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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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2
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Kim S, Nowicki KW, Gross BA, Wagner WR. Injectable hydrogels for vascular embolization and cell delivery: The potential for advances in cerebral aneurysm treatment. Biomaterials 2021; 277:121109. [PMID: 34530233 DOI: 10.1016/j.biomaterials.2021.121109] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 12/11/2022]
Abstract
Cerebral aneurysms are vascular lesions caused by the biomechanical failure of the vessel wall due to hemodynamic stress and inflammation. Aneurysmal rupture results in subarachnoid hemorrhage often leading to death or disability. Current treatment options include open surgery and minimally invasive endovascular options aimed at secluding the aneurysm from the circulation. Cerebral aneurysm embolization with appropriate materials is a therapeutic approach to prevent rupture and the resultant clinical sequelae. Metallic platinum coils are a typical, practical option to embolize cerebral aneurysms. However, the development of an alternative treatment modality is of interest because of poor occlusion permanence, coil migration, and coil compaction. Moreover, minimizing the implanted foreign materials during therapy is of importance not just to patients, but also to clinicians in the event an open surgical approach has to be pursued in the future. Polymeric injectable hydrogels have been investigated for transcatheter embolization and cell therapy with the potential for permanent aneurysm repair. This review focuses on how the combination of injectable embolic biomaterials and cell therapy may achieve minimally invasive remodeling of a degenerated cerebral artery with promise for superior outcomes in treatment of this devastating disease.
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Affiliation(s)
- Seungil Kim
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kamil W Nowicki
- Department of Neurosurgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bradley A Gross
- Department of Neurosurgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - William R Wagner
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Department of Chemical and Petroleum Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
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3
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Golzarian J. Visibility and Resorption: Are These Features Important? Cardiovasc Intervent Radiol 2020; 44:357-358. [PMID: 33211163 DOI: 10.1007/s00270-020-02616-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/02/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Jafar Golzarian
- Radiology and Vascular Imaging, Amplatz Chair in Interventional Radiology, University of Minnesota, 420 Delaware Street S.E., B228-A Mayo Memorial Building, Minneapolis, MN, 55455, USA.
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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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Lewis AL, Willis SL, Dreher MR, Tang Y, Ashrafi K, Wood BJ, Levy EB, Sharma KV, Negussie AH, Mikhail AS. Bench-to-clinic development of imageable drug-eluting embolization beads: finding the balance. Future Oncol 2018; 14:2741-2760. [PMID: 29944007 DOI: 10.2217/fon-2018-0196] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
This review describes the historical development of an imageable spherical embolic agent and focuses on work performed in collaboration between Biocompatibles UK Ltd (a BTG International group company) and the NIH to demonstrate radiopaque bead utility and bring a commercial offering to market that meets a clinical need. Various chemistries have been investigated and multiple prototypes evaluated in search of an optimized product with the right balance of handling and imaging properties. Herein, we describe the steps taken in the development of DC Bead LUMI™, the first commercially available radiopaque drug-eluting bead, ultimately leading to the first human experience of this novel embolic agent in the treatment of liver tumors.
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Affiliation(s)
- Andrew L Lewis
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Sean L Willis
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Matthew R Dreher
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Yiqing Tang
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Koorosh Ashrafi
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Bradford J Wood
- Center for Interventional Oncology, Radiology & Imaging Sciences, NIH Clinical Center, National Institute of Biomedical Imaging & Bioengineering, & National Cancer Institute Center for Cancer Research, NIH, 10 Center Drive, Bethesda, MD 20892, USA
| | - Elliot B Levy
- Center for Interventional Oncology, Radiology & Imaging Sciences, NIH Clinical Center, National Institute of Biomedical Imaging & Bioengineering, & National Cancer Institute Center for Cancer Research, NIH, 10 Center Drive, Bethesda, MD 20892, USA
| | - Karun V Sharma
- Department of Radiology & Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Washington, DC 20010, USA
| | - Ayele H Negussie
- Center for Interventional Oncology, Radiology & Imaging Sciences, NIH Clinical Center, National Institute of Biomedical Imaging & Bioengineering, & National Cancer Institute Center for Cancer Research, NIH, 10 Center Drive, Bethesda, MD 20892, USA
| | - Andrew S Mikhail
- Center for Interventional Oncology, Radiology & Imaging Sciences, NIH Clinical Center, National Institute of Biomedical Imaging & Bioengineering, & National Cancer Institute Center for Cancer Research, NIH, 10 Center Drive, Bethesda, MD 20892, USA
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Preparation and evaluation of MRI detectable poly (acrylic acid) microspheres loaded with superparamagnetic iron oxide nanoparticles for transcatheter arterial embolization. Int J Pharm 2016; 511:831-9. [DOI: 10.1016/j.ijpharm.2016.07.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 07/06/2016] [Accepted: 07/14/2016] [Indexed: 01/10/2023]
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Kim DH, Li W, Chen J, Zhang Z, Green RM, Huang S, Larson AC. Multimodal Imaging of Nanocomposite Microspheres for Transcatheter Intra-Arterial Drug Delivery to Liver Tumors. Sci Rep 2016; 6:29653. [PMID: 27405824 PMCID: PMC4942792 DOI: 10.1038/srep29653] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 06/06/2016] [Indexed: 12/20/2022] Open
Abstract
A modern multi-functional drug carrier is critically needed to improve the efficacy of image-guided catheter-directed approaches for the treatment of hepatic malignancies. For this purpose, a nanocomposite microsphere platform was developed for selective intra-arterial transcatheter drug delivery to liver tumors. In our study, continuous microfluidic methods were used to fabricate drug-loaded multimodal MRI/CT visible microspheres that included both gold nanorods and magnetic clusters. The resulting hydrophilic, deformable, and non-aggregated microspheres were mono-disperse and roughly 25 um in size. Sustained drug release and strong MRI T2 and CT contrast effects were achieved with the embedded magnetic nano-clusters and radiopaque gold nanorods. The microspheres were successfully infused through catheters selectively placed within the hepatic artery in rodent models and subsequent distribution in the targeted liver tissues and hepatic tumors confirmed with MRI and CT imaging. These multimodal nanocomposite drug carriers should be ideal for selective intra-arterial catheter-directed administration to liver tumors while permitting MRI/CT visualization for patient-specific confirmation of tumor-targeted delivery.
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Affiliation(s)
- Dong-Hyun Kim
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
| | - Weiguo Li
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jeane Chen
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Zhuoli Zhang
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
| | - Richard M Green
- Division of Hepatology, Northwestern University Feinberg School of Medicine Chicago, IL, USA
| | - Sui Huang
- Department of Cell and Molecular Biology, Northwestern University Feinberg School of Medicine Chicago, IL, USA
| | - Andrew C Larson
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.,Department of Electrical Engineering and Computer Science, Evanston, IL, USA.,Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA.,International Institute of Nanotechnology (IIN), Northwestern University, Evanston, IL, USA
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Duran R, Sharma K, Dreher MR, Ashrafi K, Mirpour S, Lin M, Schernthaner RE, Schlachter TR, Tacher V, Lewis AL, Willis S, Hartog MD, Radaelli A, Negussie AH, Wood BJ, Geschwind JFH. A Novel Inherently Radiopaque Bead for Transarterial Embolization to Treat Liver Cancer - A Pre-clinical Study. Am J Cancer Res 2016; 6:28-39. [PMID: 26722371 PMCID: PMC4679352 DOI: 10.7150/thno.13137] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 08/19/2015] [Indexed: 02/06/2023] Open
Abstract
Purpose: Embolotherapy using microshperes is currently performed with soluble contrast to aid in visualization. However, administered payload visibility dimishes soon after delivery due to soluble contrast washout, leaving the radiolucent bead's location unknown. The objective of our study was to characterize inherently radiopaque beads (RO Beads) in terms of physicomechanical properties, deliverability and imaging visibility in a rabbit VX2 liver tumor model. Materials and Methods: RO Beads, which are based on LC Bead® platform, were compared to LC Bead. Bead size (light microscopy), equilibrium water content (EWC), density, X-ray attenuation and iodine distribution (micro-CT), suspension (settling times), deliverability and in vitro penetration were investigated. Fifteen rabbits were embolized with either LC Bead or RO Beads + soluble contrast (iodixanol-320), or RO Beads+dextrose. Appearance was evaluated with fluoroscopy, X-ray single shot, cone-beam CT (CBCT). Results: Both bead types had a similar size distribution. RO Beads had lower EWC (60-72%) and higher density (1.21-1.36 g/cc) with a homogeneous iodine distribution within the bead's interior. RO Beads suspension time was shorter than LC Bead, with durable suspension (>5 min) in 100% iodixanol. RO Beads ≤300 µm were deliverable through a 2.3-Fr microcatheter. Both bead types showed similar penetration. Soluble contrast could identify target and non-target embolization on fluoroscopy during administration. However, the imaging appearance vanished quickly for LC Bead as contrast washed-out. RO Beads+contrast significantly increased visibility on X-ray single shot compared to LC Bead+contrast in target and non-target arteries (P=0.0043). Similarly, RO beads demonstrated better visibility on CBCT in target arteries (P=0.0238) with a trend in non-target arteries (P=0.0519). RO Beads+dextrose were not sufficiently visible to monitor embolization using fluoroscopy. Conclusion: RO Beads provide better conspicuity to determine target and non-target embolization compared to LC Bead which may improve intra-procedural monitoring and post-procedural evaluation of transarterial embolization.
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9
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Johnson CG, Tang Y, Beck A, Dreher MR, Woods DL, Negussie AH, Donahue D, Levy EB, Willis SL, Lewis AL, Wood BJ, Sharma KV. Preparation of Radiopaque Drug-Eluting Beads for Transcatheter Chemoembolization. J Vasc Interv Radiol 2015; 27:117-126.e3. [PMID: 26549370 DOI: 10.1016/j.jvir.2015.09.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 09/12/2015] [Accepted: 09/12/2015] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To develop a simple method to produce radiopaque drug-eluting microspheres (drug-eluting beads [DEBs]) that could be incorporated into the current clinical transcatheter arterial chemoembolization workflow and evaluate their performance in vitro and in vivo. MATERIALS AND METHODS An ethiodized oil (Lipiodol; Guerbet, Villepinte, France) and ethanol solution was added to a lyophilized 100-300 µm bead before loading with doxorubicin. These radiopaque drug-eluting beads (DEBs; Biocompatibles UK Ltd, Farnham, United Kingdom) were evaluated in vitro for x-ray attenuation, composition, size, drug loading and elution, and correlation between attenuation and doxorubicin concentration. In vivo conspicuity was evaluated in a VX2 tumor model. RESULTS Lipiodol was loaded into lyophilized beads using two glass syringes and a three-way stopcock. Maximum bead attenuation was achieved within 30 minutes. X-ray attenuation of radiopaque beads increased linearly (21-867 HU) with the amount of beads (0.4-12.5 vol%; R(2) = 0.9989). Doxorubicin loading efficiency and total amount eluted were similar to DC Bead (Biocompatibles UK Ltd); however, the elution rate was slower for radiopaque DEBs (P < .05). Doxorubicin concentration linearly correlated with x-ray attenuation of radiopaque DEBs (R(2) = 0. 99). Radiopaque DEBs were seen in tumor feeding arteries after administration by fluoroscopy, computed tomography, and micro-computed tomography, and their location was confirmed by histology. CONCLUSIONS A simple, rapid method to produce radiopaque DEBs was developed. These radiopaque DEBs provided sufficient conspicuity to be visualized with x-ray imaging techniques.
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Affiliation(s)
- Carmen Gacchina Johnson
- Center for Interventional Oncology, Radiology, and Imaging Sciences, Clinical Center and National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Yiqing Tang
- Biocompatibles UK Ltd, a BTG International group company, Farnham, United Kingdom
| | - Avi Beck
- Center for Interventional Oncology, Radiology, and Imaging Sciences, Clinical Center and National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Matthew R Dreher
- Biocompatibles UK Ltd, a BTG International group company, Farnham, United Kingdom
| | - David L Woods
- Center for Interventional Oncology, Radiology, and Imaging Sciences, Clinical Center and National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Ayele H Negussie
- Center for Interventional Oncology, Radiology, and Imaging Sciences, Clinical Center and National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Danielle Donahue
- Mouse Imaging Facility, National Institute of Neurologic Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - Elliot B Levy
- Center for Interventional Oncology, Radiology, and Imaging Sciences, Clinical Center and National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Sean L Willis
- Biocompatibles UK Ltd, a BTG International group company, Farnham, United Kingdom
| | - Andrew L Lewis
- Biocompatibles UK Ltd, a BTG International group company, Farnham, United Kingdom
| | - Bradford J Wood
- Center for Interventional Oncology, Radiology, and Imaging Sciences, Clinical Center and National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Karun V Sharma
- Center for Interventional Oncology, Radiology, and Imaging Sciences, Clinical Center and National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Department of Radiology, Georgetown University Hospital, Washington, DC; Department of Radiology and Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Washington, DC.
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Improved drug targeting to liver tumors after intra-arterial delivery using superparamagnetic iron oxide and iodized oil: preclinical study in a rabbit model. Invest Radiol 2014; 48:826-33. [PMID: 23835597 DOI: 10.1097/rli.0b013e31829c13ef] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the feasibility and the therapeutic efficacy of a novel drug-delivery system that uses superparamagnetic iron oxide (SPIO) and iodized oil (IO) to improve the selective intra-arterial (IA) drug delivery to an experimentally induced hepatic tumor. MATERIALS AND METHODS This animal study was approved by our institutional animal care and use committee. Fifteen rabbits with hepatic VX2 carcinomas were treated with IA delivery of 4 different agents: doxorubicin alone (group A, n = 3), doxorubicin/IO (group B, n = 3), a doxorubicin/SPIO complex (group C, n = 4), and a doxorubicin/SPIO/IO complex (group D, n = 5). The infused doxorubicin dose was 1 mg for all groups. The serum doxorubicin concentration was measured at 0, 5, 30, 60, and 120 minutes after the delivery. To assess the distribution of the SPIO, magnetic resonance (MR) scans were performed at day 7 after the delivery, when computed tomographic scans were performed in addition to MR in group B and D to assess the distribution of IO. After the completion of follow-up imaging, all the animals were euthanized to measure the intratumoral doxorubicin concentration and to assess tumor viability through pathologic examination. RESULTS Groups C and D demonstrated significantly lower MR signal intensities, which inversely corresponded to SPIO deposition, in the tumor areas than did groups A and B. Group D exhibited the lowest serum doxorubicin concentration at all time points up to 180 minutes after the delivery, suggesting minimal passage of doxorubicin into the systemic circulation. The intratumoral doxorubicin concentrations were 72.4 ng/g for group A, 142.0 ng/g for group B, 264.1 ng/g for group C, and 679.6 ng/g for group D. The proportion of viable tumor cells were 65.3% for group A, 1.3% for group B, 17.0% for group C, and 0.1% for group D. CONCLUSIONS The drug-delivery system developed using SPIO and IO can result in better drug targeting when it is used for IA delivery to liver cancer. The results of this study warrant further investigation of this potential clinical treatment of advanced liver cancer.
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Hasan MS, Kehoe S, Boyd D. Temporal analysis of dissolution by-products and genotoxic potential of spherical zinc-silicate bioglass: "imageable beads" for transarterial embolization. J Biomater Appl 2014; 29:566-81. [PMID: 24913613 DOI: 10.1177/0885328214537694] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Embolization of vascular tumors is an important tool in minimally invasive surgical intervention. Radiopaque, non-degradable, and non-deformable spherical zinc-silicate glass particles were produced in a range of 45-500 μm. Three size ranges (45-150, 150-300, and 300-500 μm) were used in the current study. The glass microspheres were eluted in polar (saline solution) and non-polar (dimethyl sulfoxide) medium, and ion release profiles were recorded using inductively coupled plasma atomic emission spectroscopy. Approximately 80% of Gaussian distribution was achieved by simple sieving. The ions released from the microspheres were dependent upon surface area to volume ratio as well as the nature of elution media. Greater ions were released from smaller particles (45-150 μm) having largest surface area in polar medium. For the genotoxicity bacterial mutation Ames assay, the concentrations of all the ions were well below their therapeutic concentration reported in the literature. No mutagenic effect was observed in the bacterial mutation Ames test. Hence, it can be concluded that the glass microspheres produced herein are non-mutagenic further supporting the materials potential as a suitable embolic agent.
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Affiliation(s)
- M S Hasan
- Department of Applied Oral Sciences, Dalhousie University, Halifax, NS, Canada School of Biomedical Engineering, Dalhousie University, Halifax, NS, Canada
| | - S Kehoe
- School of Biomedical Engineering, Dalhousie University, Halifax, NS, Canada
| | - D Boyd
- Department of Applied Oral Sciences, Dalhousie University, Halifax, NS, Canada School of Biomedical Engineering, Dalhousie University, Halifax, NS, Canada ABK Biomedical Inc., Halifax, Canada
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12
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Pouponneau P, Soulez G, Beaudoin G, Leroux JC, Martel S. MR imaging of therapeutic magnetic microcarriers guided by magnetic resonance navigation for targeted liver chemoembolization. Cardiovasc Intervent Radiol 2013; 37:784-90. [PMID: 24196271 DOI: 10.1007/s00270-013-0770-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 09/27/2013] [Indexed: 01/14/2023]
Abstract
PURPOSE Magnetic resonance navigation (MRN), achieved with an upgraded MRI scanner, aims to guide new therapeutic magnetic microcarriers (TMMC) from their release in the hepatic vascular network to liver tumor. In this technical note, in vitro and in vivo MRI properties of TMMC, loaded with iron-cobalt nanoparticles and doxorubicin, are reported by following three objectives: (1) to evaluate the lengthening of echo-time (TE) on nano/microparticle imaging; (2) to characterize by MRI TMMC distribution in the liver; and (3) to confirm the feasibility of monitoring particle distribution in real time. METHODS Phantom studies were conducted to analyze nano/microparticle signals on T 2*-weighted gradient-echo (GRE) MR images according to sample weight and TE. Twelve animal experiments were used to determine in vivo MRI parameters. TMMC tracking was evaluated by magnetic resonance imaging (MRI) in four rabbits, which underwent MRN in the hepatic artery, three without steering, two in real-time, and three as blank controls. TMMC distribution in the right and left liver lobes, determined by ex vivo MR image analysis, was compared to the one obtained by cobalt level analysis. RESULTS TMMC induced a hypointense signal that overran the physical size of the sample on MR images. This signal, due to the nanoparticles embedded into the microparticles, increased significantly with echo-time and sample amount (p < 0.05). In vivo, without steering, contrast-to-noise ratio (CNR) values for the right and left lobes were similar. With MRN, the CNR in the targeted lobe was different from that in the untargeted lobe (p = 0.003). Ex vivo, TMMC distribution, based on MRI signal loss volume measurement, was correlated with that quantified by Co level analysis (r = 0.92). TMMC accumulation was tracked in real time with an 8-s GRE sequence. CONCLUSIONS MRI signal loss induced by TMMC can serve to track particle accumulation and to assess MRN efficiency.
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Affiliation(s)
- Pierre Pouponneau
- NanoRobotics Laboratory, Department of Computer and Software Engineering and Institute of Biomedical Engineering, Ecole Polytechnique de Montréal (EPM), C.P. 6079, Succursale Centre-ville, Montreal, QC, H3C 3A7, Canada,
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Idée JM, Guiu B. Use of Lipiodol as a drug-delivery system for transcatheter arterial chemoembolization of hepatocellular carcinoma: a review. Crit Rev Oncol Hematol 2013; 88:530-49. [PMID: 23921081 DOI: 10.1016/j.critrevonc.2013.07.003] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 06/05/2013] [Accepted: 07/09/2013] [Indexed: 12/12/2022] Open
Abstract
Hepatocellular carcinoma (HCC) remains a major public health problem. Transarterial chemoembolization (TACE) is recognized as the standard of care for patients with unresectable, asymptomatic, noninvasive and multinodular HCC. This procedure is based on percutaneous administration of a cytotoxic drug emulsified with Lipiodol followed by embolization of the tumour-feeding arteries. The standard procedure involves Lipiodol, an oily contrast medium which consists of a mixture of long-chain di-iodinated ethyl esters of poppy seed fatty acids. The aim of this review is to discuss the physical properties, tumour uptake behaviour and drug delivery effects of Lipiodol, the parameters influencing tumour uptake and future prospects. Lipiodol has a unique place in TACE as it combines three specific characteristics: drug delivery, transient and plastic embolization and radiopacity properties. Substantial heterogeneity in the physicochemical characteristics of Lipiodol/cytotoxic agent emulsions might reduce the efficacy of this procedure and justifies the current interest in Lipiodol for drug delivery.
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Affiliation(s)
- Jean-Marc Idée
- Guerbet, Research and Innovation Division, BP 57400, 95943 Roissy-Charles de Gaulle cedex, France.
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Lu XJ, Zhang Y, Cui DC, Meng WJ, Du LR, Guan HT, Zheng ZZ, Fu NQ, Lv TS, Song L, Zou YH, Lu WL, Fan TY. Research of novel biocompatible radiopaque microcapsules for arterial embolization. Int J Pharm 2013; 452:211-9. [DOI: 10.1016/j.ijpharm.2013.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Revised: 04/09/2013] [Accepted: 05/02/2013] [Indexed: 01/11/2023]
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Multimodal Visibility (Radiography, Computed Tomography, and Magnetic Resonance Imaging) of Microspheres for Transarterial Embolization Tested in Porcine Kidneys. Invest Radiol 2013; 48:213-22. [DOI: 10.1097/rli.0b013e31827f6598] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Stampfl U, Sommer CM, Bellemann N, Holzschuh M, Kueller A, Bluemmel J, Gehrig T, Shevchenko M, Kenngott H, Kauczor HU, Radeleff B. Multimodal visibility of a modified polyzene-F-coated spherical embolic agent for liver embolization: feasibility study in a porcine model. J Vasc Interv Radiol 2012; 23:1225-31.e2. [PMID: 22832143 DOI: 10.1016/j.jvir.2012.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 05/27/2012] [Accepted: 06/05/2012] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To evaluate multimodal visibility of modified currently available microspheres on radiography, magnetic resonance (MR) imaging, and computed tomography (CT) in a porcine liver model. MATERIALS AND METHODS Livers of four pigs were embolized with two sizes (100 μm ± 25 and 700 μm ± 50) of modified Embozene Microspheres embedded with different densities of barium sulfate and iodine as radiopaque materials (intensity groups A-C, with increasing intensity from A to C for 100 μm and intensities A and C for 700 μm) and iron oxide as magnetic substance for MR imaging visibility. Pigs embolized with currently available Embozene Microspheres served as control groups. Pre- and postinterventional MR imaging (T1- and T2-weighted) and CT were performed. Qualitative and quantitative (ie, determination of signal-to-noise ratio [SNR]) particle visibility was evaluated on radiography, MR imaging, and CT. RESULTS Modified particles of both sizes were visible on radiography, MR imaging, and CT. Particles in the control group were not visible. For modified particles of both sizes, SNRs measured on MR imaging decreased significantly after embolization (eg, cluster analysis of group A, 100 μm ± 50 particles, T1-weighted, -74.6% ± 3.4; P = .03). For modified particles of both sizes, SNR measured on CT increased significantly after embolization (eg, cluster analysis of group A, 700 μm ± 25 particles, +54.3% ± 13.5; P = .03). CONCLUSIONS Modification of currently available Embozene Microspheres was successful, with multimodal visibility on radiography, MR imaging, and CT in porcine liver. In the future, this might improve procedure accuracy and allow monitoring, control, and improvement of embolotherapy during and after the procedure.
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Affiliation(s)
- Ulrike Stampfl
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
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Lewis AL, Dreher MR. Locoregional drug delivery using image-guided intra-arterial drug eluting bead therapy. J Control Release 2012; 161:338-50. [PMID: 22285550 PMCID: PMC3351580 DOI: 10.1016/j.jconrel.2012.01.018] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Revised: 01/13/2012] [Accepted: 01/15/2012] [Indexed: 12/30/2022]
Abstract
Lipiodol-based transarterial chemoembolization (TACE) has been performed for over 3 decades for the treatment of solid tumors and describes the infusion of chemotherapeutic agents followed by embolization with particles. TACE is an effective treatment for inoperable hepatic tumors, especially hypervascular tumors such as hepatocellular carcinoma. Recently, drug eluting beads (DEBs), in which a uniform embolic material is loaded with a drug and delivered in a single image-guided step, have been developed to reduce the variability in a TACE procedure. DEB-TACE results in localization of drug to targeted tumors while minimizing systemic exposure to chemotherapeutics. Once localized in the tissue, drug is eluted from the DEB in a controlled manner and penetrates hundreds of microns of tissue from the DEB surface. Necrosis is evident surrounding a DEB in tissue days to months after therapy; however, the contribution of drug and ischemia is currently unknown. Future advances in DEB technology may include image-ability, DEB size tailored to tumor anatomy and drug combinations.
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Affiliation(s)
- Andrew L Lewis
- Biocompatibles UK Ltd, Farnham Business Park, Weydon Lane, Farnham, Surrey, GU9 8QL, UK.
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Dreher MR, Sharma KV, Woods DL, Reddy G, Tang Y, Pritchard WF, Chiesa OA, Karanian JW, Esparza JA, Donahue D, Levy EB, Willis SL, Lewis AL, Wood BJ. Radiopaque drug-eluting beads for transcatheter embolotherapy: experimental study of drug penetration and coverage in swine. J Vasc Interv Radiol 2012; 23:257-64.e4. [PMID: 22178039 PMCID: PMC3360470 DOI: 10.1016/j.jvir.2011.10.019] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 10/12/2011] [Accepted: 10/24/2011] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To determine local doxorubicin levels surrounding radiopaque drug-eluting beads (DEBs) in normal swine liver and kidney following transcatheter arterial chemoembolization. The influence of bead size (70-150 μm or 100-300 μm) was compared with regard to tissue penetration and spatial distribution of the bead, as well as eventual drug coverage (ie, amount of tissue exposed to drug). MATERIALS AND METHODS Radiopaque DEBs were synthesized by suspension polymerization followed by incorporation of iodized oil and doxorubicin. Chemoembolization of swine liver and kidney was performed under fluoroscopic guidance. Three-dimensional tissue penetration of "imageable" DEBs was investigated ex vivo with micro-computed tomography (microCT). Drug penetration from the bead surface and drug coverage was evaluated with epifluorescence microscopy, and cellular localization of doxorubicin was evaluated with confocal microscopy. Necrosis was evaluated with hematoxylin and eosin staining. RESULTS MicroCT demonstrated that 70-150-μm DEBs were present in more distal arteries and located in a more frequent and homogeneous spatial distribution. Tissue penetration of doxorubicin from the bead appeared similar (∼300 μm) for both DEBs, with a maximum tissue drug concentration at 1 hour coinciding with nuclear localization of doxorubicin. The greater spatial frequency of the 70-150-μm DEBs resulted in approximately twofold improved drug coverage in kidney. Cellular death is predominantly observed around the DEBs beginning at 8 hours, but increased at 24 and 168 hours. CONCLUSIONS Smaller DEBs penetrated further into targeted tissue (ie, macroscopic) with a higher spatial density, resulting in greater and more uniform drug coverage (ie, microscopic) in swine.
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Affiliation(s)
- Matthew R Dreher
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Building 10 Room 1C341 MSC 1182, Bethesda, MD 20892, USA
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First Multimodal Embolization Particles Visible on X-ray/Computed Tomography and Magnetic Resonance Imaging. Invest Radiol 2011; 46:178-86. [DOI: 10.1097/rli.0b013e318205af53] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Sharma KV, Dreher MR, Tang Y, Pritchard W, Chiesa OA, Karanian J, Peregoy J, Orandi B, Woods D, Donahue D, Esparza J, Jones G, Willis SL, Lewis AL, Wood BJ. Development of "imageable" beads for transcatheter embolotherapy. J Vasc Interv Radiol 2010; 21:865-76. [PMID: 20494290 DOI: 10.1016/j.jvir.2010.02.031] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 01/06/2010] [Accepted: 02/18/2010] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To develop and characterize radiopaque embolization microspheres capable of in vivo detection with intraprocedural fluoroscopy and computed tomography (CT) imaging and to evaluate their spatial distribution inside target tissues during and after transcatheter embolization. MATERIALS AND METHODS Polyvinyl alcohol hydrogel microspheres were loaded with Lipiodol and examined for iodine content, stability of loading, and conspicuity with fluoroscopy and CT in vitro. Transcatheter embolization of swine liver and kidney was performed with the radiopaque microspheres and spatial distribution was evaluated with intraprocedural fluoroscopy and CT. Ex vivo evaluation was performed with light microscopy and micro-CT. RESULTS In vitro analyses demonstrated that radiopaque microspheres could be loaded with sufficient iodine content to be detected with routine fluoroscopy and CT imaging and that such loading was relatively stable. Radiopaque microspheres were visible in vivo with fluoroscopy and CT during transcatheter embolization. CT imaging during embolization procedures demonstrated a dose-dependent relationship in the number and size of visualized embolized arteries. Imaging features of radiopaque microsphere distribution inside target tissues correlated well with ex vivo light microscopic and micro-CT evaluation of microsphere distribution. CONCLUSIONS Radiopaque embolization microspheres are visualized during transcatheter embolization with routine intraprocedural fluoroscopy and CT. These radiopaque microspheres provided the three-dimensional spatial distribution of embolic material inside target organs during the procedure, and therefore can provide real-time intraprocedural feedback for the interventional radiologist. These microspheres may be useful for demonstrating the influence of material and technical variability in transcatheter embolization in addition to providing intraprocedural identification of tissue at risk of undertreatment.
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Affiliation(s)
- Karun V Sharma
- Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
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MR imaging of hydrogel filament embolic devices loaded with superparamagnetic iron oxide or gadolinium. Neuroradiology 2010; 53:449-56. [DOI: 10.1007/s00234-010-0744-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Accepted: 06/28/2010] [Indexed: 10/19/2022]
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Abstract
Last years, calibrated microspheres have proven their superiority in targeting embolization over non spherical particles in many applications. For the very near future they represent the best tool for controlling drug delivery in chemoembolization, under the two conditions that they would be image detectable and that the "dosimetry" would be tailored to pathological process.
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Affiliation(s)
- A Laurent
- Assistance Publique, Hôpitaux de Paris, Hôpital Lariboisière, Department of Interventional Neuroradiology, Paris, France.
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Distribution of iron oxide-containing Embosphere particles after transcatheter arterial embolization in an animal model of liver cancer: evaluation with MR imaging and implication for therapy. J Vasc Interv Radiol 2008; 19:1490-6. [PMID: 18755602 DOI: 10.1016/j.jvir.2008.06.008] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Revised: 06/05/2008] [Accepted: 06/09/2008] [Indexed: 01/08/2023] Open
Abstract
PURPOSE To test whether different-sized iron oxide-containing Embosphere (IOE) particles can be detected by dedicated magnetic resonance (MR) imaging when injected intraarterially in an animal model of liver cancer and whether their distribution could be accurately predicted by MR imaging before confirmation with histopathologic analysis. MATERIALS AND METHODS Twenty New Zealand White rabbits implanted with VX2 liver tumor were randomly assigned to undergo embolization with 100-300-microm particles (group S; n = 10) or 300-500-microm particles (group L; n = 10). Embolization was performed with the catheter placed in the proper hepatic artery. T2*-weighted multiplanar MR imaging was performed within 24 hours after the procedure to detect paramagnetic IOE susceptibility artifact. MR imaging interpretation parameters included presence of artifact in the artery and/or at the tumor bed. Hematoxylin and eosin- and Prussian blue-stained pathologic slides were also obtained and the presence of IOE was evaluated similarly. RESULTS The MR detectability rates for IOEs were 100% in both groups. Paramagnetic susceptibility IOE artifact inside the tumor was detected in 30% of group S animals. On pathologic analysis, IOE particles were detected inside the tumor in 70% of this group. IOEs in group L were found outside the tumor within the hepatic artery on MR imaging and histopathologic study (P < .05). CONCLUSIONS MR imaging readily detected IOE particles in an animal model of liver cancer regardless of the particle size. The smaller particles (100-300 microm) were delivered inside the tumor or in close proximity to the tumor margin, justifying their use for drug delivery or precise embolization.
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