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Qi T, Jing Y, Deng J, Chang J, Sun W, Yang R, Liu X, Zhang Q, Wan M, Lu M. Boiling Histotripsy Using Dual-Frequency Protocol on Murine Breast Tumor Model and Promotes Immune Activation. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:1773-1785. [PMID: 37871099 DOI: 10.1109/tuffc.2023.3326561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Histotripsy is an ultrasound-guided, noninvasive, nonthermal ablation therapy that can mechanically lyse target tissues. There have been no reports of enhanced histotripsy for large-volume triple-negative breast cancer (TNBC). This study aims to verify the ability of a novel approach of dual-frequency mode combined with two-stage millisecond-length ultrasound pulses (DF-TS) to accelerate the treatment of murine subcutaneous 4T1 tumors and determine immune changes after treatment. A custom-designed 1.1-/2.2-MHz two-element confocal-annular array was used to treat approximately 6-mm tumors under ultrasound guidance and real-time monitoring. Two-stage millisecond-length ultrasound pulses were used to generate approximate cuboid ablation volumes (diagonal 5-6 mm) within each tumor, with a dose of 100 pulses/point. Immune effects were characterized by changes of pro-inflammatory cytokine levels and infiltration levels of immune cells. In all targeted treatment areas, bubble cloud activity was visualized by ultrasound monitoring. The novel protocol resulted in elliptical and controllable sized lesions, reducing the number of scanning points, and was generally well tolerated. After treatment, tumor growth experienced a seven-day stagnation period, the survival period of mice was prolonged, and the levels of pro-inflammatory cytokines and immune cell infiltration increased. This study demonstrates that DF-TS boiling histotripsy (BH) has a noninvasive, efficient, and precise ablation ability for TNBC and potentially enhances immune responses.
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Li H, He H, Tang J, Luo T, Yang G, Huang L, Dong X, Liu Z. A new sonoablation using acoustic droplet vaporization and focused ultrasound: A feasibility study. Med Phys 2023; 50:6663-6672. [PMID: 37731063 DOI: 10.1002/mp.16742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Histotripsy and boiling histotripsy are two methods of mechanical ablation that use high-pressure focused ultrasound (FUS). PURPOSE Here, a new bubble sonoablation technique was investigated using low-pressure FUS in combination with local injection of perfluoropentane (PFP) in rabbit liver. METHODS Fifteen healthy New Zealand white rabbits were treated with FUS alone, FUS + PFP or PFP alone. FUS was performed using a single-element focused transducer (frequency 596 kHz, 0.27 ms pulses, 0.54% duty cycle, and peak negative pressure 2.0 MPa). Ten minutes before FUS treatment, the PFP droplet was locally injected into the rabbit liver, where the ultrasound was focused. Contrast-enhanced ultrasound (CEUS) of the liver was performed, and the temperature at the liver surface in the targeted liver region was recorded during treatment. The livers were collected for pathological examination. Statistical significance was set at p < 0.05. Paired t-tests were used to compare the pre- and post-treatment values. One-way analysis of variance was performed to compare multiple groups, and the least significant difference method was used for further comparisons between the two groups. RESULTS Analysis of CEUS data showed that the values of area under the curve (AUC) were significantly different in the PFP + FUS group pre- (10453.644 ± 1182.93) and post-treatment (4058.098 ± 2720.41), and the AUC values of PFP + FUS post-treatment (4058.098 ± 2720.41) were also significantly lower than those of the FUS (9946.694 ± 1071.54) and the PFP (10364.794 ± 2181.53) groups. The peak intensity values also showed the same results, the value of peak intensity of PFP+FUS post-treatment was 82.958 ± 13.99, whereas there was no difference between FUS (106.61 ± 7.61) and PFP (104.136 ± 10.55). Hematoxylin and eosin (H&E) staining revealed that the pathological damage ratings of the PFP + FUS, PFP, and FUS groups were grade 3, grade 1, and grade 0, respectively. Specifically, the area of liver necrosis in the PFP + FUS group (0.99 ± 0.29 cm2 ) was 198 times higher than that in the PFP group (0.005 ± 0.008 cm2 ), whereas no necrosis was observed in the livers treated with FUS alone. Simultaneously, the number of vacuoles in the liver of the PFP + FUS group (35.50 ± 23.31) was approximately five times that of the PFP group (7.00 ± 12.88), whereas no vacuoles were found in the liver treated with FUS alone. CONCLUSION PFP droplets combined with FUS can destroy liver tissue and cause tissue necrosis in the droplet injection area, without affecting the structure of surrounding tissue.
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Affiliation(s)
- Hui Li
- Department of Ultrasound, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Huan He
- Department of Ultrasound, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Jiawei Tang
- Department of Ultrasound, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Tingting Luo
- Department of Ultrasound, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Guoliang Yang
- Department of Ultrasound, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Leidan Huang
- Department of Ultrasound, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Xiaoxiao Dong
- Department of Ultrasound, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Zheng Liu
- Department of Ultrasound, The Second Affiliated Hospital of Army Medical University, Chongqing, China
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Hay AN, Imran KM, Hendricks-Wenger A, Gannon JM, Sereno J, Simon A, Lopez VA, Coutermarsh-Ott S, Vlaisavljevich E, Allen IC, Tuohy JL. Ablative and Immunostimulatory Effects of Histotripsy Ablation in a Murine Osteosarcoma Model. Biomedicines 2023; 11:2737. [PMID: 37893110 PMCID: PMC10604356 DOI: 10.3390/biomedicines11102737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023] Open
Abstract
Background: Osteosarcoma (OS) is the most frequently occurring malignant bone tumor in humans, primarily affecting children and adolescents. Significant advancements in treatment options for OS have not occurred in the last several decades, and the prognosis remains grim with only a 70% rate of 5-year survival. The objective of this study was to investigate the focused ultrasound technique of histotripsy as a novel, noninvasive treatment option for OS. Methods: We utilized a heterotopic OS murine model to establish the feasibility of ablating OS tumors with histotripsy in a preclinical setting. We investigated the local immune response within the tumor microenvironment (TME) via immune cell phenotyping and gene expression analysis. Findings: We established the feasibility of ablating heterotopic OS tumors with ablation characterized microscopically by loss of cellular architecture in targeted regions of tumors. We observed greater populations of macrophages and dendritic cells within treated tumors and the upregulation of immune activating genes 72 h after histotripsy ablation. Interpretation: This study was the first to investigate histotripsy ablation for OS in a preclinical murine model, with results suggesting local immunomodulation within the TME. Our results support the continued investigation of histotripsy as a novel noninvasive treatment option for OS patients to improve clinical outcomes and patient prognosis.
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Affiliation(s)
- Alayna N. Hay
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA
| | - Khan Mohammad Imran
- Department of Biomedical Sciences and Pathobiology, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA (I.C.A.)
- Translational Biology, Medicine and Health Graduate Research Program, Virginia Tech, Roanoke, VA 24016, USA
| | - Alissa Hendricks-Wenger
- Department of Biomedical Sciences and Pathobiology, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA (I.C.A.)
- Translational Biology, Medicine and Health Graduate Research Program, Virginia Tech, Roanoke, VA 24016, USA
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA (E.V.)
| | - Jessica M. Gannon
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA (E.V.)
| | - Jacqueline Sereno
- Department of Biomedical Sciences and Pathobiology, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA (I.C.A.)
| | - Alex Simon
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA (E.V.)
| | - Victor A. Lopez
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA (E.V.)
| | - Sheryl Coutermarsh-Ott
- Department of Biomedical Sciences and Pathobiology, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA (I.C.A.)
- Virginia Department of Agriculture and Consumer Services, Wytheville, VA 24382, USA
| | - Eli Vlaisavljevich
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA (E.V.)
| | - Irving C. Allen
- Department of Biomedical Sciences and Pathobiology, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA (I.C.A.)
- Translational Biology, Medicine and Health Graduate Research Program, Virginia Tech, Roanoke, VA 24016, USA
| | - Joanne L. Tuohy
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA
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Yeats E, Hall TL. Aberration correction in abdominal histotripsy. Int J Hyperthermia 2023; 40:2266594. [PMID: 37813397 PMCID: PMC10637766 DOI: 10.1080/02656736.2023.2266594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/28/2023] [Indexed: 10/11/2023] Open
Abstract
In transabdominal histotripsy, ultrasound pulses are focused on the body to noninvasively destroy soft tissues via cavitation. However, the ability to focus is limited by phase aberration, or decorrelation of the ultrasound pulses due to spatial variation in the speed of sound throughout heterogeneous tissue. Phase aberration shifts, broadens, and weakens the focus, thereby reducing the safety and efficacy of histotripsy therapy. This paper reviews and discusses aberration effects in histotripsy and in related therapeutic ultrasound techniques (e.g., high intensity focused ultrasound), with an emphasis on aberration by soft tissues. Methods for aberration correction are reviewed and can be classified into two groups: model-based methods, which use segmented images of the tissue as input to an acoustic propagation model to predict and compensate phase differences, and signal-based methods, which use a receive-capable therapy array to detect phase differences by sensing acoustic signals backpropagating from the focus. The relative advantages and disadvantages of both groups of methods are discussed. Importantly, model-based methods can correct focal shift, while signal-based methods can restore substantial focal pressure, suggesting that both methods should be combined in a 2-step approach. Aberration correction will be critical to improving histotripsy treatments and expanding the histotripsy treatment envelope to enable non-invasive, non-thermal histotripsy therapy for more patients.
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Affiliation(s)
- Ellen Yeats
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, United States
| | - Timothy L. Hall
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, United States
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5
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Mehkri Y, Pierre K, Woodford SJ, Davidson CG, Urhie O, Sriram S, Hernandez J, Hanna C, Lucke-Wold B. Surgical Management of Brain Tumors with Focused Ultrasound. Curr Oncol 2023; 30:4990-5002. [PMID: 37232835 DOI: 10.3390/curroncol30050377] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 04/26/2023] [Accepted: 05/02/2023] [Indexed: 05/27/2023] Open
Abstract
Focused ultrasound is a novel technique for the treatment of aggressive brain tumors that uses both mechanical and thermal mechanisms. This non-invasive technique can allow for both the thermal ablation of inoperable tumors and the delivery of chemotherapy and immunotherapy while minimizing the risk of infection and shortening the time to recovery. With recent advances, focused ultrasound has been increasingly effective for larger tumors without the need for a craniotomy and can be used with minimal surrounding soft tissue damage. Treatment efficacy is dependent on multiple variables, including blood-brain barrier permeability, patient anatomical features, and tumor-specific features. Currently, many clinical trials are currently underway for the treatment of non-neoplastic cranial pathologies and other non-cranial malignancies. In this article, we review the current state of surgical management of brain tumors using focused ultrasound.
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Affiliation(s)
- Yusuf Mehkri
- Department of Neurosurgery, College of Medicine, University of Florida, 1505 SW Archer Rd, Gainesville, FL 32608, USA
| | - Kevin Pierre
- Department of Radiology, College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32608, USA
| | - Samuel Joel Woodford
- Department of Neurosurgery, College of Medicine, University of Florida, 1505 SW Archer Rd, Gainesville, FL 32608, USA
| | - Caroline Grace Davidson
- Department of Neurosurgery, College of Medicine, University of Florida, 1505 SW Archer Rd, Gainesville, FL 32608, USA
| | - Ogaga Urhie
- Department of Neurosurgery, College of Medicine, University of Florida, 1505 SW Archer Rd, Gainesville, FL 32608, USA
| | - Sai Sriram
- Department of Neurosurgery, College of Medicine, University of Florida, 1505 SW Archer Rd, Gainesville, FL 32608, USA
| | - Jairo Hernandez
- Department of Neurosurgery, College of Medicine, University of Florida, 1505 SW Archer Rd, Gainesville, FL 32608, USA
| | - Chadwin Hanna
- Department of Neurosurgery, College of Medicine, University of Florida, 1505 SW Archer Rd, Gainesville, FL 32608, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, College of Medicine, University of Florida, 1505 SW Archer Rd, Gainesville, FL 32608, USA
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Froghi S, Hall A, Hanafi Bin Jalal A, de Andrade MO, Mohammad Hadi L, Rashidi H, Gélat P, Saffari N, Davidson B, Quaglia A. Ultrasound Histotripsy on a Viable Perfused Whole Porcine Liver: Histological Aspects, Including 3D Reconstruction of the Histotripsy Site. Bioengineering (Basel) 2023; 10:bioengineering10030278. [PMID: 36978669 PMCID: PMC10044833 DOI: 10.3390/bioengineering10030278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/26/2023] [Accepted: 02/11/2023] [Indexed: 02/24/2023] Open
Abstract
Non-invasive therapeutic-focused ultrasound (US) can be used for the mechanical dissociation of tissue and is described as histotripsy. We have performed US histotripsy in viable perfused ex vivo porcine livers as a step in the development of a novel approach to hepatocyte cell transplantation. The histotripsy nidus was created with a 2 MHz single-element focused US transducer, producing 50 pulses of 10 ms duration, with peak positive and negative pressure values of P+ = 77.7 MPa and P− = –13.7 MPaat focus, respectively, and a duty cycle of 1%. Here, we present the histological analysis, including 3D reconstruction of histotripsy sites. Five whole porcine livers were retrieved fresh from the abattoir using human transplant retrieval and cold static preservation techniques and were then perfused using an organ preservation circuit. Whilst under perfusion, histotripsy was performed to randomly selected sites on the live. Fifteen lesional sites were formalin-fixed and paraffin-embedded. Sections were stained with Haematoxylin and Eosin and picro-Sirius red, and they were also stained for reticulin. Additionally, two lesion sites were used for 3D reconstruction. The core of the typical lesion consisted of eosinophilic material associated with reticulin loss, collagen damage including loss of birefringence to fibrous septa, and perilesional portal tracts, including large portal vein branches, but intact peri-lesional hepatic plates. The 3D reconstruction of two histotripsy sites was successful and confirmed the feasibility of this approach to investigate the effects of histotripsy on tissue in detail.
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Affiliation(s)
- Saied Froghi
- Department of HPB & Liver Transplantation Surgery, Royal Free London NHS Foundation Trust, Pond Street, Hampstead, London NW3 2QG, UK
- Centre for Surgical Innovation, Organ Regeneration and Transplantation, UCL Division of Surgery & Interventional Sciences, Royal Free Hospital Campus, Pond Street, Hampstead, London NW3 2QG, UK
| | - Andrew Hall
- Department of Cellular Pathology, UCL Cancer Institute Royal Free London NHS Foundation Trust, Pond Street, Hampstead, London NW3 2QG, UK
| | - Arif Hanafi Bin Jalal
- UCL Medical School, University College London, 74 Huntley Street, London WC1E 6BT, UK
| | - Matheus Oliveira de Andrade
- Ultrasonics Group, Department of Mechanical Engineering, Roberts Engineering Building, University College London, Torrington Place, London WC1E 7JE, UK
| | - Layla Mohammad Hadi
- Centre for Surgical Innovation, Organ Regeneration and Transplantation, UCL Division of Surgery & Interventional Sciences, Royal Free Hospital Campus, Pond Street, Hampstead, London NW3 2QG, UK
| | - Hassan Rashidi
- Developmental Biology and Cancer Program, UCL Great Ormond Street, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Pierre Gélat
- Department of Surgical Biotechnology, Division of Surgery and Interventional Science, UCL, Royal Free Hospital Campus, Pond Street, Hampstead, London NW3 2QG, UK
| | - Nader Saffari
- Ultrasonics Group, Department of Mechanical Engineering, Roberts Engineering Building, University College London, Torrington Place, London WC1E 7JE, UK
| | - Brian Davidson
- Department of HPB & Liver Transplantation Surgery, Royal Free London NHS Foundation Trust, Pond Street, Hampstead, London NW3 2QG, UK
- Centre for Surgical Innovation, Organ Regeneration and Transplantation, UCL Division of Surgery & Interventional Sciences, Royal Free Hospital Campus, Pond Street, Hampstead, London NW3 2QG, UK
| | - Alberto Quaglia
- Department of Cellular Pathology, UCL Cancer Institute Royal Free London NHS Foundation Trust, Pond Street, Hampstead, London NW3 2QG, UK
- Correspondence:
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7
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Tang J, Tang J, Li H, Zhou J, Tang N, Zhu Q, Wang X, Zhu B, Li N, Liu Z. Mechanical destruction using a minimally invasive Ultrasound Needle induces anti-tumor immune responses and synergizes with the anti-PD-L1 blockade. Cancer Lett 2023; 554:216009. [PMID: 36400312 DOI: 10.1016/j.canlet.2022.216009] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022]
Abstract
Immune checkpoint inhibitors (ICIs) have been widely used in treating various tumors; however, the objective response rate of ICIs is less than 40%. In this study, we attempted to induce anti-tumor immune responses using an improved ultrasonic horn device, Ultrasound Needle (UN). We tested its synergistic anti-tumor efficacy with an anti-PD-L1 antibody in a mouse tumor model. Under different parameters, UN treatment selectively induced mechanical destruction and thermal ablation effects on tumor tissues. The mechanical destruction effect of UN treatment increased the infiltration of CD8+ T cells in tumors and relieved the immunosuppressive tumor microenvironment. It also induced systemic anti-tumor immune responses and enhanced the therapeutic efficacy of the anti-PD-L1 antibody in both local and abscopal tumors. The mechanical destruction effect of UN treatment resulted in the release of damage-associated molecular patterns and promoted dendritic cells (DCs)-based antigen presentation. Depletion of DCs or CD8+ T cells eliminated the anti-tumor immune responses induced by UN treatment and weakened the synergistic anti-tumor efficacy with anti-PD-L1 antibody. Therefore, minimally invasive UN may provide a new therapeutic modality for ultrasound-assisted immunotherapy.
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Affiliation(s)
- Jiawei Tang
- Department of Ultrasound, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Junhui Tang
- Department of Ultrasound, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hui Li
- Department of Ultrasound, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jing Zhou
- Institute of Immunology, PLA, Third Military Medical University, Chongqing, China
| | - Najiao Tang
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
| | - Qiong Zhu
- Department of Ultrasound, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xinxin Wang
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University, Chongqing, China; Chongqing Key Laboratory of Immunotherapy, Chongqing, China
| | - Bo Zhu
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University, Chongqing, China; Chongqing Key Laboratory of Immunotherapy, Chongqing, China
| | - Ningshan Li
- Department of Ultrasound, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
| | - Zheng Liu
- Department of Ultrasound, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
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Pickard D, Martynowych D, Lem J, Koshakji A, Lin S, Zhao X, Nelson K, Giovanardi B, Radovitzky R. Converging-diverging shock-driven instabilities along soft hydrogel surfaces. Phys Rev E 2023; 107:L022601. [PMID: 36932538 DOI: 10.1103/physreve.107.l022601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 01/06/2023] [Indexed: 06/18/2023]
Abstract
Intense surface eruptions are observed along the curved surface of a confined cylindrical film of hydrogel subject to laser-induced converging-diverging shock loading. Detailed numerical simulations are used to identify the dominant mechanisms causing mechanical instability. The mechanisms that produce surface instability are found to be fundamentally different from both acoustic parametric instability and shock-driven Richtmyer-Meshkov instability. The time scale of observed and simulated eruption formation is much larger than that of a single shock reflection, in stark contrast to previously studied shock-driven instabilities. Moreover, surface undulations are only found along external, as opposed to internal, soft solid boundaries. Specifically, classic bubble surface instability mechanisms do not occur in our experiments and here we comment only on the new surface undulations found along the outer boundary of solid hydrogel cylinders. Our findings indicate a new class of impulsively excited surface instability that is driven by cycles of internal shock reflections.
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Affiliation(s)
- Daniel Pickard
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
- Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Dmitro Martynowych
- Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Jet Lem
- Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Anwar Koshakji
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
- Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Shaoting Lin
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Xuanhe Zhao
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Keith Nelson
- Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Bianca Giovanardi
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
- Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
- Faculty of Aerospace Engineering, Delft University of Technology, 2628 CD Delft, Netherlands
| | - Raul Radovitzky
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
- Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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9
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Khokhlova VA, Rosnitskiy PB, Tsysar SA, Buravkov SV, Ponomarchuk EM, Sapozhnikov OA, Karzova MM, Khokhlova TD, Maxwell AD, Wang YN, Kadrev AV, Chernyaev AL, Chernikov VP, Okhobotov DA, Kamalov AA, Schade GR. Initial Assessment of Boiling Histotripsy for Mechanical Ablation of Ex Vivo Human Prostate Tissue. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:62-71. [PMID: 36207225 PMCID: PMC9712256 DOI: 10.1016/j.ultrasmedbio.2022.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 07/27/2022] [Accepted: 07/31/2022] [Indexed: 05/16/2023]
Abstract
Boiling histotripsy (BH) is a focused ultrasound technology that uses millisecond-long pulses with shock fronts to induce mechanical tissue ablation. The pulsing scheme and mechanisms of BH differ from those of cavitation cloud histotripsy, which was previously developed for benign prostatic hyperplasia. The goal of the work described here was to evaluate the feasibility of using BH to ablate fresh ex vivo human prostate tissue as a proof of principle for developing BH for prostate applications. Fresh human prostate samples (N = 24) were obtained via rapid autopsy (<24 h after death, institutional review board exempt). Samples were analyzed using shear wave elastography to ensure that mechanical properties of autopsy tissue were clinically representative. Samples were exposed to BH using 10- or 1-ms pulses with 1% duty cycle under real-time B-mode and Doppler imaging. Volumetric lesions were created by sonicating 1-4 rectangular planes spaced 1 mm apart, containing a grid of foci spaced 1-2 mm apart. Tissue then was evaluated grossly and histologically, and the lesion content was analyzed using transmission electron microscopy and scanning electron microscopy. Observed shear wave elastography characterization of ex vivo prostate tissue (37.9 ± 22.2 kPa) was within the typical range observed clinically. During BH, hyperechoic regions were visualized at the focus on B-mode, and BH-induced bubbles were also detected using power Doppler. As treatment progressed, hypoechoic regions of tissue appeared, suggesting successful tissue fractionation. BH treatment was twofold faster using shorter pulses (1 ms vs. 10 ms). Histological analysis revealed lesions containing completely homogenized cell debris, consistent with histotripsy-induced mechanical ablation. It was therefore determined that BH is feasible in fresh ex vivo human prostate tissue producing desired mechanical ablation. The study supports further work aimed at translating BH technology as a clinical option for prostate ablation.
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Affiliation(s)
- Vera A. Khokhlova
- University of Washington, Applied Physics Laboratory, Center for Industrial and Medical Ultrasound, Seattle, WA
- Lomonosov Moscow State University, Physics Faculty, Moscow, Russia
| | | | - Sergey A. Tsysar
- Lomonosov Moscow State University, Physics Faculty, Moscow, Russia
| | - Sergey V. Buravkov
- Lomonosov Moscow State University, Faculty of Fundamental Medicine, Laboratory of Cell Image Analysis, Moscow, Russia
- Research Institute of Human Morphology, Moscow, Russia
| | | | - Oleg A. Sapozhnikov
- University of Washington, Applied Physics Laboratory, Center for Industrial and Medical Ultrasound, Seattle, WA
- Lomonosov Moscow State University, Physics Faculty, Moscow, Russia
| | - Maria M. Karzova
- Lomonosov Moscow State University, Physics Faculty, Moscow, Russia
| | - Tatiana D. Khokhlova
- University of Washington School of Medicine, Department of Medicine Division of Gastroenterology, Seattle, WA
| | - Adam D. Maxwell
- University of Washington School of Medicine, Department of Urology, Seattle, WA
| | - Yak-Nam Wang
- University of Washington, Applied Physics Laboratory, Center for Industrial and Medical Ultrasound, Seattle, WA
| | - Alexey V. Kadrev
- Lomonosov Moscow State University, Medical Research and Educational Center, Department of Urology and Andrology, Moscow, Russia
- Russian Medical Academy of Continuous Professional Education, Diagnostic Ultrasound Division, Moscow, Russia
| | - Andrey L. Chernyaev
- Research Institute of Human Morphology, Moscow, Russia
- Pulmonology Scientific Research Institute, Moscow, Russia
| | | | - Dmitriy A. Okhobotov
- Lomonosov Moscow State University, Medical Research and Educational Center, Department of Urology and Andrology, Moscow, Russia
| | - Armais A. Kamalov
- Lomonosov Moscow State University, Medical Research and Educational Center, Department of Urology and Andrology, Moscow, Russia
| | - George R. Schade
- University of Washington School of Medicine, Department of Urology, Seattle, WA
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Furusawa Y, Kondo T, Tachibana K, Feril LB. Ultrasound-Induced DNA Damage and Cellular Response: Historical Review, Mechanisms Analysis, and Therapeutic Implications. Radiat Res 2022; 197:662-672. [PMID: 35275998 DOI: 10.1667/rade-21-00140.1.s1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 02/22/2022] [Indexed: 11/03/2022]
Abstract
The biological effects of ultrasound may be classified into thermal and nonthermal mechanisms. The nonthermal effects may be further classified into cavitational and noncavitational mechanisms. DNA damage induced by ultrasound is considered to be related to nonthermal cavitations. For this aspect, many in vitro studies on DNA have been conducted for evaluating the safety of diagnostic ultrasound, particularly in fetal imaging. Technological advancement in detecting DNA damage both in vitro and in vivo have elucidated the mechanism of DNA damage formation and their cellular response. Damage to DNA, and the residual damages after DNA repair are implicated in the biological effects. Here, we discuss the historical evidence of ultrasound on DNA damage and the mechanism of DNA damage formation both in vitro and in vivo, compared with those induced by ionizing radiation. We also offer a commentary on the safety of ultrasound over X-ray-based imaging. Also, understanding the various mechanisms involved in the bioeffects of ultrasound will lead us to alternative strategies for use of ultrasound for therapy.
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Affiliation(s)
- Yukihiro Furusawa
- Department of Liberal Arts and Sciences, Toyama Prefecture University, Toyama 939-0398, Japan
| | - Takashi Kondo
- Department of Radiological Sciences Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan
| | - Katsuro Tachibana
- Department of Anatomy. Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Loreto B Feril
- Department of Anatomy. Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
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11
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Zhang W, Shi Y, Abd Shukor S, Vijayakumaran A, Vlatakis S, Wright M, Thanou M. Phase-shift nanodroplets as an emerging sonoresponsive nanomaterial for imaging and drug delivery applications. NANOSCALE 2022; 14:2943-2965. [PMID: 35166273 DOI: 10.1039/d1nr07882h] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Nanodroplets - emerging phase-changing sonoresponsive materials - have attracted substantial attention in biomedical applications for both tumour imaging and therapeutic purposes due to their unique response to ultrasound. As ultrasound is applied at different frequencies and powers, nanodroplets have been shown to cavitate by the process of acoustic droplet vapourisation (ADV), causing the development of mechanical forces which promote sonoporation through cellular membranes. This allows drugs to be delivered efficiently into deeper tissues where tumours are located. Recent reviews on nanodroplets are mostly focused on the mechanism of cavitation and their applications in biomedical fields. However, the chemistry of the nanodroplet components has not been discussed or reviewed yet. In this review, the commonly used materials and preparation methods of nanodroplets are summarised. More importantly, this review provides examples of variable chemistry components in nanodroplets which link them to their efficiency as ultrasound-multimodal imaging agents to image and monitor drug delivery. Finally, the drawbacks of current research, future development, and future direction of nanodroplets are discussed.
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Affiliation(s)
- Weiqi Zhang
- School of Cancer & Pharmaceutical Sciences, King's College London, UK.
| | - Yuhong Shi
- School of Cancer & Pharmaceutical Sciences, King's College London, UK.
| | | | | | - Stavros Vlatakis
- School of Cancer & Pharmaceutical Sciences, King's College London, UK.
| | - Michael Wright
- School of Cancer & Pharmaceutical Sciences, King's College London, UK.
| | - Maya Thanou
- School of Cancer & Pharmaceutical Sciences, King's College London, UK.
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12
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Jeong MK, Choi MJ, Kwon SJ. High-spatial-resolution, instantaneous passive cavitation imaging with temporal resolution in histotripsy: a simulation study. Ultrasonography 2022; 41:566-577. [PMID: 35535468 PMCID: PMC9262664 DOI: 10.14366/usg.21153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 02/22/2022] [Indexed: 11/08/2022] Open
Abstract
Purpose In histotripsy, a shock wave is transmitted, and the resulting inertial bubble cavitation that disrupts tissue is used for treatment. Therefore, it is necessary to detect when cavitation occurs and track the position of cavitation occurrence using a new passive cavitation (PC) imaging method. Methods An integrated PC image, which is constructed by collecting the focused signals at all times, does not provide information on when cavitation occurs and has poor spatial resolution. To solve this problem, we constructed instantaneous PC images by applying delay and sum beamforming at instantaneous time instants. By calculating instantaneous PC images at all data acquisition times, the proposed method can detect cavitation when it occurs by using the property that when signals from the cavitation are focused, their amplitude becomes large, and it can obtain a high-resolution PC image by masking out side lobes in the vicinity of cavitation. Results Ultrasound image simulation confirmed that the proposed method has higher resolution than conventional integrated PC imaging and showed that it can determine the position and time of cavitation occurrence as well as the signal strength. Conclusion Since the proposed novel PC imaging method can detect each cavitation separately when the incidence of cavitations is low, it can be used to monitor the treatment process of shock wave therapy and histotripsy, in which cavitation is an important mechanism of treatment.
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Affiliation(s)
- Mok Kun Jeong
- Department of Electronic Engineering, Daejin University, Pocheon, Korea
| | - Min Joo Choi
- Department of Medicine, Jeju National University, Jeju, Korea
| | - Sung Jae Kwon
- Division of IT Convergence Engineering, Daejin University, Pocheon, Korea
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13
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Current Landscape of Sonodynamic Therapy for Treating Cancer. Cancers (Basel) 2021; 13:cancers13246184. [PMID: 34944804 PMCID: PMC8699567 DOI: 10.3390/cancers13246184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 12/21/2022] Open
Abstract
Simple Summary Recently, ultrasound has advanced in its treatment opportunities. One example is sonodynamic therapy, a minimally invasive anti-cancer therapy involving a chemical sonosensitizer and focused ultrasound. The combination of the ultrasound and chemical sonosensitizer amplifies the drug’s ability to target cancer cells. Combining multiple chemical sonosensitizers with ultrasound can create a synergistic effect that could effectively disrupt tumorigenic growth, induce cell death, and elicit an immune response. This review provides an oversight of the application of this treatment to various types of cancer, including prostate cancer, glioma, and pancreatic ductal adenocarcinoma tumors. Abstract Recent advancements have tangibly changed the cancer treatment landscape. However, curative therapy for this dreadful disease remains an unmet need. Sonodynamic therapy (SDT) is a minimally invasive anti-cancer therapy involving a chemical sonosensitizer and focused ultrasound. A high-intensity focused ultrasound (HIFU) beam is used to destroy or denature targeted cancer tissues. Some SDTs are based on unfocused ultrasound (US). In some SDTs, HIFU is combined with a drug, known as a chemical sonosensitizer, to amplify the drug’s ability to damage cancer cells preferentially. The mechanism by which US interferes with cancer cell function is further amplified by applying acoustic sensitizers. Combining multiple chemical sonosensitizers with US creates a substantial synergistic effect that could effectively disrupt tumorigenic growth, induce cell death, and elicit an immune response. Therefore, the minimally invasive SDT treatment is currently attracting attention. It can be combined with targeted therapy (double-targeting cancer therapy) and immunotherapy in the future and is expected to be a boon for treating previously incurable cancers. In this paper, we will consider the current state of this therapy and discuss parts of our research.
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Wu M, He S, Hu X, Chen J, Ha E, Ai F, Ji T, Hu J, Ruan S. A Near-Infrared Light Triggered Composite Nanoplatform for Synergetic Therapy and Multimodal Tumor Imaging. Front Chem 2021; 9:695511. [PMID: 34368079 PMCID: PMC8339317 DOI: 10.3389/fchem.2021.695511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/07/2021] [Indexed: 12/17/2022] Open
Abstract
Transition-metal chalcogenide compounds with facile preparation and multifunctional elements act as ideal photothermal agents for cancer theranostics. This work synthesizes Cu7.2S4/5MoS2 composite nanoflowers and investigates the crystal growth mechanism to optimize the synthesis strategy and obtain excellent photothermal therapy agents. Cu7.2S4/5MoS2 exhibits a high photothermal conversion efficiency of 58.7% and acts as a theranostic nanoplatform and demonstrated an effective photothermal–chemodynamic–photodynamic synergetic therapeutic effect in both in vitro and in vivo tests. Moreover, Cu7.2S4/5MoS2 shows strong photoacoustic signal amplitudes and computed tomographic contrast enhancement in vivo. These results suggest a potential application of Cu7.2S4/5MoS2 composite nanoflowers as photo/H2O2-responsive therapeutic agents against tumors.
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Affiliation(s)
- Mingzhou Wu
- Shenzhen Key Laboratory of Laser Engineering, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen, China.,College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Shuqing He
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Xin Hu
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Jingqin Chen
- Research Laboratory for Biomedical Optics and Molecular Imaging, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Enna Ha
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Fujin Ai
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Tao Ji
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Junqing Hu
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Shuangchen Ruan
- Shenzhen Key Laboratory of Laser Engineering, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen, China.,Sino-German College of Intelligent Manufacturing, Shenzhen Technology University, Shenzhen, China
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15
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Xu Z, Hall TL, Vlaisavljevich E, Lee FT. Histotripsy: the first noninvasive, non-ionizing, non-thermal ablation technique based on ultrasound. Int J Hyperthermia 2021; 38:561-575. [PMID: 33827375 PMCID: PMC9404673 DOI: 10.1080/02656736.2021.1905189] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/23/2021] [Accepted: 03/12/2021] [Indexed: 01/09/2023] Open
Abstract
Histotripsy is the first noninvasive, non-ionizing, and non-thermal ablation technology guided by real-time imaging. Using focused ultrasound delivered from outside the body, histotripsy mechanically destroys tissue through cavitation, rendering the target into acellular debris. The material in the histotripsy ablation zone is absorbed by the body within 1-2 months, leaving a minimal remnant scar. Histotripsy has also been shown to stimulate an immune response and induce abscopal effects in animal models, which may have positive implications for future cancer treatment. Histotripsy has been investigated for a wide range of applications in preclinical studies, including the treatment of cancer, neurological diseases, and cardiovascular diseases. Three human clinical trials have been undertaken using histotripsy for the treatment of benign prostatic hyperplasia, liver cancer, and calcified valve stenosis. This review provides a comprehensive overview of histotripsy covering the origin, mechanism, bioeffects, parameters, instruments, and the latest results on preclinical and human studies.
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Affiliation(s)
- Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Timothy L. Hall
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Eli Vlaisavljevich
- Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Fred T. Lee
- Departments of Radiology, Biomedical Engineering, and Urology, University of Wisconsin, Madison, WI, USA
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