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Gao F, Rafiq M, Cong H, Yu B, Shen Y. Current research status and development prospects of embolic microspheres containing biological macromolecules and others. Int J Biol Macromol 2024; 267:131494. [PMID: 38608974 DOI: 10.1016/j.ijbiomac.2024.131494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/27/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
Transcatheter arterial embolization (TACE) has been used in the treatment of malignant tumors, sudden hemorrhage, uterine fibroids, and other diseases, and with advances in imaging techniques and devices, materials science, and drug release technology, more and more embolic agents that are drug-carrying, self-imaging, or have multiple functions are being developed. Microspheres provide safer and more effective therapeutic results as embolic agents, with their unique spherical appearance and good embolic properties. Embolic microspheres are the key to arterial embolization, blocking blood flow and nutrient supply to the tumor target. This review summarizes some of the currently published embolic microspheres, classifies embolic microspheres according to matrix, and summarizes the characteristics of the microsphere materials, the current status of research, directions, and the value of existing and potential applications. It provides a direction to promote the development of embolic microspheres towards multifunctionalization, and provides a reference to promote the research and application of embolic microspheres in the treatment of tumors.
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Affiliation(s)
- Fengyuan Gao
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China
| | - Muhammad Rafiq
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China
| | - Hailin Cong
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China; State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China; School of Materials Science and Engineering, Shandong University of Technology, Zibo 255000, China.
| | - Bing Yu
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China; State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China.
| | - Youqing Shen
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China; Key Laboratory of Biomass Chemical Engineering of Ministry of Education, Center for Bionanoengineering, and Department of Chemical and Biological Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, China
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Ren D, Zhou B, Li J, Guo S, Guo B. Control of the injection velocity of embolic agents in embolization treatment. Biomed Eng Online 2023; 22:58. [PMID: 37316898 DOI: 10.1186/s12938-023-01126-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 06/08/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Embolization is a common treatment method for tumor-targeting, anti-organ hyper-function, and hemostasis. However, the injection of embolic agents largely depends on the experiences of doctors, and doctors need to work in an X-ray environment that hurts their health. Even for a well-trained doctor, complications such as ectopic embolism caused by excessive embolic agents are always inevitable. RESULTS This paper established a flow control curve model for embolic injection based on local arterial pressure. The end-vessel network was simplified as a porous media. The hemodynamic changes at different injection velocities and embolization degrees were simulated and analyzed. Sponge, a typical porous medium, was used to simulate the blocking and accumulation of embolic agents by capillary networks in the in vitro experimental platform. CONCLUSIONS The simulation and experimental results show that the local arterial pressure is closely related to the critical injection velocity of the embolic agent reflux at a certain degree of embolization. The feasibility of this method for an automatic embolic injection system is discussed. It is concluded that the model of the flow control curve of embolic injection can effectively reduce the risk of ectopic embolism and shorten the time of embolic injection. The clinical application of this model is of great value in reducing radiation exposure and improving the success rate of interventional embolization.
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Affiliation(s)
- Dongcheng Ren
- Academy for Engineering and Technology, Fudan University, 220 Handan Rd., Shanghai, China
- Shanghai Engineering Research Center of AI & Robotics, 539 Handan Rd., Shanghai, 200433, China
- Engineering Research Center of AI & Robotics, Ministry of Education, 539 Handan Rd., Shanghai, China
| | - Bo Zhou
- Department of Interventional Radiology, Fudan University Zhongshan Hospital, 180 Fenglin Rd., Shanghai, China
- National Clinical Research Center for Interventional Medicine, 180 Fenglin Rd., Shanghai, China
| | - Jiasheng Li
- Academy for Engineering and Technology, Fudan University, 220 Handan Rd., Shanghai, China
- Shanghai Engineering Research Center of AI & Robotics, 539 Handan Rd., Shanghai, 200433, China
- Engineering Research Center of AI & Robotics, Ministry of Education, 539 Handan Rd., Shanghai, China
| | - Shijie Guo
- Academy for Engineering and Technology, Fudan University, 220 Handan Rd., Shanghai, China.
- Shanghai Engineering Research Center of AI & Robotics, 539 Handan Rd., Shanghai, 200433, China.
- Engineering Research Center of AI & Robotics, Ministry of Education, 539 Handan Rd., Shanghai, China.
| | - Baolei Guo
- Department of Vascular Surgery, Fudan University Zhongshan Hospital, 180 Fenglin Rd., Shanghai, 200032, China.
- National Clinical Research Center for Interventional Medicine, 180 Fenglin Rd., Shanghai, China.
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Zhou Y, Jiang H, Diao Z, Tong G, Luan Q, Li Y, Li X. MRLA-Net: A tumor segmentation network embedded with a multiple receptive-field lesion attention module in PET-CT images. Comput Biol Med 2023; 153:106538. [PMID: 36646023 DOI: 10.1016/j.compbiomed.2023.106538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/14/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
The tumor image segmentation is an important basis for doctors to diagnose and formulate treatment planning. PET-CT is an extremely important technology for recognizing the systemic situation of diseases due to the complementary advantages of their respective modal information. However, current PET-CT tumor segmentation methods generally focus on the fusion of PET and CT features. The fusion of features will weaken the characteristics of the modality itself. Therefore, enhancing the modal features of the lesions can obtain optimized feature sets, which is extremely necessary to improve the segmentation results. This paper proposed an attention module that integrates the PET-CT diagnostic visual field and the modality characteristics of the lesion, that is, the multiple receptive-field lesion attention module. This paper made full use of the spatial domain, frequency domain, and channel attention, and proposed a large receptive-field lesion localization module and a small receptive-field lesion enhancement module, which together constitute the multiple receptive-field lesion attention module. In addition, a network embedded with a multiple receptive-field lesion attention module has been proposed for tumor segmentation. This paper conducted experiments on a private liver tumor dataset as well as two publicly available datasets, the soft tissue sarcoma dataset, and the head and neck tumor segmentation dataset. The experimental results showed that the proposed method achieves excellent performance on multiple datasets, and has a significant improvement compared with DenseUNet, and the tumor segmentation results on the above three PET/CT datasets were improved by 7.25%, 6.5%, 5.29% in Dice per case. Compared with the latest PET-CT liver tumor segmentation research, the proposed method improves by 8.32%.
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Affiliation(s)
- Yang Zhou
- Department of Software College, Northeastern University, Shenyang 110819, China
| | - Huiyan Jiang
- Department of Software College, Northeastern University, Shenyang 110819, China.
| | - Zhaoshuo Diao
- Department of Software College, Northeastern University, Shenyang 110819, China
| | - Guoyu Tong
- Department of Software College, Northeastern University, Shenyang 110819, China
| | - Qiu Luan
- Department of Nuclear Medicine, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Yaming Li
- Department of Nuclear Medicine, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Xuena Li
- Department of Nuclear Medicine, The First Affiliated Hospital of China Medical University, Shenyang 110001, China.
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Yang SH, Ju XJ, Deng CF, Cai QW, Tian XY, Xie R, Wang W, Liu Z, Pan DW, Chu LY. In Vitro Study on Effects of Physico-Chemo-Mechanical Properties of Embolic Microspheres on Embolization Performances. Ind Eng Chem Res 2023. [DOI: 10.1021/acs.iecr.2c03418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Shi-Hao Yang
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Xiao-Jie Ju
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Chuan-Fu Deng
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Quan-Wei Cai
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Xiao-Yu Tian
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Rui Xie
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Wei Wang
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Zhuang Liu
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Da-Wei Pan
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Liang-Yin Chu
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
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Chen H, Xie CS, Li YS, Deng ZQ, Lv YF, Bi QC, Tang JJ, Luo RG, Tang Q. Evaluation of the safety and efficacy of transarterial sevelamer embolization in a rabbit liver cancer model: A challenge on the size rule for vascular occlusion. Front Bioeng Biotechnol 2022; 10:1058042. [PMID: 36578505 PMCID: PMC9790902 DOI: 10.3389/fbioe.2022.1058042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
As the most efficient method to treat hepatocellular carcinoma in the immediate or advanced stage, transarterial chemoembolization (TACE) is coming into the era of microsphere (MP). Drug-eluting beads have shown their huge potential as an embolic agent and drug carrier for chemoembolization, but their sizes are strictly limited to be above 40 μm, which was considered to occlude vessels in a safe mode. microsphere smaller than 40 µm is easy to be washed out and transported to the normal liver lobe or other organs, causing severe adverse events and failed embolization. To determine whether sevelamer ultrafine particle (0.2-0.5 µm) is qualified as a safe and efficient embolic agent, we investigated the safety and therapeutic efficiency of transarterial sevelamer embolization (TASE) in the VX2 rabbit liver cancer model, aiming to challenge the "40 µm" rule on the selection criteria of the MP. In a four-arm study, blank bead (Callisphere, 100-300 µm), luminescent polystyrene microsphere (10, 100 µm), and sevelamer particle were transarterially administered to evaluate the threshold size of the MP size for intrahepatic or extrahepatic permeability. Another four-arm study was designed to clarify the safety and efficiency of preclinical transarterial sevelamer embolizationTASE tests over other techniques. Sham (saline), TASE, C-TACE, and D-TACE (n = 6) were compared in terms of serum chemistry, histopathology, and tumor necrosis ratio. In the first trials, the "40 µm" rule was detectable on the VX2 cancer model, but the regulation has no application to the new embolic agent as sevelamer ultrafine particles have not been found to leak out from the VX2 lesions, only found in the embolized vessels. Pathology proves that less viable tumor residue was found 2 weeks after the procedure, evidencing a better therapeutic outcome. No adverse events were found except for a short stress response. These results indicate that sevelamer is a safe and efficient embolic as an alternative to the current MP-based embolization therapy techniques.
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Affiliation(s)
- Hong Chen
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, China
| | - Chuan-Sheng Xie
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, China
| | - Yan-Shu Li
- Jiangxi Center of Medical Device Testing, Nanchang, China
| | - Zhi-Qiang Deng
- Department of Oncology, The First People’s Hospital of Fuzhou, Fuzhou, China
| | - Yang-Feng Lv
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, China,Institute for Advanced Study, Nanchang University, Nanchang, China
| | - Qiu-Chen Bi
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, China,Institute for Advanced Study, Nanchang University, Nanchang, China
| | - Jian-Jun Tang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Rong-Guang Luo
- Department of Medical Imaging and Interventional Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qun Tang
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, China,Institute for Advanced Study, Nanchang University, Nanchang, China,*Correspondence: Qun Tang,
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Li X, Lv W, Yang W, Guo Y, Huang J, Liang W, Huang Y, Qin A, Deng X, Li X, Chen M, Yang H, Liang L, Du L. Poly (hydroxyethyl methacrylate - acrylic acid) microspheres loaded with magnetically responsive Fe3O4 nanoparticles for arterial embolization, drug loading and MRI detection. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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7
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Go G, Yoo A, Nguyen KT, Nan M, Darmawan BA, Zheng S, Kang B, Kim CS, Bang D, Lee S, Kim KP, Kang SS, Shim KM, Kim SE, Bang S, Kim DH, Park JO, Choi E. Multifunctional microrobot with real-time visualization and magnetic resonance imaging for chemoembolization therapy of liver cancer. SCIENCE ADVANCES 2022; 8:eabq8545. [PMID: 36399561 PMCID: PMC9674283 DOI: 10.1126/sciadv.abq8545] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/30/2022] [Indexed: 05/28/2023]
Abstract
Microrobots that can be precisely guided to target lesions have been studied for in vivo medical applications. However, existing microrobots have challenges in vivo such as biocompatibility, biodegradability, actuation module, and intra- and postoperative imaging. This study reports microrobots visualized with real-time x-ray and magnetic resonance imaging (MRI) that can be magnetically guided to tumor feeding vessels for transcatheter liver chemoembolization in vivo. The microrobots, composed of a hydrogel-enveloped porous structure and magnetic nanoparticles, enable targeted delivery of therapeutic and imaging agents via magnetic guidance from the actuation module under real-time x-ray imaging. In addition, the microrobots can be tracked using MRI as postoperative imaging and then slowly degrade over time. The in vivo validation of microrobot system-mediated chemoembolization was demonstrated in a rat liver with a tumor model. The proposed microrobot provides an advanced medical robotic platform that can overcome the limitations of existing microrobots and current liver chemoembolization.
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Affiliation(s)
- Gwangjun Go
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21205, USA
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- School of Mechanical Engineering, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea
| | - Ami Yoo
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
| | - Kim Tien Nguyen
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
| | - Minghui Nan
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
| | - Bobby Aditya Darmawan
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- School of Mechanical Engineering, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea
| | - Shirong Zheng
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- School of Mechanical Engineering, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea
| | - Byungjeon Kang
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- College of AI Convergence, Chonnam National University, Gwangju 34931, Korea
| | - Chang-Sei Kim
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- School of Mechanical Engineering, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea
| | - Doyeon Bang
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- College of AI Convergence, Chonnam National University, Gwangju 34931, Korea
| | - Seonmin Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-Gu, Seoul 05505, Korea
| | - Kyu-Pyo Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-Gu, Seoul 05505, Korea
| | - Seong Soo Kang
- Department of Veterinary Surgery, College of Veterinary Medicine and Biomaterial R&BD Center, Chonnam National University, Gwangju 61186, Korea
| | - Kyung Mi Shim
- Department of Veterinary Surgery, College of Veterinary Medicine and Biomaterial R&BD Center, Chonnam National University, Gwangju 61186, Korea
| | - Se Eun Kim
- Department of Veterinary Surgery, College of Veterinary Medicine and Biomaterial R&BD Center, Chonnam National University, Gwangju 61186, Korea
| | - Seungmin Bang
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea
| | - Deok-Ho Kim
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21205, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Jong-Oh Park
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
| | - Eunpyo Choi
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- School of Mechanical Engineering, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea
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Embolization therapy with microspheres for the treatment of liver cancer: State-of-the-art of clinical translation. Acta Biomater 2022; 149:1-15. [PMID: 35842035 DOI: 10.1016/j.actbio.2022.07.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/17/2022] [Accepted: 07/07/2022] [Indexed: 02/07/2023]
Abstract
Embolization with microspheres is a therapeutic strategy based on the selective occlusion of the blood vessels feeding a tumor. This procedure is intraarterially performed in the clinical setting for the treatment of liver cancer. The practice has evolved over the last decade through the incorporation of drug loading ability, biodegradability and imageability with the subsequent added functionality for the physicians and improved clinical outcomes for the patients. This review highlights the evolution of the embolization systems developed through the analysis of the marketed embolic microspheres for the treatment of malignant hepatocellular carcinoma, namely the most predominant form of liver cancer. Embolic microspheres for the distinct modalities of embolization (i.e., bland embolization, chemoembolization and radioembolization) are here comprehensively compiled with emphasis on material characteristics and their impact on microsphere performance. Moreover, the future application of the embolics under clinical investigation is discussed along with the scientific and regulatory challenges ahead in the field. STATEMENT OF SIGNIFICANCE: Embolization therapy with microspheres is currently used in the clinical setting for the treatment of most liver cancer conditions. The progressive development of added functionalities on embolic microspheres (such as biodegradability, imageability or drug and radiopharmaceutical loading capability) provides further benefit to patients and widens the therapeutic armamentarium for physicians towards truly personalized therapies. Therefore, it is important to analyze the possibilities that advanced biomaterials offer in the field from a clinical translational perspective to outline the future trends in therapeutic embolization.
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Emerging Polymer Materials in Trackable Endovascular Embolization and Cell Delivery: From Hype to Hope. Biomimetics (Basel) 2022; 7:biomimetics7020077. [PMID: 35735593 PMCID: PMC9221114 DOI: 10.3390/biomimetics7020077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/05/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023] Open
Abstract
Minimally invasive endovascular embolization is a widely used clinical technique used for the occlusion of blood vessels to treat various diseases. Different occlusive agents ranging from gelatin foam to synthetic polymers such as poly(vinyl alcohol) (PVA) have been commercially used for embolization. However, these agents have some drawbacks, such as undesired toxicity and unintended and uncontrolled occlusion. To overcome these issues, several polymer-based embolic systems are under investigation including biocompatible and biodegradable microspheres, gelling liquid embolic with controlled occlusive features, and trackable microspheres with enhanced safety profiles. This review aims to summarize recent advances in current and emerging polymeric materials as embolization agents with varying material architectures. Furthermore, this review also explores the potential of combining injectable embolic agents and cell therapy to achieve more effective embolization with the promise of outstanding results in treating various devastating diseases. Finally, limitations and challenges in developing next-generation multifunctional embolic agents are discussed to promote advancement in this emerging field.
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Bi QC, Li YS, Luo RG, Chen H, Lv YF, Liu ZX, Liang QR, Chen L, Xu BH, Tang Q. Pi-induced in-situaggregation of sevelamer nanoparticles for vascular embolization. NANOTECHNOLOGY 2022; 33:355101. [PMID: 35616242 DOI: 10.1088/1361-6528/ac738b] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
Decades have witnessed rapid progress of polymeric materials for vascular embolic or chemoembolic applications. Commercially available polymeric embolics range from gelatin foam to synthetic polymers such as poly(vinyl alcohol). Current systems under investigation include tunable, bioresorbable microspheres composed of chitosan or poly(ethylene glycol) derivatives,in situgelling liquid embolics with improved safety profiles, and radiopaque embolics that are trackablein vivo. In this paper, we proposed a concept of 'responsive embolization'. Sevelamer, clinically proved as an inorganic phosphate binder, was ground into nanoparticles. Sevelamer nanoparticle is highly mobile and capable of swelling and aggregating in the presence of endogenous inorganic phosphate, thereby effectively occluding blood flow in the vessel as it was administered as an embolic agent for interventional therapy. Moreover, citrated sevelamer nanoparticles delayed the aggregation, preferable to penetrate deeply into the capillary system. On the rabbit VX2 liver cancer model, both sevelamer particles aggregates occlude the tumor feeding artery, but backflow was found for the pristine one, thereby citrate passivation of sevelamer nanoparticles endows it have potential from 'bench to bedside' as a new type of vascular embolic.
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Affiliation(s)
- Qiu-Chen Bi
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330031, People's Republic of China
- Institute for Advanced Study, Nanchang University, Nanchang, 330031, People's Republic of China
| | - Yan-Shu Li
- Jiangxi Center of Medical Device Testing, Nanchang, 330029, People's Republic of China
| | - Rong-Guang Luo
- Department of Medical Imaging and Interventional Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, People's Republic of China
| | - Hong Chen
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330031, People's Republic of China
| | - Yang-Feng Lv
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330031, People's Republic of China
- Institute for Advanced Study, Nanchang University, Nanchang, 330031, People's Republic of China
| | - Zhi-Xing Liu
- Department of Ultrasonic Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, People's Republic of China
| | - Qing-Rong Liang
- Institute for Advanced Study, Nanchang University, Nanchang, 330031, People's Republic of China
| | - Li Chen
- Department of Ultrasonic Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, People's Republic of China
| | - Bao-Hua Xu
- Jiangxi Province Key Laboratory of Laboratory Animal, Department of Laboratory Animal Science, Nanchang University, Nanchang, 330031, People's Republic of China
| | - Qun Tang
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330031, People's Republic of China
- Institute for Advanced Study, Nanchang University, Nanchang, 330031, People's Republic of China
- Jiangxi Province Key Laboratory of Laboratory Animal, Department of Laboratory Animal Science, Nanchang University, Nanchang, 330031, People's Republic of China
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Krieg S, Essing T, Krieg A, Roderburg C, Luedde T, Loosen SH. Recent Trends and In-Hospital Mortality of Transarterial Chemoembolization (TACE) in Germany: A Systematic Analysis of Hospital Discharge Data between 2010 and 2019. Cancers (Basel) 2022; 14:cancers14092088. [PMID: 35565218 PMCID: PMC9100764 DOI: 10.3390/cancers14092088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/19/2022] [Accepted: 04/19/2022] [Indexed: 02/06/2023] Open
Abstract
(1) Background: Transarterial chemoembolization (TACE) is a minimally invasive procedure, characterized by the selective occlusion of tumor-feeding hepatic arteries, via injection of an embolizing agent and an anticancer drug. It represents a standard of care for intermediate-stage hepatocellular carcinoma (HCC), and it is also increasingly performed in cholangiocarcinoma (CCA), as well as in liver metastases. Apart from the original method, based on intra-arterial infusion of a liquid drug followed by embolization, newer particle-based TACE procedures have been introduced recently. As yet, comprehensive data on current trends of TACE, as well as its in-hospital mortality in Germany, which could help to further improve outcome following TACE, are missing. (2) Methods: Based on standardized hospital discharge data, provided by the German Federal Statistical Office from 2010 to 2019, we aimed at systematically evaluating current clinical developments and in-hospital mortality related to TACE in Germany. (3) Results: A total of 49,595 individual cases undergoing TACE were identified within the observation period. The overall in-hospital mortality was 1.00% and significantly higher in females compared to males (1.12 vs. 0.93%; p < 0.001). We identified several post-interventional complications, such as liver failure (51.49%), sepsis (33.87%), renal failure (23.9%), and liver abscess (15.87%), which were associated with a significantly increased in-hospital mortality. Moreover, in-hospital mortality significantly differed between the underlying indications for TACE (HCC: 0.83%, liver metastases: 1.22%, and CCA: 1.40%), as well as between different embolization agents (liquid embolization: 0.80%, loaded microspheres: 0.92%, spherical particles: 1.54%, and non-spherical particles: 2.84%), for which we observed large geographic differences in their frequency of use. Finally, in-hospital mortality was significantly increased in centers with a low annual TACE case volume (<15 TACE/year: 2.08% vs. >275 TACE/year: 0.45%). (4) Conclusion: Our data provide a systematic overview of indications and embolization methods for TACE in Germany. We identified a variety of factors, such as post-interventional complications, the embolization method used, and the hospitals’ annual case volume, which are associated with an increased in-hospital mortality following TACE. These data might help to further reduce the mortality of this routinely performed local-ablative procedure in the future.
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Affiliation(s)
- Sarah Krieg
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (S.K.); (T.E.); (C.R.)
| | - Tobias Essing
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (S.K.); (T.E.); (C.R.)
- Paracelsus Medical University, Klinikum Nürnberg, 90419 Nürnberg, Germany
| | - Andreas Krieg
- Department of Surgery (A), Heinrich-Heine-University and University Hospital Düsseldorf, 40225 Düsseldorf, Germany;
| | - Christoph Roderburg
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (S.K.); (T.E.); (C.R.)
| | - Tom Luedde
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (S.K.); (T.E.); (C.R.)
- Correspondence: (T.L.); (S.H.L.)
| | - Sven H. Loosen
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (S.K.); (T.E.); (C.R.)
- Correspondence: (T.L.); (S.H.L.)
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12
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Yin P, Wei C, Jin X, Yu X, Wu C, Zhang W. Magnetic polyvinyl alcohol microspheres with self-regulating temperature hyperthermia and CT/MR imaging for arterial embolization. Polym Bull (Berl) 2022. [DOI: 10.1007/s00289-022-04192-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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13
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Goh GS, Goodwin MD, Huang JF, Kavnoudias H, Holden A. A Phase I First in Human Study of Embrace™ a Polyethylene Glycol Based Liquid Embolic in the Embolization of Malignant and Benign Hypervascular Tumors. J Vasc Interv Radiol 2022; 33:660-667. [PMID: 35278638 DOI: 10.1016/j.jvir.2022.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 01/11/2022] [Accepted: 02/28/2022] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To investigate the safety and efficacy of an aqueous polyethylene glycol (PEG) based liquid embolic Embrace HES in the treatment of benign and malignant hypervascular tumors. MATERIAL AND METHODS A prospective, single-arm, multicenter study included eight patients, 5 males and 3 females median age 58.5 (30-85), who underwent embolization in eight tumors between October 2019 and May 2020. Technical success was defined as successful delivery of HES to the index vessel with disappearance of >90% of the targeted vascular enhancement, or for portal vein embolization, occlusion of the portal branches to the liver segments for future resection. The volume of HES administered, ease of use (Likert scale), administration time and adverse events were recorded. Evaluation at 7, 30 and 90 days via clinical assessment and blood testing; and follow-up imaging at 30 days. RESULTS Eight patients were enrolled with 10 embolizations performed in 8 lesions. Tumors included Hepatocellular carcinoma (n=4), Renal Angiomyolipoma (n=3) and Intrahepatic Cholangiocarcinoma (n=1). Technical success was 100% and average ease of use was 3.3 +/- 1.0 standard deviation. HES delivery time was 1-28 minutes (median 16.5) and HES volume injected was 0.4-4.0mL (median 1.3). All patients reached 30 day follow-up with imaging and 6 reached 90 day follow-up. There were 3 serious adverse events in 2 patients which were unrelated to the embolic agent. CONCLUSION HES resulted in a 100% embolization technical success. Product ease of use was acceptable and no target vessel recanalization was noted in follow up imaging at 30 days.
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Affiliation(s)
- Gerard S Goh
- Department of Radiology, The Alfred Hospital, Melbourne, Australia; Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia; National Trauma Research Institute, Central Clinical School, Monash University, Melbourne, Australia.
| | - Mark D Goodwin
- Department of Radiology, Austin Health, Heidelberg, Australia; University of Melbourne, Parkville, Victoria, Australia
| | - Jee-Fu Huang
- Hepatobiliary Division and Hepatitis Centre, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung City, Taiwan
| | - Helen Kavnoudias
- Department of Radiology, The Alfred Hospital, Melbourne, Australia; Department of Radiology, Austin Health, Heidelberg, Australia; Department of Neuroscience, Monash University, Melbourne, Australia
| | - Andrew Holden
- Auckland City Hospital, Auckland, New Zealand; University of Auckland, Auckland, New Zealand
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Development of PVA-based microsphere as a potential embolization agent. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2022; 135:112677. [DOI: 10.1016/j.msec.2022.112677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/06/2022] [Accepted: 01/19/2022] [Indexed: 12/12/2022]
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15
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Torres-Jiménez J, Esteban-Villarrubia J, Ferreiro-Monteagudo R, Carrato A. Local Treatments in the Unresectable Patient with Colorectal Cancer Metastasis: A Review from the Point of View of the Medical Oncologist. Cancers (Basel) 2021; 13:5938. [PMID: 34885047 PMCID: PMC8656541 DOI: 10.3390/cancers13235938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 12/12/2022] Open
Abstract
For patients with isolated liver metastases from colorectal cancer who are not candidates for potentially curative resections, non-surgical local treatments may be useful. Non-surgical local treatments are classified according to how the treatment is administered. Local treatments are applied directly on hepatic parenchyma, such as radiofrequency, microwave hyperthermia and cryotherapy. Locoregional therapies are delivered through the hepatic artery, such as chemoinfusion, chemoembolization or selective internal radiation with Yttrium 90 radioembolization. The purpose of this review is to describe the different interventional therapies that are available for these patients in routine clinical practice, the most important clinical trials that have tried to demonstrate the effectiveness of each therapy and recommendations from principal medical oncologic societies.
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Affiliation(s)
- Javier Torres-Jiménez
- Medical Oncology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain; (J.E.-V.); (R.F.-M.)
| | - Jorge Esteban-Villarrubia
- Medical Oncology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain; (J.E.-V.); (R.F.-M.)
| | - Reyes Ferreiro-Monteagudo
- Medical Oncology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain; (J.E.-V.); (R.F.-M.)
| | - Alfredo Carrato
- Medical Oncology Department, Ramón y Cajal Health Research Institute (IRYCIS), CIBERONC, Alcalá University, University Hospital Ramon y Cajal, 28034 Madrid, Spain;
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Zhu YX, Jia HR, Guo Y, Liu X, Zhou N, Liu P, Wu FG. Repurposing Erythrocytes as a "Photoactivatable Bomb": A General Strategy for Site-Specific Drug Release in Blood Vessels. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2021; 17:e2100753. [PMID: 34259382 DOI: 10.1002/smll.202100753] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/20/2021] [Indexed: 06/13/2023]
Abstract
Tumor vasculature has long been considered as an extremely valuable therapeutic target for cancer therapy, but how to realize controlled and site-specific drug release in tumor blood vessels remains a huge challenge. Despite the widespread use of nanomaterials in constructing drug delivery systems, they are suboptimal in principle for meeting this demand due to their easy blood cell adsorption/internalization and short lifetime in the systemic circulation. Here, natural red blood cells (RBCs) are repurposed as a remote-controllable drug vehicle, which retains RBC's morphology and vessel-specific biodistribution pattern, by installing photoactivatable molecular triggers on the RBC membrane via covalent conjugation with a finely tuned modification density. The molecular triggers can burst the RBC vehicle under short and mild laser irradiation, leading to a complete and site-specific release of its payloads. This cell-based vehicle is generalized by loading different therapeutic agents including macromolecular thrombin, a blood clotting-inducing enzyme, and a small-molecule hypoxia-activatable chemodrug, tirapazamine. In vivo results demonstrate that the repurposed "anticancer RBCs" exhibit long-term stability in systemic circulation but, when tumors receive laser irradiation, precisely releases their cargoes in tumor vessels for thrombosis-induced starvation therapy and local deoxygenation-enhanced chemotherapy. This study proposes a general strategy for blood vessel-specific drug delivery.
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Affiliation(s)
- Ya-Xuan Zhu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing, 210096, P. R. China
| | - Hao-Ran Jia
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing, 210096, P. R. China
| | - Yuxin Guo
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing, 210096, P. R. China
| | - Xiaoyang Liu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing, 210096, P. R. China
| | - Ningxuan Zhou
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing, 210096, P. R. China
| | - Peidang Liu
- School of Medicine, Southeast University, Nanjing, 210009, P. R. China
| | - Fu-Gen Wu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing, 210096, P. R. China
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Rossi SM, Murray T, McDonough L, Kelly H. Loco-regional drug delivery in oncology: current clinical applications and future translational opportunities. Expert Opin Drug Deliv 2020; 18:607-623. [PMID: 33253052 DOI: 10.1080/17425247.2021.1856074] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: Drug-based treatment regimens for cancer are often associated with off-target toxic side effects and low penetration of the drug at the tumor site leading to patient morbidity and limited efficacy. Loco-regional drug delivery has the potential to increase efficacy while concomitantly reducing toxicity.Areas covered: Clinical applications using loco-regional delivery include intra-arterial drug delivery in retinoblastoma, direct intra-tumoral (IT) injection of ethanol for ablation in hepatocellular carcinoma (HCC) and the use of HIPEC in peritoneal carcinomas. In recent years, there has been a significant increase in both approved products and clinical trials, with a particular emphasis on drug delivery platforms such as drug-eluting beads for HCC and hydrogel platforms for intravesical delivery in bladder cancer.Expert opinion: Development of loco-regional drug-delivery systems has been slow, limited by weak clinical data for early applications and challenges relating to dosing, delivery and retention of drugs at the site of action. However, there is increasing focus on the potential of loco-regional drug delivery when combined with bespoke drug-delivery platforms. With the growth in immunotherapies, the use of IT delivery to drive priming of the anti-tumor response has opened up a new field of opportunity for loco-regional drug delivery.
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Affiliation(s)
- Seona M Rossi
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
| | - Timothy Murray
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Liam McDonough
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
| | - Helena Kelly
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
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Arterial Embolization Using Microspheres for Hypervascular Liver Metastases Refractory to Standard Treatments: A Multicenter Prospective Clinical Trial. Cardiovasc Intervent Radiol 2020; 44:392-400. [PMID: 33098022 DOI: 10.1007/s00270-020-02673-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/29/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the clinical utility of bland arterial embolization using microspheres in patients with hypervascular liver metastases refractory to standard treatments. MATERIALS AND METHODS Primary endpoints of this prospective single-arm non-comparative study were objective response and disease control rates (ORR and DCR), based on the modified Response Evaluation Criteria in Solid Tumors at 4 weeks after embolization. Secondary endpoints were ORR according to primary tumor, overall survival, progression-free survival (PFS), and safety. RESULTS Twenty-five patients with a median age of 66 years (range, 40-95 years) were enrolled in this study. The median maximum diameter of liver metastasis was 3.7 cm (range, 2.0-15.2 cm). Primary lesions were colorectal cancer in 12 patients (48%, 12/25), other cancer in 7 (28%, 7/25), neuroendocrine tumor in 4 (16%, 4/25), and sarcoma in 2 (8%, 2/25). ORR and DCR were 52% (13/25) and 72% (18/25) in all patients, 42% (5/12) and 75% (9/12) in colorectal cancer patients, and 62% (8/13) and 69% (9/13) in other malignant tumor patients (p = 0.43, p > 0.99). Median survival time was 19 months in all patients, 19 months in colorectal cancer patients, and 8 months (p = 0.16) in other malignant tumor patients. Median PFS time was 4 months in all patients, 4 months in colorectal cancer patients, and 6 months (p = 0.0085) in other malignant tumor patients. There were no grade-3 or -4 adverse events. CONCLUSION Microsphere embolization appears to be an effective and safe treatment for hypervascular liver metastases refractory to standard treatments.
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Zou M, Xu P, Wang L, Wang L, Li T, Liu C, Shi L, Xie J, Li W, Wang S, Wu G, Luo F, Wu T, Yan J. Design and construction of a magnetic targeting pro-coagulant protein for embolic therapy of solid tumors. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2020; 48:116-128. [PMID: 31852257 DOI: 10.1080/21691401.2019.1699817] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
In this study, we have designed a magnetic targeting pro-coagulant protein (MTPCP) for the embolic therapy of solid tumours. The MTPCP consists of a magnetic carrier and a pro-coagulant protein. The pro-coagulant protein used in this study is the fusion protein tTF-EG3287 which is not pro-coagulant when free in the blood circulation, but presents strong pro-coagulant ability once bound to the Neuropilin-1(NRP-1) that is highly expressed on tumour-associated vascular endothelial cells. And the magnetic carrier is O-Carboxymethyl chitosan-coated iron oxide nanoparticles (OCMC/Fe3O4). In vitro, we assessed the NRP-1 targeting ability of the MTPCP using confocal microscopy and flow cytometry, and evaluated the potential pro-coagulant activity of the MTPCP using the Spectozyme FXa assay. In vivo, the magnetic targeting ability of the MTPCP was detected using a living imaging system. At last, we assessed the anticancer activity of the MTPCP on HepG2 tumour bearing BALB/c nude mice models including subcutaneous transplantation and orthotopic transplantation. HepG2 tumour bearing mice models revealed that after intravenous administration of the MTPCP, thrombosis specifically occurs on tumour-associated blood vessels, and resulting in tumour growth retardation. No apparent side effects, such as thrombosis in other organs or other treatment-related toxicity, were observed during the treatment. Our data showed that the MTPCP may be a promising embolic agent for the embolic therapy of solid tumours.
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Affiliation(s)
- Mingyuan Zou
- Medical School of Southeast University, Nanjing, Jiangsu, China.,Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Peilan Xu
- Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Li Wang
- Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Lanlan Wang
- Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Tingting Li
- Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Cong Liu
- Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Lei Shi
- Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jun Xie
- Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Wanyun Li
- Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Shengyu Wang
- Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Guoqiu Wu
- Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China
| | - Fanghong Luo
- Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Ting Wu
- Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jianghua Yan
- Cancer Research Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
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Gao Y, Li Z, Hong Y, Li T, Hu X, Sun L, Chen Z, Chen Z, Luo Z, Wang X, Kong J, Li G, Wang HL, Leo HL, Yu H, Xi L, Guo Q. Decellularized liver as a translucent ex vivo model for vascular embolization evaluation. Biomaterials 2020; 240:119855. [DOI: 10.1016/j.biomaterials.2020.119855] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/06/2020] [Accepted: 02/08/2020] [Indexed: 12/25/2022]
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21
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Qin XY, Liu XX, Li ZY, Guo LY, Zheng ZZ, Guan HT, Song L, Zou YH, Fan TY. MRI Detectable Polymer Microspheres Embedded With Magnetic Ferrite Nanoclusters For Embolization: In Vitro And In Vivo Evaluation. Int J Nanomedicine 2019; 14:8989-9006. [PMID: 31819414 PMCID: PMC6873973 DOI: 10.2147/ijn.s209603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 09/25/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The objective of this study was to develop magnetic embolic microspheres that could be visualized by clinical magnetic resonance imaging (MRI) scanners aiming to improve the efficiency and safety of embolotherapy. METHODS AND DISCUSSION Magnetic ferrite nanoclusters (FNs) were synthesized with microwave-assisted solvothermal method, and their morphology, particle size, crystalline structure, magnetic properties as well as T2 relaxivity were characterized to confirm the feasibility of FNs as an MRI probe. Magnetic polymer microspheres (FNMs) were then produced by inverse suspension polymerization with FNs embedded inside. The physicochemical and mechanical properties (including morphology, particle size, infrared spectra, elasticity, etc.) of FNMs were investigated, and the magnetic properties and MRI detectable properties of FNMs were also assayed by vibrating sample magnetometer and MRI scanners. Favorable biocompatibility and long-term MRI detectability of FNMs were then studied in mice by subcutaneous injection. FNMs were further used to embolize rabbits' kidneys to evaluate the embolic property and detectability by MRI. CONCLUSION FNMs could serve as a promising MRI-visualized embolic material for embolotherapy in the future.
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Affiliation(s)
- Xiao-Ya Qin
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Xiao-Xin Liu
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Zi-Yuan Li
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Li-Ying Guo
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Zhuo-Zhao Zheng
- Department of Nuclear Medicine, Beijing Tsinghua Changgung Hospital, Beijing, People’s Republic of China
| | - Hai-Tao Guan
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, People’s Republic of China
| | - Li Song
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, People’s Republic of China
| | - Ying-Hua Zou
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, People’s Republic of China
| | - Tian-Yuan Fan
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
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Hu J, Albadawi H, Oklu R, Chong BW, Deipolyi AR, Sheth RA, Khademhosseini A. Advances in Biomaterials and Technologies for Vascular Embolization. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2019; 31:e1901071. [PMID: 31168915 PMCID: PMC7014563 DOI: 10.1002/adma.201901071] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/24/2019] [Indexed: 05/03/2023]
Abstract
Minimally invasive transcatheter embolization is a common nonsurgical procedure in interventional radiology used for the deliberate occlusion of blood vessels for the treatment of diseased or injured vasculature. A wide variety of embolic agents including metallic coils, calibrated microspheres, and liquids are available for clinical practice. Additionally, advances in biomaterials, such as shape-memory foams, biodegradable polymers, and in situ gelling solutions have led to the development of novel preclinical embolic agents. The aim here is to provide a comprehensive overview of current and emerging technologies in endovascular embolization with respect to devices, materials, mechanisms, and design guidelines. Limitations and challenges in embolic materials are also discussed to promote advancement in the field.
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Affiliation(s)
- Jingjie Hu
- Division of Vascular & Interventional Radiology, Minimally Invasive Therapeutics Laboratory, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Hassan Albadawi
- Division of Vascular & Interventional Radiology, Minimally Invasive Therapeutics Laboratory, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Rahmi Oklu
- Division of Vascular & Interventional Radiology, Minimally Invasive Therapeutics Laboratory, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Brian W Chong
- Departments of Radiology and Neurological Surgery, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Amy R. Deipolyi
- Department of Interventional Radiology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical Center, 1275 York Avenue, New York, New York 10065, USA
| | - Rahul A. Sheth
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77054, USA
| | - Ali Khademhosseini
- Department of Bioengineering, Department of Radiological Sciences, Department of Chemical and Biomolecular Engineering, Center for Minimally Invasive Therapeutics, California Nanosystems Institute, University of California, 410 Westwood Plaza, Los Angeles, California 90095, USA
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Bala MM, Riemsma RP, Wolff R, Pedziwiatr M, Mitus JW, Storman D, Swierz MJ, Kleijnen J. Cryotherapy for liver metastases. Cochrane Database Syst Rev 2019; 7:CD009058. [PMID: 31291464 PMCID: PMC6620095 DOI: 10.1002/14651858.cd009058.pub3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The liver is affected by two of the most common groups of malignant tumours: primary liver tumours and liver metastases from colorectal carcinoma. Liver metastases are significantly more common than primary liver cancer and long-term survival rates reported for patients after radical surgical treatment is approximately 50%. However, R0 resection (resection for cure) is not feasible in the majority of patients. Cryotherapy is performed with the use of an image-guided cryoprobe which delivers liquid nitrogen or argon gas to the tumour tissue. The subsequent process of freezing is associated with formation of ice crystals, which directly damage exposed tissue, including cancer cells. OBJECTIVES To assess the beneficial and harmful effects of cryotherapy compared with no intervention, other ablation methods, or systemic treatments in people with liver metastases. SEARCH METHODS We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, and six other databases up to June 2018. SELECTION CRITERIA Randomised clinical trials assessing beneficial and harmful effects of cryotherapy and its comparators for liver metastases, irrespective of the location of the primary tumour. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. We extracted information on participant characteristics, interventions, study outcomes, and data on the outcomes important for our review, as well as information on the design and methodology of the trials. Two review authors independently assessed risk of bias in each study. One review author performed data extraction and a second review author checked entries. MAIN RESULTS We found no randomised clinical trials comparing cryotherapy versus no intervention or versus systemic treatments; however, we identified one randomised clinical trial comparing cryotherapy with conventional surgery. The trial was conducted in Ukraine. The trial included 123 participants with solitary, or multiple unilobar or bilobar liver metastases; 63 participants received cryotherapy and 60 received conventional surgery. There were 36 women and 87 men. The primary sites for the metastases were colon and rectum (66.6%), stomach (7.3%), breast (6.5%), skin (4.9%), ovaries (4.1%), uterus (3.3%), kidney (3.3%), intestines (1.6%), pancreas (1.6%), and unknown (0.8%). The trial was not reported sufficiently enough to assess the risk of bias of the randomisation process, allocation concealment, or presence of blinding. It was also not possible to assess incomplete outcome data and selective outcome reporting bias. The certainty of evidence was low because of risk of bias and imprecision.The participants were followed for up to 10 years (minimum five months). The trial reported that the mortality at 10 years was 81% (51/63) in the cryotherapy group and 92% (55/60) in the conventional surgery group. The calculated by us relative risk (RR) with 95% Confidence Interval (CI) was: RR 0.88, 95% CI 0.77 to 1.02. We judged the evidence as low-certainty evidence. Regarding adverse events and complications, separately and in total, our calculation showed no evidence of a difference in recurrence of the malignancy in the liver: 86% (54/63) of the participants in the cryotherapy group and 95% (57/60) of the participants in the conventional surgery group developed a new malignancy (RR 0.90, 95% CI 0.80 to 1.01; low-certainty evidence). The frequency of reported complications was similar between the cryotherapy group and the conventional surgery group, except for postoperative pain. Both insignificant and pronounced pain were reported to be more common in the cryotherapy group while intense pain was reported to be more common in the conventional surgery group. However, the authors did not report whether there was any evidence of a difference. There were no intervention-related mortality or bile leakages.We identified no evidence for health-related quality of life, cancer mortality, or time to progression of liver metastases. The study reported tumour response in terms of the carcinoembryonic antigen level in 69% of participants, and reported results in the form of a graph for 30% of participants. The carcinoembryonic antigen level was lower in the cryotherapy group, and decreased to normal values faster in comparison with the control group (P < 0.05). FUNDING the trial did not provide information on funding. AUTHORS' CONCLUSIONS The evidence for the effectiveness of cryotherapy versus conventional surgery in people with liver metastases is of low certainty. We are uncertain about our estimate and cannot determine whether cryotherapy compared with conventional surgery is beneficial or harmful. We found no evidence for the benefits or harms of cryotherapy compared with no intervention, or versus systemic treatments.
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Affiliation(s)
- Malgorzata M Bala
- Jagiellonian University Medical CollegeChair of Epidemiology and Preventive Medicine; Department of Hygiene and Dietetics; Systematic Reviews UnitKopernika 7KrakowPoland31‐034
| | - Robert P Riemsma
- Kleijnen Systematic Reviews LtdUnit 6, Escrick Business ParkRiccall Road, EscrickYorkUKYO19 6FD
| | - Robert Wolff
- Kleijnen Systematic Reviews LtdUnit 6, Escrick Business ParkRiccall Road, EscrickYorkUKYO19 6FD
| | - Michal Pedziwiatr
- Jagiellonian University Medical College2nd Department of General SurgeryKopernika Street 21KrakówMalopolskaPoland31‐501
| | - Jerzy W Mitus
- Centre of Oncology, Maria Skłodowska – Curie Memorial Institute, Krakow Branch. Department of Anatomy, Jagiellonian University Medical College Krakow, PolandDepartment of Surgical Oncologyul. Garncarska 11KrakowPoland31‐115
| | - Dawid Storman
- University HospitalDepartment of Hygiene and Dietetics, Systematic Reviews Unit, Jagiellonian University Medical College, Department of Adult PsychiatryKrakowPoland
| | - Mateusz J Swierz
- Jagiellonian University Medical CollegeDepartment of Hygiene and Dietetics, Systematic Reviews UnitKrakowPoland
| | - Jos Kleijnen
- Kleijnen Systematic Reviews LtdUnit 6, Escrick Business ParkRiccall Road, EscrickYorkUKYO19 6FD
- School for Public Health and Primary Care (CAPHRI), Maastricht UniversityMaastrichtNetherlands6200 MD
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Matsui Y, Fujiwara H, Hiraki T, Iguchi T, Komaki T, Tanaka T, Yagi T, Gobara H, Kanazawa S. Histological findings in non-tumoral liver and tumor after chemoembolization with drug-eluting beads. MINIM INVASIV THER 2019; 29:217-223. [PMID: 31187680 DOI: 10.1080/13645706.2019.1626250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To evaluate the histological findings in both tumor and surrounding non-tumoral liver parenchyma after trans-arterial chemoembolization with drug-eluting beads (DEB-TACE) for hepatocellular carcinoma (HCC) in patients who subsequently underwent hepatectomy.Material and methods: This study included six patients with an HCC (size 15-61 mm). DEB-TACE was performed using polyvinyl alcohol-based hydrogel microspheres loaded with epirubicin. Radiological tumor response was evaluated after DEB-TACE and before hepatectomy, according to the Modified Response Evaluation Criteria in Solid Tumors. Surgical specimens were histologically evaluated with hematoxylin and eosin, and elastic Van Gieson's staining.Results: Segmental, sub-segmental, or partial hepatectomy were performed 14-58 days after DEB-TACE. There was no remarkable destructive change and minimal to absent inflammatory cell infiltration in the surrounding non-tumoral liver parenchyma. There was no evidence of biliary tract or arterial wall impairment. Complete and partial histological tumor necrosis were found in three cases, respectively, in agreement with the complete and partial responses seen during the radiological evaluation.Conclusion: Histological examination of resected liver specimens after DEB-TACE showed substantial tumor necrosis without any severe inflammatory or destructive changes in the non-tumoral liver parenchyma.
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Affiliation(s)
- Yusuke Matsui
- Department of Radiology, Okayama University Medical School, Okayama, Japan
| | - Hiroyasu Fujiwara
- Department of Radiology, Okayama University Medical School, Okayama, Japan
| | - Takao Hiraki
- Department of Radiology, Okayama University Medical School, Okayama, Japan
| | - Toshihiro Iguchi
- Department of Radiology, Okayama University Medical School, Okayama, Japan
| | - Toshiyuki Komaki
- Department of Radiology, Okayama University Medical School, Okayama, Japan
| | - Takehiro Tanaka
- Department of Pathology, Okayama University Medical School, Okayama, Japan
| | - Takahito Yagi
- Department of Hepato-Biliary and Pancreatic Surgery, Okayama University Medical School, Okayama, Japan
| | - Hideo Gobara
- Department of Radiology, Okayama University Medical School, Okayama, Japan
| | - Susumu Kanazawa
- Department of Radiology, Okayama University Medical School, Okayama, Japan
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Zhou C, Zu QQ, Wang B, Zhou CG, Shi HB, Liu S. Efficacy and prognostic factors of transarterial embolization as initial treatment for spontaneously ruptured hepatocellular carcinoma: a single-center retrospective analysis in 57 patients. Jpn J Radiol 2018; 37:255-263. [PMID: 30511145 DOI: 10.1007/s11604-018-0799-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/26/2018] [Indexed: 01/03/2023]
Abstract
PURPOSE To evaluate the efficacy and prognostic factors following transarterial embolization (TAE) as initial treatment for spontaneously ruptured hepatocellular carcinoma (HCC). METHODS From June 2012 to June 2016, a total of 57 spontaneously ruptured HCC patients who received TAE as initial therapy were retrospectively studied at our institution. Patients were followed until October 2016. Survival rates were estimated using the Kaplan-Meier method, and prognostic factors related to survival were evaluated using Cox regression analysis. RESULTS Among them, 8 (14.0%) patients died within 30 days after initial TAE. The median overall survival time was 208 days. The 6-month, 1-year, and 2-year cumulative overall survival rates were 50.3%, 35.9%, and 14.7%, respectively. Multivariate analysis indicated that tumor size [HR (hazard ratio) 1.12; 95% CI (confidence interval) 1.02-1.23, P = 0.022] Child-Pugh class (HR 1.78; 95% CI 1.13-2.80; P = 0.013), absence of shock on admission (HR 0.40; 95% CI 0.17-0.95; P = 0.039), and embolization with lipiodol and gelatin sponge particles (HR 0.33; 95% CI 0.16-0.70; P = 0.004) were independent prognostic factors for survival. CONCLUSION TAE appeared to be an effective initial treatment for spontaneously ruptured HCC. The results indicated that large tumors, poor Child-Pugh class, and shock on admission were associated with poor prognosis. For these patients, embolization with lipiodol and gelatin sponge particles could achieve better survival than PVA particles used.
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Affiliation(s)
- Chun Zhou
- Department of Interventional Radiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, 210029, China
| | - Qing-Quan Zu
- Department of Interventional Radiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, 210029, China
| | - Bin Wang
- Department of Interventional Radiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, 210029, China
| | - Chun-Gao Zhou
- Department of Interventional Radiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, 210029, China
| | - Hai-Bin Shi
- Department of Interventional Radiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, 210029, China
| | - Sheng Liu
- Department of Interventional Radiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, 210029, China.
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Lu S, Jun Z, Li M, Hou W, Yin Y, Zhou C, Liu G, Duan C, Toft ES, Zhang H. Improved liquid phase separation processes for generating biodegradable microspheres loaded with high concentrations of drugs for tumor embolization. POLYM-PLAST TECH MAT 2018. [DOI: 10.1080/03602559.2018.1542716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Shoutao Lu
- Tongji University School of Medicine, Shanghai, P.R. China
- National United Engineering Laboratory for Biomedical Material Modification, Shandong, P.R. China
| | - Zhang Jun
- Tongji University School of Medicine, Shanghai, P.R. China
| | - Maoquan Li
- Tongji University School of Medicine, Shanghai, P.R. China
- Tenth people’s hospital of Tongji University, Shanghai, P.R. China
| | - Wenbo Hou
- National United Engineering Laboratory for Biomedical Material Modification, Shandong, P.R. China
| | - Yuxia Yin
- National United Engineering Laboratory for Biomedical Material Modification, Shandong, P.R. China
| | - Chao Zhou
- National United Engineering Laboratory for Biomedical Material Modification, Shandong, P.R. China
| | - Guang Liu
- National United Engineering Laboratory for Biomedical Material Modification, Shandong, P.R. China
| | - Cuihai Duan
- National United Engineering Laboratory for Biomedical Material Modification, Shandong, P.R. China
| | - Egon Steen Toft
- Medical and Health Sciences Office, College of Medicine, Qatar University, Doha, Qatar
| | - Haijun Zhang
- National United Engineering Laboratory for Biomedical Material Modification, Shandong, P.R. China
- Tenth people’s hospital of Tongji University, Shanghai, P.R. China
- Medical and Health Sciences Office, College of Medicine, Qatar University, Doha, Qatar
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Poliektov N, Johnson DT. Treatment of Liver Tumors with Transarterial Chemoembolization. Semin Intervent Radiol 2018; 35:350-355. [PMID: 30402018 DOI: 10.1055/s-0038-1673423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Natalie Poliektov
- Department of Radiology, University of Colorado College of Medicine, Aurora, Colorado
| | - D Thor Johnson
- Department of Radiology, University of Colorado College of Medicine, Aurora, Colorado
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Wang Q, Xiao A, Liu Y, Zou Q, Zhou Q, Wang H, Yang X, Zheng C, Yang Y, Zhu Y. One-step preparation of nano-in-micro poly(vinyl alcohol) embolic microspheres and used for dual-modal T 1/T 2-weighted magnetic resonance imaging. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2018; 14:2551-2561. [PMID: 30153472 DOI: 10.1016/j.nano.2018.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 08/03/2018] [Accepted: 08/08/2018] [Indexed: 12/17/2022]
Abstract
It is crucial to develop dual or multi-modal self-imaging embolic microspheres to evaluate the effects of transcatheter arterial embolization therapy of tumor. However, the preparation of such hybrid microspheres always involved in multiple steps or complicated conditions. Here, poly(vinyl alcohol) (PVA) hybrid microspheres with dual-modal T1/T2-weighted magnetic resonance imaging (MRI) have been prepared based on microfluidic technique in one step. Gd2O3 and Fe3O4 nanoparticles with a size of ~5 nm act as T1- and T2-weighted MRI contrast agents, respectively, which are simultaneously in-situ synthesized in the PVA matrix via the reaction of metal ions and alkali with PVA chains as a soft template. Meanwhile, these metallic-oxide nanoparticles act as cross-linker to gelatinize the PVA droplets to obtain nano-in-micro PVA microspheres in one step. This procedure is simple, economic and feasible. The obtained nano-in-micro PVA microspheres show good magnetothermal effect, enhanced T1- and T2-weighted MRI and embolization effect.
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Affiliation(s)
- Qin Wang
- Hubei Key Laboratory of Bioinorganic Chemistry & Materia Medica, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan, China
| | - Ai Xiao
- Hubei Key Laboratory of Bioinorganic Chemistry & Materia Medica, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan, China
| | - Yiming Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Zou
- Hubei Key Laboratory of Bioinorganic Chemistry & Materia Medica, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Zhou
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Wang
- Hubei Key Laboratory of Bioinorganic Chemistry & Materia Medica, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan, China
| | - Xiangliang Yang
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Yajiang Yang
- Hubei Key Laboratory of Bioinorganic Chemistry & Materia Medica, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan, China.
| | - Yanhong Zhu
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China.
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Vollherbst DF, Gockner T, Do T, Holzer K, Mogler C, Flechsig P, Harms A, Schlett CL, Pereira PL, Richter GM, Kauczor HU, Sommer CM. Computed tomography and histopathological findings after embolization with inherently radiopaque 40μm-microspheres, standard 40μm-microspheres and iodized oil in a porcine liver model. PLoS One 2018; 13:e0198911. [PMID: 29985928 PMCID: PMC6037373 DOI: 10.1371/journal.pone.0198911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 05/29/2018] [Indexed: 02/07/2023] Open
Abstract
Purpose The present study compared standard computed tomography (CT) and histopathological findings after endovascular embolization using a prototype of inherently radiopaque 40μm-microspheres with both standard 40μm-microspheres and iodized oil in a porcine liver model. Materials and methods Twelve pigs were divided into six study groups, of two pigs each. Four pigs were embolized with iodized oil alone and four with radiopaque microspheres; two animals in each group were sacrificed at 2 hours and two at 7 days. Two pigs were embolized with radiopaque microspheres and heparin and sacrificed at 7 days. Two pigs were embolized with standard microspheres and sacrificed at 2 hours. CT was performed before and after segmental embolization and before sacrifice at 7 days. The distribution of embolic agent, inflammatory response and tissue necrosis were assessed histopathologically. Results Radiopaque microspheres and iodized oil were visible on standard CT 2 hours and 7 days after embolization, showing qualitatively comparable arterial and parenchymal enhancement. Quantitatively, the enhancement was more intense for iodized oil. Standard microspheres, delivered without contrast, were not visible by imaging. Radiopaque and standard microspheres similarly occluded subsegmental and interlobular arteries and, to a lesser extent, sinusoids. Iodized oil resulted in the deepest penetration into sinusoids. Necrosis was always observed after embolization with microspheres, but never after embolization with iodized oil. The inflammatory response was mild to moderate for microspheres and moderate to severe for iodized oil. Conclusion Radiopaque 40μm-microspheres are visible on standard CT with qualitatively similar but quantitatively less intense enhancement compared to iodized oil, and with a tendency towards less of an inflammatory reaction than iodized oil. These microspheres also result in tissue necrosis, which was not observed after embolization with iodized oil. Both radiopaque and standard 40μm-microspheres are found within subsegmental and interlobar arteries, as well as in hepatic sinusoids.
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Affiliation(s)
- Dominik F. Vollherbst
- Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany
- Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Theresa Gockner
- Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Clinic for Diagnostic and Interventional Radiology, University Hospital Mainz, Mainz, Germany
| | - Thuy Do
- Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Kerstin Holzer
- Department of General Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Carolin Mogler
- Institute of Pathology, Technical University Munich, Munich, Germany
| | - Paul Flechsig
- Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Alexander Harms
- Department of General Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Christopher L. Schlett
- Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Philippe L. Pereira
- Clinic for Radiology, Minimally-invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Heilbronn, Germany
| | - Götz M. Richter
- Clinic for Diagnostic and Interventional Radiology, Klinikum Stuttgart, Stuttgart, Germany
| | - Hans U. Kauczor
- Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Christof M. Sommer
- Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Clinic for Diagnostic and Interventional Radiology, Klinikum Stuttgart, Stuttgart, Germany
- * E-mail:
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Tian X, Kong T, Zhu P, Kang Z, Lei L, Tang X, Wang L. Engineering embolic microparticles from a periodically-pulsating charged liquid meniscus. Chem Eng Sci 2018. [DOI: 10.1016/j.ces.2018.02.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Nosrati Z, Li N, Michaud F, Ranamukhaarachchi S, Karagiozov S, Soulez G, Martel S, Saatchi K, Häfeli UO. Development of a Coflowing Device for the Size-Controlled Preparation of Magnetic-Polymeric Microspheres as Embolization Agents in Magnetic Resonance Navigation Technology. ACS Biomater Sci Eng 2018; 4:1092-1102. [DOI: 10.1021/acsbiomaterials.7b00839] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Zeynab Nosrati
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Ning Li
- NanoRobotics Laboratory, Department of Computer and Software Engineering, Institute of Biomedical Engineering, Polytechnique Montréal, Montréal, Quebec H3T 1J4, Canada
| | - François Michaud
- Laboratoire clinique du traitement de l’image, Centre de recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, Quebec H2X 0A9, Canada
| | - Sahan Ranamukhaarachchi
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Stoyan Karagiozov
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Gilles Soulez
- Department of Radiology, Centre Hospitalier de l’Université de Montréal (CHUM)—Hôpital Notre-Dame, Montréal, Quebec H2L 4M1, Canada
| | - Sylvain Martel
- NanoRobotics Laboratory, Department of Computer and Software Engineering, Institute of Biomedical Engineering, Polytechnique Montréal, Montréal, Quebec H3T 1J4, Canada
| | - Katayoun Saatchi
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Urs O. Häfeli
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
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Tong H, Duan LG, Zhou HY, Feng S. Modification of the method to establish a hepatic VX2 carcinoma model in rabbits. Oncol Lett 2018; 15:5333-5338. [PMID: 29552175 DOI: 10.3892/ol.2018.7980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 12/15/2017] [Indexed: 02/05/2023] Open
Abstract
The hepatic VX2 carcinoma model in rabbits is widely used for the preclinical study of hepatocellular carcinoma. In the present study, a modification was made to the conventional method to establish the animal model, as the conventional method gives rise to frequent tumor seeding due to the drop-out of tumor fragments. In order to evaluate each distinct method of establishing the model, the rabbits were divided into two groups: Group A (the conventional method; n=20) and group B (the modified method; n=20). All surgical details were recorded for reference. At 14 days post-surgery, contrast-enhanced computed tomography (CECT) and autopsy were conducted. Microscopic morphology of tumor cells was observed using hematoxylin and eosin (H&E) and transmission electron microscopy (TEM). Vascular endothelial growth factor (VEGF) and cluster of differentiation (CD)31 were detected via immunochemistry and reverse transcription-polymerase chain reaction. In total, 19 rabbits in each group succeeded in model establishment. Throughout the surgery, group A experienced a longer surgery time compared with group B (group A vs. group B, 22.57±1.34 vs. 20.17±1.50 min; P<0.001), an increased tumor fragment drop-out frequency (group A vs. group B, 1.84±0.96 vs. 1.16±0.38; P=0.008) and an increased peritoneal nodule incidence (group A vs. group B, 35 vs. 5%, P=0.042). As for CECT, H&E and TEM, hepatic VX2 allografts in the two groups demonstrated similar imaging presentations and tumor cell morphology. In addition, VEGF and CD31 levels did not differ between the two groups. In conclusion, the modified method for the establishment of hepatic VX2 carcinoma model in rabbits may decrease tumor fragment drop-out frequency during surgery and incidence of tumor seeding without affecting the properties of VX2 carcinoma.
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Affiliation(s)
- Huan Tong
- Department of Human Anatomy, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Li-Geng Duan
- Department of Emergency, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Hong-Ying Zhou
- Department of Human Anatomy, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Shi Feng
- Department of Human Anatomy, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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Kim B, Han SW, Choi SE, Yim D, Kim JH, Wyss HM, Kim JW. Monodisperse Microshell Structured Gelatin Microparticles for Temporary Chemoembolization. Biomacromolecules 2018; 19:386-391. [DOI: 10.1021/acs.biomac.7b01479] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
| | | | | | | | | | - Hans M. Wyss
- Eindhoven University of Technology, WTB/MaTe and ICMS, Eindhoven, The Netherlands
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Liang YJ, Yu H, Feng G, Zhuang L, Xi W, Ma M, Chen J, Gu N, Zhang Y. High-Performance Poly(lactic-co-glycolic acid)-Magnetic Microspheres Prepared by Rotating Membrane Emulsification for Transcatheter Arterial Embolization and Magnetic Ablation in VX 2 Liver Tumors. ACS APPLIED MATERIALS & INTERFACES 2017; 9:43478-43489. [PMID: 29116741 DOI: 10.1021/acsami.7b14330] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Interventional embolization is a popular minimally invasive vascular therapeutic technique and has been widely applied for hepatocellular carcinoma (HCC) therapy. However, harmful effects caused by transcatheter arterial chemoembolization (TACE) and radioembolization, such as the toxicity of chemotherapy or excessive radiation damage, are serious disadvantages and significantly reduce the therapeutic efficacy. Here, a synergistic therapeutic strategy combined transcatheter arterial embolization and magnetic ablation (TAEMA) by using poly(lactic-co-glycolic acid) (PLGA)-magnetic microspheres (MMs) has been successfully applied to orthotopic VX2 liver tumors of rabbits. These MMs fabricated by novel rotating membrane emulsification system with well-controlled sizes (100-1000 μm) exhibited extremely low hemolysis ratio and excellent biocompatibility with HepG2 cells and L02 cells. Moreover, experimental results demonstrated that, while exposed to alternating magnetic field (AMF) after TAE, the tumor edge could be heated up by more than 15 °C both in vivo and in vitro, whereas only a negligible increase of temperature was observed in the normal hepatic parenchyma (NHP) nearby. Sufficient temperature increase induces apoptosis of tumor cells. This can further inhibit the tumor angiogenesis and results in necrosis compared to the rabbits only treated with TAE. In stark contrast, tumors rapidly grow and subtotal metastasis occurs in the lungs or kidneys, causing severe complications for rabbits only irradiated under AMF. Importantly, the results from the biochemical examination and the gene expression of relative HCC markers further confirmed that the treatment protocol using PLGA-MMs could achieve good biosafety and excellent therapeutic efficacy, which are promising for liver cancer therapy.
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Affiliation(s)
- Yi-Jun Liang
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University , Nanjing 210096, PR China
- Collaborative Innovation Center of Suzhou Nano-Science and Technology, Suzhou Key Laboratory of Biomaterials and Technologies , Suzhou 215123, PR China
| | - Hui Yu
- Jiangsu Cancer Hospital, The Cancer Hospital of Nanjing Medical University , Nanjing 210009, PR China
| | - Guodong Feng
- Jiangsu Cancer Hospital, The Cancer Hospital of Nanjing Medical University , Nanjing 210009, PR China
| | - Linlin Zhuang
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University , Nanjing 210096, PR China
| | - Wei Xi
- Jiangsu Cancer Hospital, The Cancer Hospital of Nanjing Medical University , Nanjing 210009, PR China
| | - Ming Ma
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University , Nanjing 210096, PR China
- Collaborative Innovation Center of Suzhou Nano-Science and Technology, Suzhou Key Laboratory of Biomaterials and Technologies , Suzhou 215123, PR China
| | - Jun Chen
- Jiangsu Cancer Hospital, The Cancer Hospital of Nanjing Medical University , Nanjing 210009, PR China
| | - Ning Gu
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University , Nanjing 210096, PR China
- Collaborative Innovation Center of Suzhou Nano-Science and Technology, Suzhou Key Laboratory of Biomaterials and Technologies , Suzhou 215123, PR China
| | - Yu Zhang
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University , Nanjing 210096, PR China
- Collaborative Innovation Center of Suzhou Nano-Science and Technology, Suzhou Key Laboratory of Biomaterials and Technologies , Suzhou 215123, PR China
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Chandrawati R, Olesen MTJ, Marini TCC, Bisra G, Guex AG, de Oliveira MG, Zelikin AN, Stevens MM. Enzyme Prodrug Therapy Engineered into Electrospun Fibers with Embedded Liposomes for Controlled, Localized Synthesis of Therapeutics. Adv Healthc Mater 2017; 6:10.1002/adhm.201700385. [PMID: 28699219 PMCID: PMC5590711 DOI: 10.1002/adhm.201700385] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 05/31/2017] [Indexed: 12/11/2022]
Abstract
Enzyme prodrug therapy (EPT) enables localized conversion of inert prodrugs to active drugs by enzymes. Performance of EPT necessitates that the enzyme remains active throughout the time frame of the envisioned therapeutic application. β-glucuronidase is an enzyme with historically validated performance in EPT, however it retains its activity in biomaterials for an insufficiently long period of time, typically not exceeding 7 d. Herein, the encapsulation of β-glucuronidase in liposomal subcompartments within poly(vinyl alcohol) electrospun fibers is reported, leading to the assembly of biocatalytically active materials with activity of the enzyme sustained over at least seven weeks. It is further shown that liposomes provide the highly beneficial stabilization of the enzyme when incubated in cell culture media. The assembled biocatalytic materials successfully produce antiproliferative drugs (SN-38) using externally administered prodrugs (SN-38-glucuronide) and effectively suppress cell proliferation, with envisioned utility in the design of cardiovascular grafts.
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Affiliation(s)
- Rona Chandrawati
- Department of Materials, Department of Bioengineering, and Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, UK
| | - Morten T. J. Olesen
- Department of Chemistry and iNANO Interdisciplinary Nanoscience Center, Aarhus University, Aarhus C 8000, Denmark
| | - Thatiane C. C. Marini
- Institute of Chemistry, University of Campinas, UNICAMP, Campinas, 13083-970, São Paulo, Brazil
| | - Gurpal Bisra
- Department of Materials, Department of Bioengineering, and Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, UK
| | - Anne Géraldine Guex
- Department of Materials, Department of Bioengineering, and Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, UK
| | - Marcelo G. de Oliveira
- Institute of Chemistry, University of Campinas, UNICAMP, Campinas, 13083-970, São Paulo, Brazil
| | - Alexander N. Zelikin
- Department of Chemistry and iNANO Interdisciplinary Nanoscience Center, Aarhus University, Aarhus C 8000, Denmark
| | - Molly M. Stevens
- Department of Materials, Department of Bioengineering, and Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, UK
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Porcu EP, Salis A, Rassu G, Maestri M, Galafassi J, Bruni G, Giunchedi P, Gavini E. Engineered polymeric microspheres obtained by multi-step method as potential systems for transarterial embolization and intraoperative imaging of HCC: Preliminary evaluation. Eur J Pharm Biopharm 2017; 117:160-167. [DOI: 10.1016/j.ejpb.2017.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 04/06/2017] [Accepted: 04/11/2017] [Indexed: 12/11/2022]
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Paprottka KJ, Waggershauser T, Rübenthaler J, Paprottka FJ, Clevert DA, Reiser MF, Paprottka PM. In vitro study of physical properties of various embolization particles regarding morphology before, during and after catheter passage. Clin Hemorheol Microcirc 2016; 64:887-898. [PMID: 27802211 DOI: 10.3233/ch-168002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate various embolization particles on their physical properties with special regard on morphological variability and elasticity. METHODS 8 embolization particles (EmboCept®, Contour SE® Microspheres, Embosphere® Micorspheres 400 μm, 500 μm, 1300 μm, Embozene® Microspheres, DC Beads®, Embozene Tandem®) were evaluated and graduated from 1-6 microscopically due to morphologic changes in vitro before, during and after their catheter passage by 4 blinded reviewers. To facilitate comparison, microscopic images were provided with a scale. RESULTS All tested particles showed a homogenous shape and morphology before passage through the simulation catheter. During the passage all particles were elastically deformable, where necessary. After the catheter passage no loss of basic shape was seen. Changes in size were found in 5/8 particles. Grading of morphologic changes varied between mean value of 1.0 and 3.0. No complete destruction or loss of function was seen. CONCLUSION All tested embolization particles are, regarding their morphological properties in sense of homogenous shape and deformation after catheter passage, a safe treatment option. Tested in vitro no less of functionality regarding physical properties should be expected.
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Affiliation(s)
- Karolin J Paprottka
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich, Campus Grosshadern, Munich, Germany
| | - Tobias Waggershauser
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich, Campus Grosshadern, Munich, Germany
| | - Johannes Rübenthaler
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich, Campus Grosshadern, Munich, Germany
| | - Felix J Paprottka
- Department of Plastical Surgery, Diakonieklinikum Rotenburg, Germany
| | - Dirk A Clevert
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich, Campus Grosshadern, Munich, Germany
| | - Maximilian F Reiser
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich, Campus Grosshadern, Munich, Germany
| | - Philipp M Paprottka
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich, Campus Grosshadern, Munich, Germany
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Affiliation(s)
- Clement Chung
- Lyndon B. Johnson General Hospital, Harris Health System, Houston, TX
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Dasse KD, Lander MJ, Novelli PM. Chemoembolization With Drug-Eluting Beads for the Treatment of Hepatocellular Carcinoma. J Adv Pract Oncol 2016; 7:764-778. [PMID: 29670812 PMCID: PMC5902156 DOI: 10.6004/jadpro.2016.7.7.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Kathy Diener Dasse
- Department of Pharmacy Services, University of Michigan Health Systems, Ann Arbor, Michigan
| | - Michael J Lander
- Pharmacy Services, Mayo Clinic - St. Mary's Hospital, Rochester, Minnesota
| | - Paula M Novelli
- Division of Vascular and Interventional Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Bioabsorbable radiopaque water-responsive shape memory embolization plug for temporary vascular occlusion. Biomaterials 2016; 102:98-106. [DOI: 10.1016/j.biomaterials.2016.06.014] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 06/03/2016] [Accepted: 06/05/2016] [Indexed: 11/23/2022]
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Chattopahdyay C, Kim DW, Gombos D, Oba J, Qin Y, Williams M, Esmaeli B, Grimm E, Wargo J, Woodman S, Patel S. Uveal melanoma: From diagnosis to treatment and the science in between. Cancer 2016; 122:2299-312. [PMID: 26991400 PMCID: PMC5567680 DOI: 10.1002/cncr.29727] [Citation(s) in RCA: 241] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 09/01/2015] [Accepted: 09/04/2015] [Indexed: 12/25/2022]
Abstract
Melanomas of the choroid, ciliary body, and iris of the eye are collectively known as uveal melanomas. These cancers represent 5% of all melanoma diagnoses in the United States, and their age-adjusted risk is 5 per 1 million population. These less frequent melanomas are dissimilar to their more common cutaneous melanoma relative, with differing risk factors, primary treatment, anatomic spread, molecular changes, and responses to systemic therapy. Once uveal melanoma becomes metastatic, therapy options are limited and are often extrapolated from cutaneous melanoma therapies despite the routine exclusion of patients with uveal melanoma from clinical trials. Clinical trials directed at uveal melanoma have been completed or are in progress, and data from these well designed investigations will help guide future directions in this orphan disease. Cancer 2016;122:2299-2312. © 2016 American Cancer Society.
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Affiliation(s)
| | - Dae Won Kim
- Moffitt Cancer Center, Tampa, Florida, United States
| | - Dan Gombos
- MD Anderson Cancer Center, Houston, Texas, United States
| | - Junna Oba
- MD Anderson Cancer Center, Houston, Texas, United States
| | - Yong Qin
- MD Anderson Cancer Center, Houston, Texas, United States
| | | | - Bita Esmaeli
- MD Anderson Cancer Center, Houston, Texas, United States
| | | | - Jennifer Wargo
- MD Anderson Cancer Center, Houston, Texas, United States
| | - Scott Woodman
- MD Anderson Cancer Center, Houston, Texas, United States
| | - Sapna Patel
- MD Anderson Cancer Center, Houston, Texas, United States
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43
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Ogawa M, Takayasu K, Hirayama M, Miura T, Shiozawa K, Abe M, Matsumoto N, Nakagawara H, Ohshiro S, Yamamoto T, Tanaka N, Moriyama M, Mutou H, Yamamoto Y, Irie T. Efficacy of a microballoon catheter in transarterial chemoembolization of hepatocellular carcinoma using miriplatin, a lipophilic anticancer drug: Short-term results. Hepatol Res 2016; 46:E60-9. [PMID: 25974615 DOI: 10.1111/hepr.12527] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 04/14/2015] [Accepted: 04/18/2015] [Indexed: 12/14/2022]
Abstract
AIM The goal of the study was to evaluate the efficacy and safety of balloon-occluded transarterial chemoembolization (B-TACE) of hepatocellular carcinoma (HCC) using miriplatin (a lipophilic anticancer drug) and gelatin particles. METHODS B-TACE was performed for 62 HCC nodules in 33 patients who could not be treated by surgical resection or radiofrequency ablation. All 33 patients had a history of transarterial chemoembolization (TACE) treatment prior to B-TACE. As a historical comparison, we investigated 40 nodules in 28 patients treated by TACE using a conventional microcatheter (C-TACE), miriplatin and gelatin particles. The therapeutic effect per tumor was compared between the groups based on the Response Evaluation Criteria in Cancer Study Group of Japan (RECICL) and side-effects were compared based on the Common Terminology Criteria for Adverse Events (ver. 4.0). RESULTS The therapeutic efficacy after 4-12 weeks was evaluated in 59 nodules in the B-TACE group and in 37 nodules in the C-TACE group. Of these nodules, TE4 occurred in 29 (49.2%) in the B-TACE group and in 10 (27%) in the C-TACE group. Local efficacy was significantly higher in nodules treated by B-TACE than by C-TACE. The side-effects on hepatic function were similar in the two groups. CONCLUSION Our results suggest that B-TACE with miriplatin is a useful treatment for hepatocellular carcinoma.
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Affiliation(s)
| | | | | | - Takao Miura
- Department of Gastroenterology and Hepatology
| | | | | | | | | | - Shu Ohshiro
- Department of Gastroenterology and Hepatology
| | | | | | | | | | | | - Toshiyuki Irie
- Department of Radiology, Hitachi General Hospital, Hitachi, Japan
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Practical Tantalum Coating of Microspheres for Experimental Visualization under Fluoroscopy and CT. J Vasc Interv Radiol 2016; 27:127-32. [PMID: 26723923 DOI: 10.1016/j.jvir.2015.07.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 07/28/2015] [Accepted: 07/31/2015] [Indexed: 11/21/2022] Open
Abstract
The present report describes a simple technique for tantalum coating of microspheres for visualization by fluoroscopy and computed tomography (CT). Spherical microspheres were soaked with Ta powder under different conditions and microscopically evaluated for Ta-coating quality by assessing bound and unbound Ta. For 100-300-µm Embosphere particles, soaking with 0.05 mL Ta powder for 30 minutes and centrifugation at 500 rpm produced optimal coating. Optimized microspheres were injected in swine renal arteries and assessed by fluoroscopy and micro-CT for the opacification of segmental, arcuate, and interlobular arteries. This practical method can be used for experimental studies with commonly available microspheres.
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45
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Qiu S, Ge N, Sun D, Zhao S, Sun J, Guo Z, Hu K, Gu N. Synthesis and characterization of multifunctional magnetic polyvinyl alcohol (PVA) microspheres for embolization of blood vessel. IEEE Trans Biomed Eng 2016; 63:730-6. [DOI: 10.1109/tbme.2015.2469735] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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46
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Li Y, Sarıyer OS, Ramachandran A, Panyukov S, Rubinstein M, Kumacheva E. Universal behavior of hydrogels confined to narrow capillaries. Sci Rep 2015; 5:17017. [PMID: 26596468 PMCID: PMC4657056 DOI: 10.1038/srep17017] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 10/23/2015] [Indexed: 11/22/2022] Open
Abstract
Flow of soft matter objects through one-dimensional environments is important in industrial, biological and biomedical systems. Establishing the underlying principles of the behavior of soft matter in confinement can shed light on its performance in many man-made and biological systems. Here, we report an experimental and theoretical study of translocation of micrometer-size hydrogels (microgels) through microfluidic channels with a diameter smaller than an unperturbed microgel size. For microgels with different dimensions and mechanical properties, under a range of applied pressures, we established the universal principles of microgel entrance and passage through microchannels with different geometries, as well as the reduction in microgel volume in confinement. We also show a non-monotonic change in the flow rate of liquid through the constrained microgel, governed by its progressive confinement. The experimental results were in agreement with the theory developed for non-linear biaxial deformation of unentangled polymer gels. Our work has implications for a broad range of phenomena, including occlusion of blood vessels by thrombi and needle-assisted hydrogel injection in tissue engineering.
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Affiliation(s)
- Yang Li
- Department of Chemical Engineering & Applied Chemistry,
University of Toronto, Toronto
| | - Ozan S. Sarıyer
- Department of Chemistry, University of North Carolina,
Chapel Hill, North Carolina
27599-3290
| | - Arun Ramachandran
- Department of Chemical Engineering & Applied Chemistry,
University of Toronto, Toronto
| | - Sergey Panyukov
- P. N. Lebedev Physics Institute, Russian Academy of
Sciences, Moscow
117924
| | - Michael Rubinstein
- Department of Chemistry, University of North Carolina,
Chapel Hill, North Carolina
27599-3290
| | - Eugenia Kumacheva
- Department of Chemical Engineering & Applied Chemistry,
University of Toronto, Toronto
- Department of Chemistry, University of Toronto,
Toronto
- Institute of Biomaterials & Biomedical Engineering,
University of Toronto, Toronto
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47
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Biocompatibility of Bletilla striata Microspheres as a Novel Embolic Agent. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:840896. [PMID: 26472985 PMCID: PMC4579312 DOI: 10.1155/2015/840896] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 08/17/2015] [Accepted: 08/25/2015] [Indexed: 11/24/2022]
Abstract
We have prepared Chinese traditional herb Bletilla striata into microspheres as a novel embolic agent for decades. The aim of this study was to evaluate the biocompatibility of Bletilla striata microspheres (BSMs). After a thermal test of BSMs in vitro, the cell biocompatibility of BSMs was investigated in mouse fibroblasts and human umbilical vein endothelial cells using the methyl tetrazolium (MTT) assay. In addition, blood biocompatibility was evaluated. In vivo intramuscular implantation and renal artery embolization in rabbits with BSMs were used to examine the inflammatory response. The experimental rabbits did not develop any fever symptoms after injection of BSMs, and BSMs exhibited no cytotoxicity in cultured mouse fibroblasts and human umbilical vein endothelial cells. Additionally, BSMs exhibited high compatibility with red blood cells and no hemolysis activity. Intramuscular implantation with BSMs resulted in a gradually lessened mild inflammatory reaction that disappeared after eight weeks. The occlusion of small renal vessels was associated with a mild perivascular inflammatory reaction without significant renal and liver function damage. In conclusion, we believe that BSMs exhibit high biocompatibility and are a promising embolic agent.
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48
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Transarterial Embolization for Hepatocellular Carcinoma: A Comparison between Nonspherical PVA and Microspheres. BIOMED RESEARCH INTERNATIONAL 2015; 2015:435120. [PMID: 26413523 PMCID: PMC4564629 DOI: 10.1155/2015/435120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 05/04/2015] [Accepted: 05/14/2015] [Indexed: 12/13/2022]
Abstract
Transarterial chemoembolization (TACE) and transarterial embolization (TAE) have improved the survival rates of patients with unresectable hepatocellular carcinoma (HCC); however, the optimal TACE/TAE embolic agent has not yet been identified. The aim of this study was to compare the effect of two different embolic agents such as microspheres (ME) and polyvinyl alcohol (PVA) on survival, tumor response, and complications in patients with HCC submitted to transarterial embolization (TAE). Eighty HCC patients who underwent TAE between June 2008 and December 2012 at a single center were retrospectively studied. A total of 48 and 32 patients were treated with PVA and ME, respectively. There were no significant differences in survival (P = 0.679) or tumoral response (P = 0.369) between groups (PVA or ME). Overall survival rates at 12, 18, 24, 36, and 48 months were 97.9, 88.8, 78.9, 53.4, and 21.4% in the PVA-TAE group and 100, 92.9, 76.6, 58.8, and 58% in the ME-TAE group (P = 0.734). Patients submitted to TAE with ME presented postembolization syndrome more frequently when compared with the PVA group (P = 0.02). According to our cohort, the choice of ME or PVA as embolizing agent had no significant impact on overall survival.
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49
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Nosher JL, Ahmed I, Patel AN, Gendel V, Murillo PG, Moss R, Jabbour SK. Non-operative therapies for colorectal liver metastases. J Gastrointest Oncol 2015; 6:224-40. [PMID: 25830041 DOI: 10.3978/j.issn.2078-6891.2014.065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 07/20/2014] [Indexed: 12/16/2022] Open
Abstract
Locoregional therapies for colorectal liver metastases complement systemic therapy by providing an opportunity for local control of hepatic spread. The armamentarium for liver-directed therapy includes ablative therapies, embolization, and stereotactic body radiation therapy. At this time, prospective studies comparing these modalities are limited and decision-making relies on a multidisciplinary approach for optimal patient management. Herein, we describe multiple therapeutic non-surgical procedures and an overview of the results of these treatments.
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Affiliation(s)
- John L Nosher
- 1 Department of Radiology, Rutgers-Robert Wood Johnson Medical School, New Bruswick, NJ, USA ; 2 Department of Radiation Oncology, 3 Division of Medical Oncology, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Inaya Ahmed
- 1 Department of Radiology, Rutgers-Robert Wood Johnson Medical School, New Bruswick, NJ, USA ; 2 Department of Radiation Oncology, 3 Division of Medical Oncology, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Akshar N Patel
- 1 Department of Radiology, Rutgers-Robert Wood Johnson Medical School, New Bruswick, NJ, USA ; 2 Department of Radiation Oncology, 3 Division of Medical Oncology, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Vyacheslav Gendel
- 1 Department of Radiology, Rutgers-Robert Wood Johnson Medical School, New Bruswick, NJ, USA ; 2 Department of Radiation Oncology, 3 Division of Medical Oncology, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Philip G Murillo
- 1 Department of Radiology, Rutgers-Robert Wood Johnson Medical School, New Bruswick, NJ, USA ; 2 Department of Radiation Oncology, 3 Division of Medical Oncology, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Rebecca Moss
- 1 Department of Radiology, Rutgers-Robert Wood Johnson Medical School, New Bruswick, NJ, USA ; 2 Department of Radiation Oncology, 3 Division of Medical Oncology, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Salma K Jabbour
- 1 Department of Radiology, Rutgers-Robert Wood Johnson Medical School, New Bruswick, NJ, USA ; 2 Department of Radiation Oncology, 3 Division of Medical Oncology, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
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Meng WJ, Lu XJ, Wang H, Fan TY, Cui DC, Zhang SS, Zheng ZZ, Guan HT, Song L, Zou YH. Preparation and evaluation of biocompatible long-term radiopaque microspheres based on polyvinyl alcohol and lipiodol for embolization. J Biomater Appl 2015; 30:133-46. [PMID: 25766037 DOI: 10.1177/0885328215575622] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The aim of this work was to develop long-term radiopaque microspheres (LRMs) by entrapping lipiodol in biocompatible polyvinyl alcohol with multiple emulsions chemical crosslinking method. The high content of lipiodol (0.366 g/mL) was hardly released from LRMs in vitro and the radiopacity could maintain at least 3 months after subcutaneous injection in mice without weakening. A series of tests was performed to evaluate the feasibility of LRMs for embolization. LRMs were proved to be smooth, spherical, and well dispersed with diameter range of 100–1200 μm. Young's modulus of LRMs was 55.39 ± 9.10 kPa and LRMs could be easily delivered through catheter without aggregating or clogging. No toxicity of LRMs was found to mouse L929 fibroblasts cells and only moderate inflammatory in surrounding tissue of mice was found after subcutaneous injection of LRMs. After LRMs were embolized in renal artery of a rabbit, the distribution and radiopacity of LRMs in vivo were easily detectable by X-ray fluoroscopy and computed tomography (CT) imaging, respectively. More accurate distribution of LRMs in embolized kidney and vessels could be detected by high-revolution visualization of micro-CT ex vivo. In conclusion, the LRMs were proved to be biocompatible and provide long-term radiopacity with good physical and mechanical properties for embolization.
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Affiliation(s)
- Wen-Jing Meng
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Xiao-Jing Lu
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Huan Wang
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Tian-Yuan Fan
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Dai-Chao Cui
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Shui-Sheng Zhang
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Zhuo-Zhao Zheng
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Hai-Tao Guan
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Li Song
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Ying-Hua Zou
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China
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