: 25726003 DOI: 10.1007/s10555-015-9550-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Approximately 1.6 million new cases of lung cancer are diagnosed annually (Jemal et al. CA: A Cancer Journal for Clinicians, 61, 69-90, 2011) and it remains the leading cause of cancer-related mortality worldwide. Despite decades of bench and clinical research to attempt to improve outcome for locally advanced, good performance status patients, the 5-year survival remains less than 15 % (Molina et al. 2008). Immune checkpoint inhibitor (ICH) therapies have shown a significant promise in preclinical and clinical trails to date in the treatment of non-small cell lung cancer (NSCLC). The idea of combining these systemic immune therapies with local ablative techniques is one that is gaining momentum. Electrochemotherapy (ECT) is a unique atraumatic local therapy that has had very promising objective response rates and a number of advantages including but not limited to its immunostimulatory effects. ECT in combination with ICHs offers a novel approach for dealing with this difficult disease process.
Collapse
Affiliation(s)
- R E Gardiner
- Cork Cancer Research Centre, University College Cork, Cork, Ireland,
| | | | | | | | | | | | | |
Collapse
|
158
|
Wu F. Heat-Based Tumor Ablation: Role of the Immune Response. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 880:131-53. [DOI: 10.1007/978-3-319-22536-4_8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
159
|
Nanocomposite hydrogel incorporating gold nanorods and paclitaxel-loaded chitosan micelles for combination photothermal–chemotherapy. Int J Pharm 2016; 497:210-21. [DOI: 10.1016/j.ijpharm.2015.11.032] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 11/05/2015] [Accepted: 11/16/2015] [Indexed: 12/18/2022]
|
160
|
Tseng H, Lin SE, Chang YL, Chen MH, Hung SH. Determining the critical effective temperature and heat dispersal pattern in monopolar radiofrequency ablation using temperature-time integration. Exp Ther Med 2015; 11:763-768. [PMID: 26997990 PMCID: PMC4774398 DOI: 10.3892/etm.2015.2956] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 11/25/2015] [Indexed: 11/29/2022] Open
Abstract
The radiofrequency ablation (RFA) lesion size is posited to be disproportionate to the total delivered energy, and temperature-time integration (TTI) may have a more critical effect on lesion size. The present study aimed to evaluate this hypothesis by determining the temperature threshold and temperature distribution over tissues during the RFA lesioning process. Using an ex vivo chicken tissue model and an in vivo rabbit model with RFA applied for 2 min under various target temperature settings, the resultant lesions were evaluated histologically using Masson's trichrome stain. The temperature distribution over the tissue during the RFA lesioning process was also determined using a VT02 Visual IR Thermometer. It was revealed that the thermal injury threshold for RFA in the chicken tissues was ~65°C, but that it ranged from 55–65°C in mammals. Using infra-red thermal imaging, the temperature gradient (from the center to the periphery) during the RFA lesioning process demonstrated a uniform heat diffusion pattern. This data supports the proposed hypothesis that TTI is a critical parameter in determining RFA lesion size and can be applied clinically using the following equation: [Target temperature − 55 (°C)] × time (sec) is proportional to RFA lesion size.
Collapse
Affiliation(s)
- How Tseng
- Department of Biochemistry, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Sey-En Lin
- Department of Pathology, Taipei Medical University Hospital, Taipei 110, Taiwan, R.O.C
| | - Yen-Liang Chang
- Department of Otolaryngology, Head and Neck Surgery, Cathay General Hospital, Taipei 106, Taiwan, R.O.C.; School of Medicine, Fu-Jen Catholic University, Taipei 242, Taiwan, R.O.C
| | - Ming-Hsu Chen
- Department of Otolaryngology, Head and Neck Surgery, Cathay General Hospital, Taipei 106, Taiwan, R.O.C
| | - Shih-Han Hung
- Department of Otolaryngology, Taipei Medical University Hospital, Taipei 110, Taiwan, R.O.C.; Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| |
Collapse
|
161
|
Hinshaw JL, Lubner MG, Ziemlewicz TJ, Lee FT, Brace CL. Percutaneous tumor ablation tools: microwave, radiofrequency, or cryoablation--what should you use and why? Radiographics 2015; 10:47-57. [PMID: 25208284 DOI: 10.1053/j.tvir.2007.08.005] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Image-guided thermal ablation is an evolving and growing treatment option for patients with malignant disease of multiple organ systems. Treatment indications have been expanding to include benign tumors as well. Specifically, the most prevalent indications to date have been in the liver (primary and metastatic disease, as well as benign tumors such as hemangiomas and adenomas), kidney (primarily renal cell carcinoma, but also benign tumors such as angiomyolipomas and oncocytomas), lung (primary and metastatic disease), and soft tissue and/or bone (primarily metastatic disease and osteoid osteomas). Each organ system has different underlying tissue characteristics, which can have profound effects on the resulting thermal changes and ablation zone. Understanding these issues is important for optimizing clinical results. In addition, thermal ablation technology has evolved rapidly during the past several decades, with substantial technical and procedural improvements that can help improve clinical outcomes and safety profiles. Staying up to date on these developments is challenging but critical because the physical properties underlying the different ablation modalities and the appropriate use of adjuncts will have a tremendous effect on treatment results. Ultimately, combining an understanding of the physical properties of the ablation modalities with an understanding of the thermal kinetics in tissue and using the most appropriate ablation modality for each patient are key to optimizing clinical outcomes. Suggested algorithms are described that will help physicians choose among the various ablation modalities for individual patients.
Collapse
Affiliation(s)
- J Louis Hinshaw
- From the Departments of Radiology (J.L.H., M.G.L., T.J.Z., F.T.L., C.L.B.), Biomedical Engineering (C.L.B.), and Medical Physics (C.L.B.), University of Wisconsin, 600 Highland Ave, E3 366, Madison, WI 53792-3252
| | | | | | | | | |
Collapse
|
162
|
Hinshaw JL, Lubner MG, Ziemlewicz TJ, Lee FT, Brace CL. Percutaneous tumor ablation tools: microwave, radiofrequency, or cryoablation--what should you use and why? Radiographics 2015; 34:1344-62. [PMID: 25208284 DOI: 10.1148/rg.345140054] [Citation(s) in RCA: 204] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Image-guided thermal ablation is an evolving and growing treatment option for patients with malignant disease of multiple organ systems. Treatment indications have been expanding to include benign tumors as well. Specifically, the most prevalent indications to date have been in the liver (primary and metastatic disease, as well as benign tumors such as hemangiomas and adenomas), kidney (primarily renal cell carcinoma, but also benign tumors such as angiomyolipomas and oncocytomas), lung (primary and metastatic disease), and soft tissue and/or bone (primarily metastatic disease and osteoid osteomas). Each organ system has different underlying tissue characteristics, which can have profound effects on the resulting thermal changes and ablation zone. Understanding these issues is important for optimizing clinical results. In addition, thermal ablation technology has evolved rapidly during the past several decades, with substantial technical and procedural improvements that can help improve clinical outcomes and safety profiles. Staying up to date on these developments is challenging but critical because the physical properties underlying the different ablation modalities and the appropriate use of adjuncts will have a tremendous effect on treatment results. Ultimately, combining an understanding of the physical properties of the ablation modalities with an understanding of the thermal kinetics in tissue and using the most appropriate ablation modality for each patient are key to optimizing clinical outcomes. Suggested algorithms are described that will help physicians choose among the various ablation modalities for individual patients.
Collapse
Affiliation(s)
- J Louis Hinshaw
- From the Departments of Radiology (J.L.H., M.G.L., T.J.Z., F.T.L., C.L.B.), Biomedical Engineering (C.L.B.), and Medical Physics (C.L.B.), University of Wisconsin, 600 Highland Ave, E3 366, Madison, WI 53792-3252
| | | | | | | | | |
Collapse
|
163
|
Abstract
Although a surgical procedure is performed by visual inspection with histopathological assessment of the excised tumor and margins, percutaneous and noninvasive thermal ablation is performed strictly with the aid of imaging. Applicator guidance into the target zone, treatment monitoring and verification, and clinical follow-up rely on effective imaging. Detailed discussion of imaging is beyond the scope of this article, but the influence of imaging on the choice of thermal ablation or procedural approach will be discussed as needed. More information on imaging for interventional therapies can be found in other articles in this issue of IEEE Pulse.
Collapse
|
164
|
Zhang F, Cao J, Chen X, Yang K, Zhu L, Fu G, Huang X, Chen X. Noninvasive Dynamic Imaging of Tumor Early Response to Nanoparticle-mediated Photothermal Therapy. Am J Cancer Res 2015; 5:1444-55. [PMID: 26681988 PMCID: PMC4672024 DOI: 10.7150/thno.13398] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 09/12/2015] [Indexed: 12/22/2022] Open
Abstract
In spite of rapidly increasing interest in the use of nanoparticle-mediated photothermal therapy (PTT) for treatment of different types of tumors, very little is known on early treatment-related changes in tumor response. Using graphene oxide (GO) as a model nanoparticle (NP), in this study, we tracked the changes in tumors after GO NP-mediated PTT by magnetic resonance imaging (MRI) and quantitatively identified MRI multiple parameters to assess the dynamic changes of MRI signal in tumor at different heating levels and duration. We found a time- and temperature-dependent dynamic change of the MRI signal intensity in intratumor microenvironment prior to any morphological change of tumor, mainly due to quick and effective eradication of tumor blood vessels. Based on the distribution of GO particles, we also demonstrated that NP-medited PTT caused heterogeneous thermal injury of tumor. Overall, these new findings provide not only a clinical-related method for non-invasive early tracking, identifying, and monitoring treatment response of NP-mediated PTT but also show a new vision for better understanding mechanisms of NP-mediated PTT.
Collapse
|
165
|
Saccomandi P, Schena E, Massaroni C, Fong Y, Grasso RF, Giurazza F, Beomonte Zobel B, Buy X, Palussiere J, Cazzato RL. Temperature monitoring during microwave ablation in ex vivo porcine livers. Eur J Surg Oncol 2015; 41:1699-705. [PMID: 26433708 DOI: 10.1016/j.ejso.2015.08.171] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/03/2015] [Accepted: 08/17/2015] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The aim of the present study was to assess the temperature map and its reproducibility while applying two different MWA systems (915 MHz vs 2.45 GHz) in ex vivo porcine livers. MATERIALS AND METHODS Fifteen fresh pig livers were treated using the two antennae at three different settings: treatment time of 10 min and power of 45 W for both systems; 4 min and 100 W for the 2.45 GHz system. Trends of temperature were recorded during all procedures by means of fiber optic-based probes located at five fixed distances from the antenna, ranging between 10 mm and 30 mm. Each trial was repeated twice to assess the reproducibility of temperature distribution. RESULTS Temperature as function of distance from the antenna can be modeled by a decreasing exponential trend. At the same settings, temperature obtained with the 2.45 GHz system was higher than that obtained with the 915 MHz thus resulting into a wider area of ablation (diameter 17 mm vs 15 mm). Both systems showed good reproducibility in terms of temperature distribution (root mean squared difference for both systems ranged between 2.8 °C and 3.4 °C). CONCLUSIONS When both MWA systems are applied, a decreasing exponential model can predict the temperature map. The 2.45 GHz antenna causes higher temperatures as compared to the 915 MHz thus, resulting into larger areas of ablation. Both systems showed good reproducibility although better results were achieved with the 2.45 GHz antenna.
Collapse
Affiliation(s)
- P Saccomandi
- Unit of Measurements and Biomedical Instrumentation, Center for Integrated Research, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, Rome 00128, Italy.
| | - E Schena
- Unit of Measurements and Biomedical Instrumentation, Center for Integrated Research, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, Rome 00128, Italy.
| | - C Massaroni
- Unit of Measurements and Biomedical Instrumentation, Center for Integrated Research, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, Rome 00128, Italy.
| | - Y Fong
- Department of Surgery, City of Hope, Duarte-Main Campus, 1500 East Duarte Road, Duarte, CA 91010, USA.
| | - R F Grasso
- Unit of Radiology, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, Rome 00128, Italy.
| | - F Giurazza
- Unit of Radiology, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, Rome 00128, Italy.
| | - B Beomonte Zobel
- Unit of Radiology, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, Rome 00128, Italy.
| | - X Buy
- Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33076 Bordeaux Cedex, France.
| | - J Palussiere
- Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33076 Bordeaux Cedex, France.
| | - R L Cazzato
- Unit of Radiology, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, Rome 00128, Italy.
| |
Collapse
|
166
|
Cristescu M, Abel EJ, Wells S, Ziemlewicz TJ, Hedican SP, Lubner MG, Hinshaw JL, Brace CL, Lee FT. Percutaneous Microwave Ablation of Renal Angiomyolipomas. Cardiovasc Intervent Radiol 2015; 39:433-40. [PMID: 26390876 DOI: 10.1007/s00270-015-1201-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 07/18/2015] [Indexed: 12/12/2022]
Abstract
PURPOSE To evaluate the safety and efficacy of US-guided percutaneous microwave (MW) ablation in the treatment of renal angiomyolipoma (AML). MATERIALS AND METHODS From January 2011 to April 2014, seven patients (5 females and 2 males; mean age 51.4) with 11 renal AMLs (9 sporadic type and 2 tuberous sclerosis associated) with a mean size of 3.4 ± 0.7 cm (range 2.4-4.9 cm) were treated with high-powered, gas-cooled percutaneous MW ablation under US guidance. Tumoral diameter, volume, and CT/MR enhancement were measured on pre-treatment, immediate post-ablation, and delayed post-ablation imaging. Clinical symptoms and creatinine were assessed on follow-up visits. RESULTS All ablations were technically successful and no major complications were encountered. Mean ablation parameters were ablation power of 65 W (range 60-70 W), using 456 mL of hydrodissection fluid per patient, over 4.7 min (range 3-8 min). Immediate post-ablation imaging demonstrated mean tumor diameter and volume decreases of 1.8% (3.4-3.3 cm) and 1.7% (27.5-26.3 cm(3)), respectively. Delayed imaging follow-up obtained at a mean interval of 23.1 months (median 17.6; range 9-47) demonstrated mean tumor diameter and volume decreases of 29% (3.4-2.4 cm) and 47% (27.5-12.1 cm(3)), respectively. Tumoral enhancement decreased on immediate post-procedure and delayed imaging by CT/MR parameters, indicating decreased tumor vascularity. No patients required additional intervention and no patients experienced spontaneous bleeding post-ablation. CONCLUSION Our early experience with high-powered, gas-cooled percutaneous MW ablation demonstrates it to be a safe and effective modality to devascularize and decrease the size of renal AMLs.
Collapse
Affiliation(s)
- Mircea Cristescu
- Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA.
| | - E Jason Abel
- Department of Urology, University of Wisconsin, Madison, WI, USA.
| | - Shane Wells
- Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA.
| | - Timothy J Ziemlewicz
- Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA.
| | - Sean P Hedican
- Department of Urology, University of Wisconsin, Madison, WI, USA.
| | - Megan G Lubner
- Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA.
| | - J Louis Hinshaw
- Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA.
| | - Christopher L Brace
- Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA. .,Department of Medical Physics, University of Wisconsin, Madison, WI, USA. .,Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA.
| | - Fred T Lee
- Department of Radiology, University of Wisconsin, E3/366 CSC, 600 Highland Avenue, Madison, WI, USA. .,Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA.
| |
Collapse
|
167
|
Ma J, Zhang Z, Zhang Z, Huang J, Qin Y, Li X, Liu H, Yang K, Wu G. Magnetic nanoparticle clusters radiosensitise human nasopharyngeal and lung cancer cells after alternating magnetic field treatment. Int J Hyperthermia 2015; 31:800-12. [PMID: 26382714 DOI: 10.3109/02656736.2015.1063168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Heat generated by magnetic nanoparticle clusters (MNCs) in an alternating magnetic field (AMF) can be used for hyperthermia cancer treatment. Here, we have synthesised polyacrylic acid-coated MNCs according to previous report, with the ability to increase particle stability in suspension. Radiosensitisation effects of the MNCs under an AMF were investigated in vitro and in vivo. MATERIALS AND METHODS MTT assay, flow cytometry, clone formation assay, Western blotting, and a γ-H2AX experiment were used to explore the biocompatibility and radiosensitisation effect of the MNCs and their putative radiosensitisation mechanism. An NCI-H460 mouse xenograft model was used to investigate the anti-tumour effect under an AMF in vivo. RESULTS The temperature of MNC fluids at different concentrations (200 μg/mL to 2 mg/mL) increased rapidly. The MNCs were endocytosed by the cells and were found to be biocompatible. Hsp70 and caspase-3 were found to be up-regulated upon MNCs under an AMF, radiation, and combination of both treatments. MNCs under an AMF efficiently radiosensitised both CNE-2 cells and NCI-H460 cells. Finally, the tumour inhibition rate after treatment with MNCs under an AMF and radiation was significantly higher than that after either treatment alone. The mechanism of radiosensitisation putatively involves inhibition of DNA repair and induction of apoptosis. CONCLUSIONS The MNC fluids under an AMF enhanced the radiosensitivity of tumour cells both in vitro and in vivo.
Collapse
Affiliation(s)
- Jia Ma
- a Cancer Centre, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China and
| | - Zhiping Zhang
- b Tongji School of Pharmacy, Huazhong University of Science and Technology , Wuhan , Hubei , China
| | - Zhanjie Zhang
- a Cancer Centre, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China and
| | - Jing Huang
- a Cancer Centre, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China and
| | - You Qin
- a Cancer Centre, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China and
| | - Xu Li
- a Cancer Centre, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China and
| | - Hongli Liu
- a Cancer Centre, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China and
| | - Kunyu Yang
- a Cancer Centre, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China and
| | - Gang Wu
- a Cancer Centre, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China and
| |
Collapse
|
168
|
Johnson A, Brace C. Heat transfer within hydrodissection fluids: An analysis of thermal conduction and convection using liquid and gel materials. Int J Hyperthermia 2015; 31:551-9. [DOI: 10.3109/02656736.2015.1037799] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Alexander Johnson
- Department of Biomedical Engineering and Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Christopher Brace
- Department of Biomedical Engineering and Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| |
Collapse
|
169
|
Mulchrone AM, Brace CL, Hacker TA, Chesler NC. Inducing valvular regurgitation in mice via thermal ablation of cardiac valves. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:5663-6. [PMID: 25571280 DOI: 10.1109/embc.2014.6944912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study presents early data in the development of a novel mouse model of heart failure utilizing thermal ablation on cardiac valves to induce valvular regurgitation. Thermal ablation of the valve was achieved through the application of radiofrequency (RF) electrical current. The objective was to apply enough energy to induce valve stiffening and retraction, which was hypothesized to produce valve insufficiency and blood regurgitation in vivo. Preliminary studies were performed to develop a workable energy delivery catheter that could be inserted through the carotid artery to the aortic valve. Catheter position between the aortic valve leaflets was verified by echocardiography. Valve function was evaluated before and after the thermal insult using Doppler measurements near the valve inflow and outflow, and early results demonstrate that the energy delivery catheter could successfully induce acute valve insufficiency. Further study is needed to refine the catheter to provide greater control over the degree of thermal damage and resulting changes in cardiac physiology.
Collapse
|
170
|
Liu G, Hu J, Zhang G, Liu S. Rationally Engineering Phototherapy Modules of Eosin-Conjugated Responsive Polymeric Nanocarriers via Intracellular Endocytic pH Gradients. Bioconjug Chem 2015; 26:1328-38. [DOI: 10.1021/bc500548r] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Guhuan Liu
- CAS Key Laboratory of Soft
Matter Chemistry, Hefei National Laboratory for Physical Sciences
at the Microscale, Collaborative Innovation Center of Chemistry for
Energy Materials, Department of Polymer Science and Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Jinming Hu
- CAS Key Laboratory of Soft
Matter Chemistry, Hefei National Laboratory for Physical Sciences
at the Microscale, Collaborative Innovation Center of Chemistry for
Energy Materials, Department of Polymer Science and Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Guoying Zhang
- CAS Key Laboratory of Soft
Matter Chemistry, Hefei National Laboratory for Physical Sciences
at the Microscale, Collaborative Innovation Center of Chemistry for
Energy Materials, Department of Polymer Science and Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Shiyong Liu
- CAS Key Laboratory of Soft
Matter Chemistry, Hefei National Laboratory for Physical Sciences
at the Microscale, Collaborative Innovation Center of Chemistry for
Energy Materials, Department of Polymer Science and Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| |
Collapse
|
171
|
Talasso MS, Lanzoni V, Goldenberg A, Garcia RG, Moura-Franco RMA, Fernandes OOC, Mesquita RDS, Carlotto JRM, Matos D, Lopes-Filho GDJ, Linhares MM. An evaluation of the protective effect of an infusion of chilled glucose solution on thermal injury of the bile ducts caused by radiofrequency ablation of the liver. Acta Cir Bras 2015; 30:34-45. [DOI: 10.1590/s0102-86502015001000005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/15/2014] [Indexed: 11/22/2022] Open
|
172
|
Chen YC, Chiu WT, Chen JC, Chang CS, Hui-Ching Wang L, Lin HP, Chang HC. The photothermal effect of silica–carbon hollow sphere–concanavalin A on liver cancer cells. J Mater Chem B 2015; 3:2447-2454. [DOI: 10.1039/c5tb00056d] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We used silica–carbon hollow spheres (SCHSs) as material for thermal production under NIR laser irradiation. Concanavalin A (ConA), a lectin, was applied to enhance binding on the cell surface of liver cancer cells. We demonstrated that ConA conjugated SCHSs killed liver cancer cells efficiently.
Collapse
Affiliation(s)
- Ying-Chi Chen
- Department of Biomedical Engineering
- National Cheng Kung University
- Tainan 70101
- Taiwan
| | - Wen-Tai Chiu
- Department of Biomedical Engineering
- National Cheng Kung University
- Tainan 70101
- Taiwan
- Medical Device Innovation Center
| | - Jung-Chih Chen
- Institute of Biomedical Engineering
- National Chiao Tung University
- Hsinchu 30010
- Taiwan
| | - Chia-Sheng Chang
- Department of Chemistry
- National Cheng Kung University
- Tainan 70101
- Taiwan
| | - Lily Hui-Ching Wang
- Institute of Molecular and Cellular Biology
- National Tsing Hua University
- Hsinchu 30013
- Taiwan
| | - Hong-Ping Lin
- Department of Chemistry
- National Cheng Kung University
- Tainan 70101
- Taiwan
- Center for Micro/Nano Technology Research
| | - Hsien-Chang Chang
- Department of Biomedical Engineering
- National Cheng Kung University
- Tainan 70101
- Taiwan
- Medical Device Innovation Center
| |
Collapse
|
173
|
Wu F. High intensity focused ultrasound: A noninvasive therapy for locally advanced pancreatic cancer. World J Gastroenterol 2014; 20:16480-16488. [PMID: 25469016 PMCID: PMC4248191 DOI: 10.3748/wjg.v20.i44.16480] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 07/08/2014] [Accepted: 08/28/2014] [Indexed: 02/06/2023] Open
Abstract
The noninvasive ablation of pancreatic cancer with high intensity focused ultrasound (HIFU) energy is received increasingly widespread interest. With rapidly temperature rise to cytotoxic levels within the focal volume of ultrasound beams, HIFU can selectively ablate a targeted lesion of the pancreas without any damage to surrounding or overlying tissues. Preliminary studies suggest that this approach is technical safe and feasible, and can be used alone or in combination with systemic chemotherapy for the treatment of patients with locally advanced pancreatic cancer. It can effectively alleviate cancer-related abdominal pain, and may confer an additional survival benefit with few significant complications. This review provides a brief overview of HIFU, describes current clinical applications, summarizes characteristics of continuous and pulsed HIFU, and discusses future applications and challenges in the treatment of pancreatic cancer.
Collapse
|
174
|
Johnson A, Sprangers A, Cassidy P, Heyrman S, Hinshaw JL, Lubner M, Puccinelli J, Brace C. Design and validation of a thermoreversible material for percutaneous tissue hydrodissection. J Biomed Mater Res B Appl Biomater 2014; 101:1400-9. [PMID: 24591222 DOI: 10.1002/jbm.b.32959] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 03/14/2013] [Accepted: 03/27/2013] [Indexed: 12/21/2022]
Abstract
Interventional oncology procedures such as thermal ablation are becoming routine for many cancers. Hydrodissection-separating tissues with fluids-protects tissues near the treatment zone to improve ablation's safety and facilitate more aggressive treatments. However, currently used fluids such as normal saline and 5% dextrose in water (D5W) migrate in the peritoneum, reducing their protective efficacy. As a hydrodissection alternative, we investigated a thermoreversible poloxamer 407 (P407) solution. Such a material can be injected as a liquid which then forms a semi-solid gel at body temperature without syneresis. The desired gelation temperature of 32°C was achieved with 15.4 wt/wt % P407. Viscosity analysis revealed the lowest viscosity and ideal injection point was at 14°C. Solution viscosity increased during gelation, to a peak of 65 kPa*s at 40°C. The electrical impedance of P407 was significantly greater than isotonic saline, but lower than D5W, indicating its potential for electrical protection. The P407 gel was similar to other hydrodissection fluids at ultrasound and CT imaging. Ex vivo liver ablations showed that P407 protects neighboring tissues, but may require a thicker barrier for comparable protection to D5W. Overall, we found that the P407 solution is a feasible alternative to traditional hydrodissection fluids and warrants additional study.
Collapse
Affiliation(s)
- Alexander Johnson
- Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin; Department of Radiology, University of Wisconsin, Madison, Wisconsin
| | | | | | | | | | | | | | | |
Collapse
|
175
|
Chen Y, Youn P, Pysher TJ, Scaife CL, Furgeson DY. Tumour eradication using synchronous thermal ablation and Hsp90 chemotherapy with protein engineered triblock biopolymer-geldanamycin conjugates. Int J Hyperthermia 2014; 30:550-64. [PMID: 25403416 DOI: 10.3109/02656736.2014.974694] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Hepatocellular carcinoma (HCC) suffers high tumour recurrence rate after thermal ablation. Heat shock protein 90 (Hsp90) induced post-ablation is critical for tumour survival and progression. A combination therapy of thermal ablation and polymer conjugated Hsp90 chemotherapy was designed and evaluated for complete tumour eradication of HCC. MATERIALS AND METHODS A thermo-responsive, elastin-like polypeptide (ELP)-based tri-block biopolymer was developed and conjugated with a potent Hsp90 inhibitor, geldanamycin (GA). The anti-cancer efficacy of conjugates was evaluated in HCC cell cultures with and without hyperthermia (43 °C). The conjugates were also administered twice weekly in a murine HCC model as a single treatment or in combination with single electrocautery as the ablation method. RESULTS ELP-GA conjugates displayed enhanced cytotoxicity in vitro and effective heat shock inhibition under hyperthermia. The conjugates alone significantly slowed the tumour growth without systemic toxicity. Four doses of thermo-responsive ELP-GA conjugates with concomitant simple electrocautery accomplished significant Hsp90 inhibition and sustained tumour suppression. CONCLUSION Hsp90 inhibition plays a key role in preventing the recurrence of HCC, and the combination of ablation with targeted therapy holds great potential to improve prognosis and survival of HCC patients.
Collapse
Affiliation(s)
- Yizhe Chen
- Department of Pharmaceutics and Pharmaceutical Chemistry, College of Pharmacy, University of Utah , Salt Lake City
| | | | | | | | | |
Collapse
|
176
|
Abstract
Tumor ablation is a minimally invasive technique that is commonly used in the treatment of tumors of the liver, kidney, bone, and lung. During tumor ablation, thermal energy is used to heat or cool tissue to cytotoxic levels (less than -40°C or more than 60°C). An additional technique is being developed that targets the permeability of the cell membrane and is ostensibly nonthermal. Within the classification of tumor ablation, there are several modalities used worldwide: radiofrequency, microwave, laser, high-intensity focused ultrasound, cryoablation, and irreversible electroporation. Each technique, although similar in purpose, has specific and optimal indications. This review serves to discuss general principles and technique, reviews each modality, and discusses modality selection.
Collapse
Affiliation(s)
- Erica M Knavel
- Department of Radiology, University of Wisconsin Madison, Clinical Sciences Center, Madison, WI.
| | | |
Collapse
|
177
|
Courivaud F, Kazaryan AM, Lund A, Orszagh VC, Svindland A, Marangos IP, Halvorsen PS, Jebsen P, Fosse E, Hol PK, Edwin B. Thermal fixation of swine liver tissue after magnetic resonance-guided high-intensity focused ultrasound ablation. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:1564-1577. [PMID: 24768489 DOI: 10.1016/j.ultrasmedbio.2014.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 01/23/2014] [Accepted: 02/01/2014] [Indexed: 06/03/2023]
Abstract
The aim of this study was to investigate experimental conditions for efficient and controlled in vivo liver tissue ablation by magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU) in a swine model, with the ultimate goal of improving clinical treatment outcome. Histological changes were examined both acutely (four animals) and 1 wk after treatment (five animals). Effects of acoustic power and multiple sonication cycles were investigated. There was good correlation between target size and observed ablation size by thermal dose calculation, post-procedural MR imaging and histopathology, when temperature at the focal point was kept below 90°C. Structural histopathology investigations revealed tissue thermal fixation in ablated regions. In the presence of cavitation, mechanical tissue destruction occurred, resulting in an ablation larger than the target. Complete extra-corporeal MR-guided HIFU ablation in the liver is feasible using high acoustic power. Nearby large vessels were preserved, which makes MR-guided HIFU promising for the ablation of liver tumors adjacent to large veins.
Collapse
Affiliation(s)
| | - Airazat M Kazaryan
- The Intervention Centre, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | - Alice Lund
- Department of Pathology, Oslo University Hospital, University of Oslo, Oslo, Norway; Department of Pathology, Vestre Viken Hospital Trust, Drammen, Norway
| | - Vivian C Orszagh
- Department of Pathology, Akershus University Hospital, Lørenskog, Norway
| | - Aud Svindland
- Department of Pathology, Oslo University Hospital, University of Oslo, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | - Irina Pavlik Marangos
- The Intervention Centre, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | | | - Peter Jebsen
- Department of Pathology, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Erik Fosse
- The Intervention Centre, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | | | - Bjørn Edwin
- The Intervention Centre, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway; Department of Gastrointestinal and Hepatobiliary Surgery, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
178
|
Bai JF, Liu P, Xu LX. Recent Advances in Thermal Treatment Techniques and Thermally Induced Immune Responses Against Cancer. IEEE Trans Biomed Eng 2014; 61:1497-505. [DOI: 10.1109/tbme.2014.2314357] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
179
|
Kirschbaum A, Ocker M, Bartsch DK, Quint K. Heat dissipation after nonanatomical lung resection using a laser is mainly due to emission to the environment: an experimental ex vivo study. Lasers Med Sci 2014; 29:1037-42. [PMID: 24146236 PMCID: PMC4031427 DOI: 10.1007/s10103-013-1460-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 10/02/2013] [Indexed: 11/16/2022]
Abstract
Laser-directed resection of lung metastases is performed more frequently in recent years. The energy-loaded laser rays heat up the lung tissue, considerably. It is still unclear which mechanism is more important for tissue heat dissipation: the lung perfusion or the tissue emission. Therefore, we created a special experimental model to investigate the spontaneous heat dissipation after nonanatomical lung resection using a diode-pumped laser with a high output power. Experiments were conducted on paracardiac pig lung lobes (n = 12) freshly dissected at the slaughterhouse. Nonanatomical resection of lung parenchyma was performed without lobe perfusion in group 1 (n = 6), while group 2 (n = 6) was perfused at a physiological pressure of 25 cm H2O at 37 °C with saline via the pulmonary artery. For this, we used a diode-pumped neodymium-doped yttrium aluminum garnet (Nd:YAG) LIMAX® 120 laser (Gebrüder Martin GmbH & Co. KG, Tuttlingen, Germany) with a wavelength of 1,318 nm and a power output of 100 W. Immediately after completing laser resection, the lungs were monitored with an infrared camera (Type IC 120LV; Trotec, Heinsberg, Germany) while allowed to cool down. The resection surface temperature was taken at 10-s intervals and documented in a freeze-frame until a temperature of 37 °C had been reached. The temperature drop per time unit was analyzed in both groups. Immediately after laser resection, the temperature at the lung surface was 84.33 ± 8.08 °C in group 1 and 76.75 ± 5.33 °C in group 2 (p = 0.29). Group 1 attained the final temperature of 37 °C after 182.95 ± 53.76 s, and group 2 after 121.70 ± 16.02 s (p = 0.01). The temperature drop occurred exponentially in both groups. We calculated both groups' decays using nonlinear regression, which revealed nearly identical courses. The mean time of tissue temperature of >42 °C, as a surrogate marker for tissue damage, was 97.14 ± 26.90 s in group 1 and 65.00 ± 13.78 s in group 2 (p = 0.02). Heat emission to the environment surpasses heat reduction via perfusion in nonanatomically laser-resected lung lobes. In developing a cooling strategy, a topical cooling method would be promising.
Collapse
Affiliation(s)
- A Kirschbaum
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Giessen and Marburg GmbH, Baldingerstrasse, 35033, Marburg, Germany,
| | | | | | | |
Collapse
|
180
|
Rubert N, Varghese T. Mean scatterer spacing estimation in normal and thermally coagulated ex vivo bovine liver. ULTRASONIC IMAGING 2014; 36:79-97. [PMID: 24554290 PMCID: PMC4207088 DOI: 10.1177/0161734613511232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The liver has been hypothesized to have a unique arrangement of microvasculature that presents as an arrangement of quasiperiodic scatterers to an interrogating ultrasound pulse. The mean scatterer spacing (MSS) of these quasiperiodic scatterers has been proposed as a useful quantitative ultrasound biomarker for characterizing liver tissue. Thermal ablation is an increasingly popular method for treating hepatic tumors, and ultrasonic imaging approaches for delineating the extent of thermal ablation are in high demand. In this work, we examine the distribution of estimated MSS in thermally coagulated bovine liver and normal untreated bovine liver ex vivo. We estimate MSS by detecting local maxima in the spectral coherence function of radio frequency echoes from a clinical transducer, the Siemens VFX 9L4 transducer operating on an S2000 scanner. We find that normal untreated bovine liver was characterized by an MSS of approximately 1.3 mm. We examined regions of interest 12 mm wide laterally, and ranging from 12 mm to 18 mm axially, in 2 mm increments. Over these parameters, the mode of the MSS estimates was between 1.25 and 1.37 mm. On the other hand, estimation of MSS in thermally coagulated liver tissue yields a distribution of MSS estimates whose mode varied between 0.45 and 1.0 mm when examining regions of interest over the same sizes. We demonstrate that the estimated MSS in thermally coagulated liver favors small spacings because the randomly positioned scatterers in this tissue are better modeled as aperiodic scatterers. The submillimeter spacings result from the fact that this was the most probable spacing to be estimated if the discretely sampled spectral coherence function was a uniformly random two-dimensional function.
Collapse
Affiliation(s)
- Nicholas Rubert
- Department of Medical Physics, University of Wisconsin–Madison, WI, USA
| | - Tomy Varghese
- Department of Medical Physics, University of Wisconsin–Madison, WI, USA
| |
Collapse
|
181
|
Abstract
Minimally invasive thermal ablation of tumours has become common since the advent of modern imaging. From the ablation of small, unresectable tumours to experimental therapies, percutaneous radiofrequency ablation, microwave ablation, cryoablation and irreversible electroporation have an increasing role in the treatment of solid neoplasms. This Opinion article examines the mechanisms of tumour cell death that are induced by the most common thermoablative techniques and discusses the rapidly developing areas of research in the field, including combinatorial ablation and immunotherapy, synergy with conventional chemotherapy and radiation, and the development of a new ablation modality in irreversible electroporation.
Collapse
Affiliation(s)
- Katrina F Chu
- The Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 593 Eddy Street, Providence, Rhode Island 02903, USA
| | - Damian E Dupuy
- The Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 593 Eddy Street, Providence, Rhode Island 02903, USA
| |
Collapse
|
182
|
Stoltz A, Gagnière J, Dupré A, Rivoire M. Radiofrequency ablation for colorectal liver metastases. J Visc Surg 2014; 151 Suppl 1:S33-44. [PMID: 24582728 DOI: 10.1016/j.jviscsurg.2013.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The management of hepatic metastases from colorectal cancer (HMCRC) is multimodal including chemotherapy, surgical resection, radiation therapy, and focused destruction technologies. Radiofrequency ablation (RFA) is the most commonly used focused destruction technology. It represents a therapeutic option that may be potentially curative in cases where surgical excision is contra-indicated. It also increases the number of candidates for surgical resection among patients whose liver metastases were initially deemed unresectable. This article explains the techniques, indications, and results of radiofrequency ablation in the treatment of hepatic colorectal metastases.
Collapse
Affiliation(s)
- A Stoltz
- Département d'Oncologie Chirurgicale, Centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - J Gagnière
- Département d'Oncologie Chirurgicale, Centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - A Dupré
- Département d'Oncologie Chirurgicale, Centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - M Rivoire
- Département d'Oncologie Chirurgicale, Centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
| |
Collapse
|
183
|
Evaluation of a bipolar-cooled radiofrequency device for ablation of bone metastases: preclinical assessment in porcine vertebrae. Spine J 2014; 14:361-70. [PMID: 24275617 DOI: 10.1016/j.spinee.2013.08.041] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 07/09/2013] [Accepted: 08/23/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Cancer spread to the spine affects bone stability and can lead to pathologic fracture and neurologic impairment. Radiofrequency ablation (RFA) recently has gained popularity in treating skeletal tumors. Conventional RFA devices use a monopolar design, which limits the ability to comprehensively treat large tumors in bony tissues and may pose risks to adjacent critical normal neurologic tissues when applied to vertebrae. New bipolar-cooled radiofrequency (BCRF) may generate larger controlled lesions without the same degree of risk to adjacent structures. PURPOSE The purpose of this study was to evaluate the feasibility, efficacy, and safety of RFA with the use of a new bone-specific, BCRF probe in a porcine vertebral model and to evaluate the ability of magnetic resonance (MR) imaging to represent histologic outcomes of RFA treatment. STUDY DESIGN Basic science: preclinical in vivo study. METHODS RFA was evaluated in three noncontiguous lumbar vertebrae in six Yorkshire pigs (25-30 kg). Via a transpedicular approach for probe placement, two vertebrae received BCRF treatment and one vertebrae served as a sham control. MR imaging and neurological assessments were conducted pre- and posttreatment as well as immediately before animal sacrifice (n=3 at day 0, n=3 at day 14). MR ablation zones were compared with hematoxylin and eosin-stained histological sections. RESULTS With BCRF, large reproducible zones of ablation were achieved, confined within the vertebrae, without damage to adjacent tissues or the spinal cord. All animals demonstrated normal consistent neurologic behavior pre- and posttreatment. External tissue temperatures around targeted vertebrae were not increased. MR imaging after 14 days was more effective in demonstrating ablation effects than images on day 0, with radiologic findings most apparent on T2-weighted sequences. Histologic analysis of samples corresponded well to the zones of ablation observed on MR images (R=0.9, p<.01). CONCLUSIONS The study demonstrated feasibility, safety, and effectiveness of BCRF ablation of vertebral bone. This motivates ongoing preclinical evaluation in diseased models to further explore the potential for its use in clinical treatment of metastatic vertebrae.
Collapse
|
184
|
Evolution of the ablation region after magnetic resonance-guided high-intensity focused ultrasound ablation in a Vx2 tumor model. Invest Radiol 2014; 48:381-6. [PMID: 23399810 DOI: 10.1097/rli.0b013e3182820257] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Volumetric magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU) is a completely noninvasive image-guided thermal ablation technique. Recently, there has been growing interest in the use of MR-HIFU for noninvasive ablation of malignant tumors. Of particular interest for noninvasive ablation of malignant tumors is reliable treatment monitoring and evaluation of response. At this point, there is limited evidence on the evolution of the ablation region after MR-HIFU treatment. The purpose of the present study was to comprehensively characterize the evolution of the ablation region after volumetric MR-HIFU ablation in a Vx2 tumor model using MR imaging, MR temperature data, and histological data. MATERIALS AND METHODS Vx2 tumors in the hind limb muscle of New Zealand White rabbits (n = 30) were ablated using a clinical MR-HIFU system. Twenty-four animals were available for analyses. Magnetic resonance imaging was performed before and immediately after ablation; MR temperature mapping was performed during the ablation. The animals were distributed over 7 groups with different follow-up lengths. Depending on the group, animals were reimaged and then killed on day 0, 1, 3, 7, 14, 21, or 28 after ablation. For all time points, the size of nonperfused areas (NPAs) on contrast-enhanced T1-weighted (CE-T1-w) images was compared with lethal thermal dose areas (ie, the tissue area that received a thermal dose of 240 equivalent minutes or greater [EM] at 43°C) and with the necrotic tissue areas on histology sections. RESULTS The NPA on CE-T1-w imaging showed an increase in median size from 266 ± 148 to 392 ± 178 mm(2) during the first day and to 343 ± 170 mm(2) on day 3, followed by a gradual decrease to 113 ± 103 mm(2) on day 28. Immediately after ablation, the NPA was 1.6 ± 1.4 times larger than the area that received a thermal dose of 240 EM or greater in all animals. The median size of the necrotic area on histology was 1.7 ± 0.4 times larger than the NPA immediately after ablation. After 7 days, the size of the NPA was in agreement with the necrotic tissue area on histology (ratio, 1.0 ± 0.2). CONCLUSIONS During the first 3 days after MR-HIFU ablation, the ablation region increases in size, after which it gradually decreases in size. The NPA on CE-T1-w imaging underestimates the extent of tissue necrosis on histology in the initial few days, but after 1 week, the NPA is reliable in delineating the necrotic tissue area. The 240-EM thermal dose limit underestimates the necrotic tissue area immediately after MR-HIFU ablation. Reliable treatment evaluation techniques are particularly important for noninvasive, image-guided tumor ablation. Our results indicate that CE-T1-w imaging is reliable for MR-HIFU treatment evaluation after 1 week.
Collapse
|
185
|
Tu X, Ma Y, Cao Y, Huang J, Zhang M, Zhang Z. PEGylated carbon nanoparticles for efficient in vitro photothermal cancer therapy. J Mater Chem B 2014; 2:2184-2192. [DOI: 10.1039/c3tb21750g] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PEGylated carbon nanoparticles possess strong heat-producing ability and exhibit great potential in photothermal cancer therapy.
Collapse
Affiliation(s)
- Xiaolong Tu
- Suzhou Key Laboratory of Nanobiomedicine
- Division of Nanobiomedicine
- Collaborative Innovation Center of Suzhou Nano Science and Technology
- Suzhou Institute of Nano-Tech and Nano-Bionics
- Chinese Academy of Sciences
| | - Yufei Ma
- Suzhou Key Laboratory of Nanobiomedicine
- Division of Nanobiomedicine
- Collaborative Innovation Center of Suzhou Nano Science and Technology
- Suzhou Institute of Nano-Tech and Nano-Bionics
- Chinese Academy of Sciences
| | - Yuhua Cao
- Suzhou Key Laboratory of Nanobiomedicine
- Division of Nanobiomedicine
- Collaborative Innovation Center of Suzhou Nano Science and Technology
- Suzhou Institute of Nano-Tech and Nano-Bionics
- Chinese Academy of Sciences
| | - Jie Huang
- Suzhou Key Laboratory of Nanobiomedicine
- Division of Nanobiomedicine
- Collaborative Innovation Center of Suzhou Nano Science and Technology
- Suzhou Institute of Nano-Tech and Nano-Bionics
- Chinese Academy of Sciences
| | - Mengxin Zhang
- Suzhou Key Laboratory of Nanobiomedicine
- Division of Nanobiomedicine
- Collaborative Innovation Center of Suzhou Nano Science and Technology
- Suzhou Institute of Nano-Tech and Nano-Bionics
- Chinese Academy of Sciences
| | - Zhijun Zhang
- Suzhou Key Laboratory of Nanobiomedicine
- Division of Nanobiomedicine
- Collaborative Innovation Center of Suzhou Nano Science and Technology
- Suzhou Institute of Nano-Tech and Nano-Bionics
- Chinese Academy of Sciences
| |
Collapse
|
186
|
Jahangeer S, Forde P, Soden D, Hinchion J. Review of current thermal ablation treatment for lung cancer and the potential of electrochemotherapy as a means for treatment of lung tumours. Cancer Treat Rev 2013; 39:862-71. [DOI: 10.1016/j.ctrv.2013.03.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 03/08/2013] [Accepted: 03/16/2013] [Indexed: 12/21/2022]
|
187
|
Singh R, Torti SV. Carbon nanotubes in hyperthermia therapy. Adv Drug Deliv Rev 2013; 65:2045-60. [PMID: 23933617 DOI: 10.1016/j.addr.2013.08.001] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 07/31/2013] [Accepted: 08/01/2013] [Indexed: 01/17/2023]
Abstract
Thermal tumor ablation therapies are being developed with a variety of nanomaterials, including single- and multiwalled carbon nanotubes. Carbon nanotubes (CNTs) have attracted interest due to their potential for simultaneous imaging and therapy. In this review, we highlight in vivo applications of carbon nanotube-mediated thermal therapy (CNMTT) and examine the rationale for use of this treatment in recurrent tumors or those resistant to conventional cancer therapies. Additionally, we discuss strategies to localize and enhance the cancer selectivity of this treatment and briefly examine issues relating the toxicity and long term fate of CNTs.
Collapse
|
188
|
Heat shock protein 70 expression and effect of combined transcatheter arterial embolization and radiofrequency ablation in the rabbit VX2 liver tumour model. Clin Radiol 2013; 69:186-93. [PMID: 24199849 DOI: 10.1016/j.crad.2013.08.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 08/25/2013] [Accepted: 08/30/2013] [Indexed: 12/17/2022]
Abstract
AIM To evaluate the effects of a combined therapy using transcatheter arterial embolization (TAE) and radiofrequency ablation (RFA) on heat shock protein 70 (HSP70) expression and treatment effects in a rabbit model of VX2 liver tumours. MATERIALS AND METHODS Tumour growth and necrosis rates were evaluated on day 7. Five rabbits were assigned to each group and were killed on days 1, 3, and 7 after treatment. HSP70 expression was detected and quantified by immunohistochemistry, Western blot, and reverse transcription polymerase chain reaction (RT-PCR). RESULTS Tumour growth rate was significantly decreased and the necrosis rate increased in the TAE + RFA group on day 7 compared with the other groups. HSP70 expression in the TAE group peaked on day 1 and bottomed on days 3 and 7. HSP70 expression in the TAE group was significantly greater than in the control group on days 1, 3, and 7. HSP70 expression was increased on day 1, peaked on day 3, and dropped on day 7 in the RFA and TAE + RFA groups. In the TAE + RFA group, HSP70 expression was significantly greater than in the other groups on days 1, 3, and 7. HSP70 expression in Western blot analysis and HSP70 mRNA peaked on day 3 and dropped on day 7 in the TAE, RFA, and TAE + RFA groups. CONCLUSIONS HSP70 over-expression in residual tumours after TAE + RFA could be attributed to the additive effects of hypoxia and hyperpyrexia generated by TAE combined with RFA.
Collapse
|
189
|
Karampatzakis A, Kühn S, Tsanidis G, Neufeld E, Samaras T, Kuster N. Heating characteristics of antenna arrays used in microwave ablation: A theoretical parametric study. Comput Biol Med 2013; 43:1321-7. [DOI: 10.1016/j.compbiomed.2013.07.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 06/18/2013] [Accepted: 07/13/2013] [Indexed: 12/22/2022]
|
190
|
An Electromagnetic Thermotherapy System with a Deep Penetration Depth for Percutaneous Thermal Ablation. Ann Biomed Eng 2013; 42:86-96. [DOI: 10.1007/s10439-013-0899-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 08/16/2013] [Indexed: 10/26/2022]
|
191
|
Erinjeri JP, Thomas CT, Samoilia A, Fleisher M, Gonen M, Sofocleous CT, Thornton RH, Siegelbaum RH, Covey AM, Brody LA, Alago W, Maybody M, Brown KT, Getrajdman GI, Solomon SB. Image-guided thermal ablation of tumors increases the plasma level of interleukin-6 and interleukin-10. J Vasc Interv Radiol 2013; 24:1105-12. [PMID: 23582441 PMCID: PMC4167629 DOI: 10.1016/j.jvir.2013.02.015] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 02/13/2013] [Accepted: 02/14/2013] [Indexed: 01/02/2023] Open
Abstract
PURPOSE To identify changes in plasma cytokine levels after image-guided thermal ablation of human tumors and to identify the factors that independently predict changes in plasma cytokine levels. MATERIALS AND METHODS Whole-blood samples were collected from 36 patients at three time points: before ablation, after ablation (within 48 hours), and at follow-up (1-5 weeks after ablation). Plasma levels of interleukin (IL)-1α, IL-2, IL-6, IL-10, and tumor necrosis factor (TNF)-α were measured using a multiplex immunoassay. Univariate and multivariate analyses were performed using cytokine level as the dependent variable and sample collection, time, age, sex, primary diagnosis, metastatic status, ablation site, and ablation type as the independent variables. RESULTS There was a significant increase in the plasma level of IL-6 after ablation compared with before ablation (9.6-fold ± 31-fold, P<.002). IL-10 also showed a significant increase after ablation (1.9-fold ± 2.8-fold, P<.02). Plasma levels of IL-1α, IL-2, and TNF-α were not significantly changed after ablation. Cryoablation resulted in the largest change in IL-6 level (>54-fold), whereas radiofrequency ablation and microwave ablation showed 3.6-fold and 3.4-fold changes, respectively. Ablation of melanomas showed the largest change in IL-6 48 hours after ablation (92×), followed by ablation of kidney (26×), liver (8×), and lung (6×) cancers. Multivariate analysis revealed that ablation type (P<.0003) and primary diagnosis (P<.03) were independent predictors of changes to IL-6 after ablation. Age was the only independent predictor of IL-10 levels after ablation (P< .019). CONCLUSIONS Image-guided thermal ablation of tumors increases plasma levels of IL-6 and IL-10, without increasing plasma levels of IL-1α, IL-2, or TNF-α.
Collapse
Affiliation(s)
- Joseph P Erinjeri
- Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
192
|
Wu F. High intensity focused ultrasound ablation and antitumor immune response. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2013; 134:1695-1701. [PMID: 23927210 DOI: 10.1121/1.4812893] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The ideal cancer therapy not only induces the death of all localized tumor cells without damage to surrounding normal tissue, but also activates a systemic antitumor immunity. High intensity focused ultrasound (HIFU) has the potential to be such a treatment, as it can non-invasively ablate a targeted tumor below the skin surface, and may subsequently augment host antitumor immunity. This paper is to review increasing pre-clinical and clinical evidence linking antitumor immune response to HIFU ablation, and to discuss the potential mechanisms involved in HIFU-enhanced host antitumor immunity. The seminal studies performed so far indicate that although it is not possible to conclude definitively on the connection between HIFU treatment and antitumor immune response, it is nonetheless important to conduct extensive studies on the subject in order to elucidate the processes involved.
Collapse
Affiliation(s)
- Feng Wu
- Institute of Ultrasonic Engineering in Medicine, Chongqing Medical University, 1 Medical College Road, Chongqing 400016, People's Republic of China.
| |
Collapse
|
193
|
Pusceddu C, Sotgia B, Melis L, Fele RM, Meloni GB. Painful pelvic recurrence of rectal cancer: percutaneous radiofrequency ablation treatment. ACTA ACUST UNITED AC 2013; 38:1225-33. [PMID: 23736888 DOI: 10.1007/s00261-013-0012-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE To retrospectively evaluate the feasibility and efficacy of computed tomography (CT)-guided radiofrequency thermal ablation (RFA) in reducing the pain in patients with painful pelvic recurrence of rectal cancer ineligible for surgical resection. MATERIAL AND METHODS Twelve consecutive patients (10 men and 2 women; mean age 67 ± 10 years) with painful pelvic recurrence of rectal cancer underwent CT-guided RFA treatments under conscious sedation. At baseline, in all patients pelvic-sacral pain was classified as severe by Visual Analog Scale (VAS; VAS score ≥75 mm). The tumor density and carcinoembryionic antigen (CEA) serum level averages were 46 ± 7 HU and 15.7 ± 9.3 ng/mL, respectively. Clinical outcome was evaluated by VAS with a mean follow-up period of 23 months. RESULTS All RFA sessions were completed and well tolerated. Morbidity consisted of recto-vesical fistula (8 %) and rectal abscess (8 %). 1 month after RFA procedure, complete lack of enhancement was obtained in 7 cases (58 %). A significant difference in HU and CEA serum level averages between baseline and 1 month post-RFA was revealed (p < 0.000 and p < 0.002, respectively). A significant reduction in pain was obtained: VAS score was significantly different between baseline and the clinical evaluations at week 1 and month 3, 6, 12, and 22) (p < 0.000). At the end of follow-up, 11 patients (92 %) were symptom free. CONCLUSIONS CT-guided RFA of painful pelvic recurrence of rectal cancer can be considered as a feasible and effective treatment for reducing the pain in selected cases.
Collapse
Affiliation(s)
- Claudio Pusceddu
- Division of Interventional Radiology, Department of Oncologic Radiology, Businco Hospital, Regional Referral Center for Oncologic Disease, 09100, Cagliari, Italy,
| | | | | | | | | |
Collapse
|
194
|
Ihnát P, Ihnát Rudinská L, Zonča P. Radiofrequency energy in surgery: state of the art. Surg Today 2013; 44:985-91. [PMID: 23728491 DOI: 10.1007/s00595-013-0630-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 04/30/2013] [Indexed: 12/30/2022]
Abstract
Over a period of more than 100 years, radiofrequency energy has been introduced in many fields and applications in medicine. At present, radiofrequency constitutes the basis of numerous medical devices employed in almost all medical specialties. It is particularly applicable and valuable in various minimally invasive procedures for its locally focused effects. Radiofrequency energy is a technical term established to describe high-frequency alternating electrical currents (with a frequency ranging from 300 kHz to 3 MHz) and their impact on biological tissue. The application of RF energy causes controlled tissue heating with consequent cell protein denaturation and desiccation, which leads to cell death and tissue destruction. The primary principle of radiofrequency is that the generated heat can be used to cut, coagulate or induce metabolic processes in the target tissue. The authors of this paper offer a comprehensive and compact review of the definition, history, physics, biological principles and applications of radiofrequency energy in current surgery.
Collapse
Affiliation(s)
- Peter Ihnát
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic,
| | | | | |
Collapse
|
195
|
Ibsen S, Schutt CE, Esener S. Microbubble-mediated ultrasound therapy: a review of its potential in cancer treatment. DRUG DESIGN DEVELOPMENT AND THERAPY 2013; 7:375-88. [PMID: 23667309 PMCID: PMC3650568 DOI: 10.2147/dddt.s31564] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Indexed: 01/05/2023]
Abstract
The inherently toxic nature of chemotherapy drugs is essential for them to kill cancer cells but is also the source of the detrimental side effects experienced by patients. One strategy to reduce these side effects is to limit the healthy tissue exposure by encapsulating the drugs in a vehicle that demonstrates a very low leak rate in circulation while simultaneously having the potential for rapid release once inside the tumor. Designing a vehicle with these two opposing properties is the major challenge in the field of drug delivery. A triggering event is required to change the vehicle from its stable circulating state to its unstable release state. A unique mechanical actuation type trigger is possible by harnessing the size changes that occur when microbubbles interact with ultrasound. These mechanical actuations can burst liposomes and cell membranes alike allowing for rapid drug release and facilitating delivery into nearby cells. The tight focusing ability of the ultrasound to just a few cubic millimeters allows for precise control over the tissue location where the microbubbles destabilize the vehicles. This allows the ultrasound to highlight the tumor tissue and cause rapid drug release from any carrier present. Different vehicle designs have been demonstrated from carrying drug on just the surface of the microbubble itself to encapsulating the microbubble along with the drug within a liposome. In the future, nanoparticles may extend the circulation half-life of these ultrasound triggerable drug-delivery vehicles by acting as nucleation sites of ultrasound-induced mechanical actuation. In addition to the drug delivery capability, the microbubble size changes can also be used to create imaging contrast agents that could allow the internal chemical environment of a tumor to be studied to help improve the diagnosis and detection of cancer. The ability to attain truly tumor-specific release from circulating drug-delivery vehicles is an exciting future prospect to reduce chemotherapy side effects while increasing drug effectiveness.
Collapse
Affiliation(s)
- Stuart Ibsen
- Moores Cancer Center, University of California at San Diego, La Jolla, CA 92093, USA.
| | | | | |
Collapse
|
196
|
Karampatzakis A, Kühn S, Tsanidis G, Neufeld E, Samaras T, Kuster N. Antenna design and tissue parameters considerations for an improved modelling of microwave ablation in the liver. Phys Med Biol 2013; 58:3191-206. [DOI: 10.1088/0031-9155/58/10/3191] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
197
|
Furse A, Miller BJ, McCann C, Kachura JR, Jewett MA, Sherar MD. Radiofrequency coil for the creation of large ablations: ex vivo and in vivo testing. J Vasc Interv Radiol 2013; 23:1522-8. [PMID: 23101925 DOI: 10.1016/j.jvir.2012.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 07/31/2012] [Accepted: 08/13/2012] [Indexed: 01/12/2023] Open
Abstract
PURPOSE Various radiofrequency (RF) ablation electrode designs have been developed to increase ablation volume. Multiple heating cycles and electrode positions are often required, thereby increasing treatment time. The objective of this study was to evaluate the performance of a high-frequency monopolar induction coil designed to produce large thermal lesions (>3 cm) with a single electrode insertion in a treatment time of less than 10 minutes. MATERIALS AND METHODS A monopolar nitinol interstitial coil operated at 27.12 MHz and 200 W was evaluated. Ex vivo performance was tested in excised bovine liver (n = 22). In vivo testing (n = 10) was conducted in livers of seven Yorkshire pigs. Visual inspection, contrast-enhanced computed tomography (CT), and pathologic evaluation of ablation zones were performed. RESULTS Average ablation volumes in ex vivo and in vivo tests were 60.5 cm(3) ± 14.1 (5.9 × 4.4 × 4.4 cm) and 57.1cm(3) ± 13.8 (6.1 × 4.5 × 4.1cm), with average treatment times of 9.0 minutes ± 3.0 and 8.4 minutes ± 2.7, respectively. Contrast-enhanced CT ablation volume measurements corresponded with findings of gross inspection. Pathologic analysis showed morphologic and enzymatic changes suggestive of tissue death within the ablation zones. CONCLUSIONS The RF ablation coil device successfully produced large, uniform ablation volumes in ex vivo and in vivo settings in treatment times of less than 10 minutes. Ex vivo and in vivo lesion sizes were not significantly different (P = .53), suggesting that the heating efficiency of this higher-frequency coil device may help to minimize the heat-sink effect of perfusion.
Collapse
Affiliation(s)
- Alex Furse
- Division of Biophysics and Bioimaging, Ontario Cancer Institute, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada.
| | | | | | | | | | | |
Collapse
|
198
|
Trujillo M, Castellví Q, Burdío F, Sánchez Velazquez P, Ivorra A, Andaluz A, Berjano E. Can electroporation previous to radiofrequency hepatic ablation enlarge thermal lesion size? A feasibility study based on theoretical modelling andin vivoexperiments. Int J Hyperthermia 2013; 29:211-8. [DOI: 10.3109/02656736.2013.777854] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
|
199
|
Jin CS, Lovell JF, Chen J, Zheng G. Ablation of hypoxic tumors with dose-equivalent photothermal, but not photodynamic, therapy using a nanostructured porphyrin assembly. ACS NANO 2013; 7:2541-50. [PMID: 23394589 PMCID: PMC3610399 DOI: 10.1021/nn3058642] [Citation(s) in RCA: 291] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Tumor hypoxia is increasingly being recognized as a characteristic feature of solid tumors and significantly complicates many treatments based on radio-, chemo-, and phototherapies. While photodynamic therapy (PDT) is based on photosensitizer interactions with diffused oxygen, photothermal therapy (PTT) has emerged as a new phototherapy that is predicted to be independent of oxygen levels within tumors. It has been challenging to meaningfully compare these two modalities due to differences in contrast agents and irradiation parameters, and no comparative in vivo studies have been performed until now. Here, by making use of recently developed nanostructured self-quenched porphysome nanoparticles, we were able to directly compare PDT and PTT using matched light doses and matched porphyrin photosensitizer doses (with the photosensitizer being effective for either PTT or PDT based on the existence of nanostructure or not). Therefore, we demonstrated the nanostructure-driven conversion from the PDT singlet oxygen generating mechanism of porphyrin to a completely thermal mechanism, ideal for PTT enhancement. Using a novel hypoxia tumor model, we determined that nanostructured porphyrin PTT enhancers are advantageous to overcome hypoxic conditions to achieve effective ablation of solid tumors.
Collapse
Affiliation(s)
- Cheng S. Jin
- Ontario Cancer Institute, Campbell Family Cancer Research Institute and Techna Institute, University Health Network (UHN), Toronto, Canada M5G 2M9
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada M5S 3M2
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada M5S 1A1
| | - Jonathan F. Lovell
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada M5S 1A1
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, New York 14260-2050, United States
| | - Juan Chen
- Ontario Cancer Institute, Campbell Family Cancer Research Institute and Techna Institute, University Health Network (UHN), Toronto, Canada M5G 2M9
| | - Gang Zheng
- Ontario Cancer Institute, Campbell Family Cancer Research Institute and Techna Institute, University Health Network (UHN), Toronto, Canada M5G 2M9
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada M5S 3M2
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada M5S 1A1
- Department of Medical Biophysics, University of Toronto, Toronto, Canada M5G 1L7
- Address correspondence to
| |
Collapse
|
200
|
The molecular mechanism and potential role of heat shock-induced p53 protein accumulation. Mol Cell Biochem 2013; 378:161-9. [PMID: 23456460 DOI: 10.1007/s11010-013-1607-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Accepted: 02/23/2013] [Indexed: 02/08/2023]
Abstract
Workers who are exposed to extreme heat or work in hot environments may be at risk of heat stress. Exposure to extreme heat can result in occupational illnesses and injuries. On the other hand, local and regional heat therapy has been used for the treatment of some cancers, such as liver cancer, lung cancer, and kidney cancer. Although heat stress has been shown to induce the accumulation of p53 protein, a key regulator of cell cycle, apoptosis, DNA repair, and autophagy, how it regulates p53 protein accumulation and what the p53 targets are remain unclear. Here, we show that, among various genotoxic stresses, including ionizing radiation (IR) and ultraviolet (UV) radiation, heat stress contributes significantly to increase p53 protein levels in normal liver cells and liver cancer cells. Heat stress did not increase p53 mRNA expression as well as p53 promoter activity. However, heat stress enhanced the half-life of p53 protein. Moreover, heat stress increased the expression of puma and light chain 3 (LC-3), which are associated with the apoptotic and autophagic function of p53, respectively, whereas it did not change the expression of the cell cycle regulators p21, 14-3-3δ, and GADD45α, suggesting that heat-triggered alteration of p53 selectively modulates the downstream targets of p53. Our study provides a novel mechanism by which heat shock stimulates p53 protein accumulation, which is different from common DNA damages, such as IR and UV, and also provides new molecular basis for heat injuries or heat therapy.
Collapse
|