|
1
|
Perkons NR, Stein EJ, Nwaezeapu C, Wildenberg JC, Saleh K, Itkin-Ofer R, Ackerman D, Soulen MC, Hunt SJ, Nadolski GJ, Gade TP. Electrolytic ablation enables cancer cell targeting through pH modulation. Commun Biol 2018; 1:48. [PMID: 30271931 PMCID: PMC6123816 DOI: 10.1038/s42003-018-0047-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 04/05/2018] [Indexed: 02/07/2023] Open
Abstract
Minimally invasive ablation strategies enable locoregional treatment of tumors. One such strategy, electrolytic ablation, functions through the local delivery of direct current without thermal effects, facilitating enhanced precision. However, the clinical application of electrolytic ablation is limited by an incompletely characterized mechanism of action. Here we show that acid and base production at the electrodes precipitates local pH changes causing the rapid cell death that underlies macroscopic tumor necrosis at pH > 10.6 or < 4.8. The extent of cell death can be modulated by altering the local buffering capacity and antioxidant availability. These data demonstrate that electrolytic ablation is distinguished from other ablation strategies via its ability to induce cellular necrosis by directly altering the tumor microenvironment. These findings may enable further development of electrolytic ablation as a curative therapy for primary, early stage tumors.
Collapse
Affiliation(s)
- Nicholas R Perkons
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Perelman School of Medicine, 3400 Civic Center Boulevard, Bldg. 421, Philadelphia, PA, 19104, USA
- Department of Bioengineering, 210S 33rd St., Suite 240 Skirkanich Hall, Philadelphia, PA, 19104, USA
| | - Elliot J Stein
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Perelman School of Medicine, 3400 Civic Center Boulevard, Bldg. 421, Philadelphia, PA, 19104, USA
| | - Chike Nwaezeapu
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Joseph C Wildenberg
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Kamiel Saleh
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Roni Itkin-Ofer
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Daniel Ackerman
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Michael C Soulen
- Perelman School of Medicine, 3400 Civic Center Boulevard, Bldg. 421, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Stephen J Hunt
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Perelman School of Medicine, 3400 Civic Center Boulevard, Bldg. 421, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Gregory J Nadolski
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Perelman School of Medicine, 3400 Civic Center Boulevard, Bldg. 421, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Terence P Gade
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA.
- Perelman School of Medicine, 3400 Civic Center Boulevard, Bldg. 421, Philadelphia, PA, 19104, USA.
- Department of Bioengineering, 210S 33rd St., Suite 240 Skirkanich Hall, Philadelphia, PA, 19104, USA.
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
- Department of Cancer Biology, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA.
| |
Collapse
|
|
2
|
Ge BH, Weber CN, Wildenberg JC, Nadolski GJ, Gade TP, Hunt SJ, Soulen MC, Itkin M. Magnetic Resonance-Monitored Coaxial Electrochemical Ablation--Preliminary Evaluation of Technical Feasibility. J Vasc Interv Radiol 2015. [PMID: 26210247 DOI: 10.1016/j.jvir.2015.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To evaluate the technical feasibility of a coaxial electrode configuration to rapidly create a mechanically defined electrochemical ablation zone monitored by magnetic resonance (MR) imaging in real time. MATERIALS AND METHODS A direct current generator supplied the nitinol cathode cage and central platinum anode for coaxial electrochemical ablation. Safety and efficacy were evaluated by measuring local pH, temperature, and current scatter in saline solutions. Ablation zone diameters of 3-6 cm (n = 72) were created on ex vivo bovine liver and verified by gross pathology. Feasibility of MR monitoring was evaluated using 8 swine livers to create ablations of 3 cm (n = 12), 4 cm (n = 4), and 5 cm (n = 4) verified by histology. RESULTS Local pH was 3.2 at the anode and 13.8 at the cathode. Current scatter was negligible. Ablation progress increased relative to local ion concentration, and MR signal changes corresponded to histologic findings. In the ex vivo model, the times to achieve complete ablation were 15 minutes, 20 minutes, 35 minutes, and 40 minutes for diameters of 3 cm, 4 cm, 5 cm, and 6 cm, respectively. Ablation times for the in situ model were 15 minutes, 35 minutes, and 50 minutes for 3 cm, 4 cm, and 5 cm, respectively. CONCLUSIONS The coaxial configuration mechanically defined the electrochemical ablation zone with times similar to comparably sized thermal ablations. MR compatibility allowed for real-time monitoring of ablation progress.
Collapse
Affiliation(s)
- Benjamin H Ge
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104; Penn Image Guided Interventions Laboratory, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.
| | - Charles N Weber
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104; Penn Image Guided Interventions Laboratory, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104
| | - Joseph C Wildenberg
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104; Penn Image Guided Interventions Laboratory, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104
| | - Gregory J Nadolski
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104; Penn Image Guided Interventions Laboratory, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104
| | - Terence P Gade
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104; Penn Image Guided Interventions Laboratory, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104
| | - Stephen J Hunt
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104; Penn Image Guided Interventions Laboratory, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104
| | - Michael C Soulen
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104
| | - Maxim Itkin
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104; Penn Image Guided Interventions Laboratory, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104; Department of Radiology, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania
| |
Collapse
|