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Kmiec MM, Hebert KA, Tse D, Hodge S, Williams BB, Schaner PE, Kuppusamy P. OxyChip embedded with radio-opaque gold nanoparticles for anatomic registration and oximetry in tissues. Magn Reson Med 2022; 87:1621-1637. [PMID: 34719047 PMCID: PMC8776570 DOI: 10.1002/mrm.29039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/07/2021] [Accepted: 09/18/2021] [Indexed: 11/07/2022]
Abstract
PURPOSE Electron paramagnetic resonance oximetry using the OxyChip as an implantable oxygen sensor can directly and repeatedly measure tissue oxygen levels. A phase I, first-in-human clinical study has established the safety and feasibility of using OxyChip for reliable and repeated measurements of oxygen levels in a variety of tumors and treatment regimens. A limitation in these studies is the inability to easily locate and identify the implanted probes in the tissue, particularly in the long term, thus limiting spatial/anatomical registration of the implant for proper interpretation of the oxygen data. In this study, we have developed and evaluated an enhanced oxygen-sensing probe embedded with gold nanoparticles (GNP), called the OxyChip-GNP, to enable visualization of the sensor using routine clinical imaging modalities. METHODS In vitro characterization, imaging, and histopathology studies were carried out using tissue phantoms, excised tissues, and in vivo animal models (mice and rats). RESULTS The results demonstrated a substantial enhancement of ultrasound and CT contrast using the OxyChip-GNP without compromising its electron paramagnetic resonance and oxygen-sensing properties or biocompatibility. CONCLUSIONS The OxyChips embedded with gold nanoparticles (OxyChip-GNP) can be readily identified in soft tissues using standard clinical imaging modalities such as CT, cone beam-CT, or ultrasound imaging while maintaining its capability to make repeated in vivo measurements of tissue oxygen levels over the long term. This unique capability of the OxyChip-GNP facilitates precisely localized in vivo oxygen measurements in the clinical setting.
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Affiliation(s)
- Maciej M. Kmiec
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine Dartmouth College Lebanon New Hampshire USA
| | - Kendra A. Hebert
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine Dartmouth College Lebanon New Hampshire USA
| | - Dan Tse
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine Dartmouth College Lebanon New Hampshire USA
| | - Sassan Hodge
- Thayer School of Engineering Dartmouth College Hanover New Hampshire USA
| | - Benjamin B. Williams
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine Dartmouth College Lebanon New Hampshire USA
- Thayer School of Engineering Dartmouth College Hanover New Hampshire USA
- Department of Medicine Dartmouth‐Hitchcock Medical Center Lebanon New Hampshire USA
| | - Philip E. Schaner
- Department of Medicine Dartmouth‐Hitchcock Medical Center Lebanon New Hampshire USA
| | - Periannan Kuppusamy
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine Dartmouth College Lebanon New Hampshire USA
- Thayer School of Engineering Dartmouth College Hanover New Hampshire USA
- Department of Medicine Dartmouth‐Hitchcock Medical Center Lebanon New Hampshire USA
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Schaner PE, Williams BB, Chen EY, Pettus JR, Schreiber WA, Kmiec MM, Jarvis LA, Pastel DA, Zuurbier RA, DiFlorio-Alexander RM, Paydarfar JA, Gosselin BJ, Barth RJ, Rosenkranz KM, Petryakov SV, Hou H, Tse D, Pletnev A, Flood AB, Wood VA, Hebert KA, Mosher RE, Demidenko E, Swartz HM, Kuppusamy P. First-In-Human Study in Cancer Patients Establishing the Feasibility of Oxygen Measurements in Tumors Using Electron Paramagnetic Resonance With the OxyChip. Front Oncol 2021; 11:743256. [PMID: 34660306 PMCID: PMC8517507 DOI: 10.3389/fonc.2021.743256] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 09/07/2021] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE The overall objective of this clinical study was to validate an implantable oxygen sensor, called the 'OxyChip', as a clinically feasible technology that would allow individualized tumor-oxygen assessments in cancer patients prior to and during hypoxia-modification interventions such as hyperoxygen breathing. METHODS Patients with any solid tumor at ≤3-cm depth from the skin-surface scheduled to undergo surgical resection (with or without neoadjuvant therapy) were considered eligible for the study. The OxyChip was implanted in the tumor and subsequently removed during standard-of-care surgery. Partial pressure of oxygen (pO2) at the implant location was assessed using electron paramagnetic resonance (EPR) oximetry. RESULTS Twenty-three cancer patients underwent OxyChip implantation in their tumors. Six patients received neoadjuvant therapy while the OxyChip was implanted. Median implant duration was 30 days (range 4-128 days). Forty-five successful oxygen measurements were made in 15 patients. Baseline pO2 values were variable with overall median 15.7 mmHg (range 0.6-73.1 mmHg); 33% of the values were below 10 mmHg. After hyperoxygenation, the overall median pO2 was 31.8 mmHg (range 1.5-144.6 mmHg). In 83% of the measurements, there was a statistically significant (p ≤ 0.05) response to hyperoxygenation. CONCLUSIONS Measurement of baseline pO2 and response to hyperoxygenation using EPR oximetry with the OxyChip is clinically feasible in a variety of tumor types. Tumor oxygen at baseline differed significantly among patients. Although most tumors responded to a hyperoxygenation intervention, some were non-responders. These data demonstrated the need for individualized assessment of tumor oxygenation in the context of planned hyperoxygenation interventions to optimize clinical outcomes.
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Affiliation(s)
- Philip E. Schaner
- Department of Medicine, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Benjamin B. Williams
- Department of Medicine, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Eunice Y. Chen
- Department of Surgery, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Jason R. Pettus
- Department of Pathology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Wilson A. Schreiber
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Maciej M. Kmiec
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Lesley A. Jarvis
- Department of Medicine, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - David A. Pastel
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Rebecca A. Zuurbier
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Roberta M. DiFlorio-Alexander
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Joseph A. Paydarfar
- Department of Surgery, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Benoit J. Gosselin
- Department of Surgery, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Richard J. Barth
- Department of Surgery, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Kari M. Rosenkranz
- Department of Surgery, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Sergey V. Petryakov
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Huagang Hou
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Dan Tse
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Alexandre Pletnev
- Department of Chemistry, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Ann Barry Flood
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Victoria A. Wood
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Kendra A. Hebert
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Robyn E. Mosher
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Eugene Demidenko
- Department of Biomedical Data Science, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Harold M. Swartz
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Periannan Kuppusamy
- Department of Medicine, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
- Department of Radiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
- Department of Chemistry, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth College, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
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Chen EY, Tse D, Hou H, Schreiber WA, Schaner PE, Kmiec MM, Hebert KA, Kuppusamy P, Swartz HM, Williams BB. Evaluation of a Refined Implantable Resonator for Deep-Tissue EPR Oximetry in the Clinic. APPLIED MAGNETIC RESONANCE 2021; 52:1321-1342. [PMID: 34744319 PMCID: PMC8570533 DOI: 10.1007/s00723-021-01376-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 05/04/2023]
Abstract
OBJECTIVES (1) Summarize revisions made to the implantable resonator (IR) design and results of testing to characterize biocompatibility;(2) Demonstrate safety of implantation and feasibility of deep tissue oxygenation measurement using electron paramagnetic resonance (EPR) oximetry. STUDY DESIGN In vitro testing of the revised IR and in vivo implantation in rabbit brain and leg tissues. METHODS Revised IRs were fabricated with 1-4 OxyChips with a thin wire encapsulated with two biocompatible coatings. Biocompatibility and chemical characterization tests were performed. Rabbits were implanted with either an IR with 2 oxygen sensors or a biocompatible-control sample in both the brain and hind leg. The rabbits were implanted with IRs using a catheter-based, minimally invasive surgical procedure. EPR oximetry was performed for rabbits with IRs. Cohorts of rabbits were euthanized and tissues were obtained at 1 week, 3 months, and 9 months after implantation and examined for tissue reaction. RESULTS Biocompatibility and toxicity testing of the revised IRs demonstrated no abnormal reactions. EPR oximetry from brain and leg tissues were successfully executed. Blood work and histopathological evaluations showed no significant difference between the IR and control groups. CONCLUSIONS IRs were functional for up to 9 months after implantation and provided deep tissue oxygen measurements using EPR oximetry. Tissues surrounding the IRs showed no more tissue reaction than tissues surrounding the control samples. This pre-clinical study demonstrates that the IRs can be safely implanted in brain and leg tissues and that repeated, non-invasive, deep-tissue oxygen measurements can be obtained using in vivo EPR oximetry.
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Affiliation(s)
- Eunice Y. Chen
- Section of Otolaryngology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States and Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Dan Tse
- Department of Radiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Huagang Hou
- Department of Radiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Wilson A. Schreiber
- Department of Radiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Philip E. Schaner
- Section of Radiation Oncology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States and Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Maciej M. Kmiec
- Department of Radiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Kendra A. Hebert
- Department of Radiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Periannan Kuppusamy
- Department of Radiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Harold M. Swartz
- Department of Radiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- Section of Radiation Oncology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States and Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Benjamin B. Williams
- Department of Radiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- Section of Radiation Oncology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States and Geisel School of Medicine at Dartmouth, Hanover, NH
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