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Zheng H, Zhang F, Monsky W, Ji H, Yang W, Yang X. Interventional Optical Imaging-Monitored Synergistic Effect of Radio-Frequency Hyperthermia and Oncolytic Immunotherapy. Front Oncol 2022; 11:821838. [PMID: 35141157 PMCID: PMC8818682 DOI: 10.3389/fonc.2021.821838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 12/28/2021] [Indexed: 11/22/2022] Open
Abstract
Purpose To develop a new interventional oncology technique using indocyanine green (ICG)-based interventional optical imaging (OI) to monitor the synergistic effect of radiofrequency hyperthermia (RFH)-enhanced oncolytic immunotherapy. Materials and Methods This study included (1) optimization of ICG dose and detection time-window for intracellular uptake by VX2 tumor cells; (2) in-vitro confirmation of capability of using ICG-based OI to assess efficacy of RFH-enhanced oncolytic therapy (LTX-401) for VX2 cells; and (3) in-vivo validation of the interventional OI-monitored, intratumoral RFH-enhanced oncolytic immunotherapy using rabbit models with orthotopic liver VX2 tumors. Both in-vitro and in-vivo experiments were divided into four study groups (n=6/group) with different treatments: (1) combination therapy of RFH+LTX-401; (2) RFH alone at 42°C for 30 min; (3) oncolytic therapy with LTX-401; and (4) control with saline. For in-vivo validation, orthotopic hepatic VX2 tumors were treated using a new multi-functional perfusion-thermal radiofrequency ablation electrode, which enabled simultaneous delivery of both LTX-401 and RFH within the tumor and at the tumor margins. Results In in-vitro experiments, taking up of ICG by VX2 cells was linearly increased from 0 μg/mL to 100 μg/mL, while ICG-signal intensity (SI) reached the peak at 24 hours. MTS assay and apoptosis analysis demonstrated the lowest cell viability and highest apoptosis in combination therapy, compared to three monotherapies (P<0.005). In in-vivo experiments, ultrasound imaging detected the smallest relative tumor volume for the combination therapy, compared to other monotherapies (P<0.005). In both in-vitro and in-vivo experiments, ICG-based interventional optical imaging detected a significantly decreased SI in combination therapy (P<0.005), which was confirmed by the “gold standard” optical/X-ray imaging (P<0.05). Pathologic/laboratory examinations further confirmed the significantly decreased cell proliferation with Ki-67 staining, significantly increased apoptotic index with TUNEL assay, and significantly increased quantities of CD8 and CD80 positive cells with immunostaining in the combination therapy group, compared to other three control groups (P<0.005). Conclusions We present a new interventional oncology technique, interventional optical imaging-monitored RFH-enhanced oncolytic immunotherapy, which may open new avenues to effectively manage those patients with larger, irregular and unresectable malignancies, not only in liver but also the possibility in other organs.
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Affiliation(s)
- Hui Zheng
- Image-Guided Biomolecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States
- Department of Interventional Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Feng Zhang
- Image-Guided Biomolecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States
| | - Wayne Monsky
- Image-Guided Biomolecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States
| | - Hongxiu Ji
- Image-Guided Biomolecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States
- Department of Pathology, Overlake Medical Center and Incyte Diagnostics, Bellevue, WA, United States
| | - Weizhu Yang
- Department of Interventional Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaoming Yang
- Image-Guided Biomolecular Intervention Research and Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States
- *Correspondence: Xiaoming Yang,
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Chen M, Zhang F, Song J, Weng Q, Li P, Li Q, Qian K, Ji H, Pietrini S, Ji J, Yang X. Image-Guided Peri-Tumoral Radiofrequency Hyperthermia-Enhanced Direct Chemo-Destruction of Hepatic Tumor Margins. Front Oncol 2021; 11:593996. [PMID: 34235070 PMCID: PMC8255807 DOI: 10.3389/fonc.2021.593996] [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: 12/02/2020] [Accepted: 05/28/2021] [Indexed: 01/02/2023] Open
Abstract
Purpose To validate the feasibility of using peri-tumoral radiofrequency hyperthermia (RFH)-enhanced chemotherapy to obliterate hepatic tumor margins. Method and Materials This study included in vitro experiments with VX2 tumor cells and in vivo validation experiments using rabbit models of liver VX2 tumors. Both in vitro and in vivo experiments received different treatments in four groups (n=6/group): (i) RFH-enhanced chemotherapy consisting of peri-tumoral injection of doxorubicin plus RFH at 42°C; (ii) RFH alone; (iii) doxorubicin alone; and (iv) saline. Therapeutic effect on cells was evaluated using different laboratory examinations. For in vivo experiments, orthotopic hepatic VX2 tumors in 24 rabbits were treated by using a multipolar radiofrequency ablation electrode, enabling simultaneous delivery of both doxorubicin and RFH within the tumor margins. Ultrasound imaging was used to follow tumor growth overtime, correlated with subsequent histopathological analysis. Results In in vitro experiments, MTS assay demonstrated the lowest cell proliferation, and apoptosis analysis showed the highest apoptotic index with RFH-enhanced chemotherapy, compared with the other three groups (p<0.01). In in vivo experiments, ultrasound imaging detected the smallest relative tumor volume with RFH-enhanced chemotherapy (p<0.01). The TUNEL assay further confirmed the significantly increased apoptotic index and decreased cell proliferation in the RFH-enhanced therapy group (p<0.01). Conclusion This study demonstrates that peri-tumoral RFH can specifically enhance the destruction of tumor margins in combination with peri-tumoral injection of a chemotherapeutic agent. This new interventional oncology technique may address the critical clinical problem of frequent marginal tumor recurrence/persistence following thermal ablation of large (>3 cm) hepatic cancers.
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Affiliation(s)
- Minjiang Chen
- Image-Guided Bio-Molecular Interventions Research & Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States.,Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang Province, Department of Radiology, Zhejiang University Lishui Hospital, Lishui, China
| | - Feng Zhang
- Image-Guided Bio-Molecular Interventions Research & Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States
| | - Jingjing Song
- Image-Guided Bio-Molecular Interventions Research & Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States.,Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang Province, Department of Radiology, Zhejiang University Lishui Hospital, Lishui, China
| | - Qiaoyou Weng
- Image-Guided Bio-Molecular Interventions Research & Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States.,Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang Province, Department of Radiology, Zhejiang University Lishui Hospital, Lishui, China
| | - Peicheng Li
- Image-Guided Bio-Molecular Interventions Research & Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States
| | - Qiang Li
- Image-Guided Bio-Molecular Interventions Research & Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States
| | - Kun Qian
- Image-Guided Bio-Molecular Interventions Research & Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States
| | - Hongxiu Ji
- Image-Guided Bio-Molecular Interventions Research & Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States.,Department of Pathology, Overlake Medical Center and Incyte Diagnostics, Bellevue, WA, United States
| | - Sean Pietrini
- Image-Guided Bio-Molecular Interventions Research & Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States
| | - Jiansong Ji
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang Province, Department of Radiology, Zhejiang University Lishui Hospital, Lishui, China
| | - Xiaoming Yang
- Image-Guided Bio-Molecular Interventions Research & Division of Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States
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Melancon MP, Appleton Figueira T, Fuentes DT, Tian L, Qiao Y, Gu J, Gagea M, Ensor JE, Muñoz NM, Maldonado KL, Dixon K, McWatters A, Mitchell J, McArthur M, Gupta S, Tam AL. Development of an Electroporation and Nanoparticle-based Therapeutic Platform for Bone Metastases. Radiology 2018; 286:149-157. [PMID: 28825892 DOI: 10.1148/radiol.2017161721] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose To assess for nanopore formation in bone marrow cells after irreversible electroporation (IRE) and to evaluate the antitumoral effect of IRE, used alone or in combination with doxorubicin (DOX)-loaded superparamagnetic iron oxide (SPIO) nanoparticles (SPIO-DOX), in a VX2 rabbit tibial tumor model. Materials and Methods All experiments were approved by the institutional animal care and use committee. Five porcine vertebral bodies in one pig underwent intervention (IRE electrode placement without ablation [n = 1], nanoparticle injection only [n = 1], and nanoparticle injection followed by IRE [n = 3]). The animal was euthanized and the vertebrae were harvested and evaluated with scanning electron microscopy. Twelve rabbit VX2 tibial tumors were treated, three with IRE, three with SPIO-DOX, and six with SPIO-DOX plus IRE; five rabbit VX2 tibial tumors were untreated (control group). Dynamic T2*-weighted 4.7-T magnetic resonance (MR) images were obtained 9 days after inoculation and 2 hours and 5 days after treatment. Antitumor effect was expressed as the tumor growth ratio at T2*-weighted MR imaging and percentage necrosis at histologic examination. Mixed-effects linear models were used to analyze the data. Results Scanning electron microscopy demonstrated nanopores in bone marrow cells only after IRE (P , .01). Average volume of total tumor before treatment (503.1 mm3 ± 204.6) was not significantly different from those after treatment (P = .7). SPIO-DOX was identified as a reduction in signal intensity within the tumor on T2*-weighted images for up to 5 days after treatment and was related to the presence of iron. Average tumor growth ratios were 103.0% ± 75.8 with control treatment, 154.3% ± 79.7 with SPIO-DOX, 77% ± 30.8 with IRE, and -38.5% ± 24.8 with a combination of SPIO-DOX and IRE (P = .02). The percentage residual viable tumor in bone was significantly less for combination therapy compared with control (P = .02), SPIO-DOX (P , .001), and IRE (P = .03) treatment. The percentage residual viable tumor in soft tissue was significantly less with IRE (P = .005) and SPIO-DOX plus IRE (P = .005) than with SPIO-DOX. Conclusion IRE can induce nanopore formation in bone marrow cells. Tibial VX2 tumors treated with a combination of SPIO-DOX and IRE demonstrate enhanced antitumor effect as compared with individual treatments alone. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Marites P Melancon
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Tomas Appleton Figueira
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - David T Fuentes
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Li Tian
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Yang Qiao
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Jianhua Gu
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Mihai Gagea
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Joe E Ensor
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Nina M Muñoz
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Kiersten L Maldonado
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Katherine Dixon
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Amanda McWatters
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Jennifer Mitchell
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Mark McArthur
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Sanjay Gupta
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Alda L Tam
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
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