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Liu S, Sun T, Chou W, Zhao H, Zhao Y. A design strategy of pure Type-I thiadiazolo[3,4-g]quinoxaline-based photosensitizers for photodynamic therapy. Eur J Med Chem 2024; 265:116059. [PMID: 38134744 DOI: 10.1016/j.ejmech.2023.116059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Abstract
Most photosensitizers (PSs) for photodynamic therapy (PDT) can generate singlet oxygen through transferring energy with oxygen, called Type-II PSs. However, the microenvironment of solid tumor is usually anoxic. Type-I PSs can generate reactive oxygen species (ROS) through transferring electron to substrate, showing more efficient in PDT. But pure Type-I PSs are very rare. The relationship between PSs' chemical structure and Type-I mechanism has not been explicitly stated. In this study, two thiadiazolo [3,4-g]quinoxaline (TQ) PSs (PsCBz-1 and PsCBz-2) are synthesized through introducing carbazole groups to the 4,9-position of TQ backbone. Comparing with their prototype PS, 4,9-dibrominated TQ (TQs-4), the introduction of carbazole groups reverses the reaction mechanism of PSs from pure Type-II to pure Type-I. Excitingly, the water-dispersible nanoparticles (NPs) of PsCBz-1 can achieve strong phototoxicity in vitro under both normoxia and hypoxia through Type-I mechanism. In addition, PsCBz-1 NPs also exhibits remarkable PDT antitumor effect in vivo. This study provides a feasible design strategy for pure Type-I PSs.
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Affiliation(s)
- Shiyang Liu
- Key Laboratory of Photochemical Conversion and Optoelectronic Materials, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, No. 29 Zhongguancun East Road, Haidian District, Beijing, 100190, China; University of Chinese Academy of Sciences, No. 19A Yuquan Road, Beijing, 100049, China
| | - Tianzhen Sun
- School of Medical Technology, Beijing Institute of Technology, No. 5 South Street, Zhongguancun, Haidian District, Beijing, 100081, China
| | - Wenxin Chou
- School of Medical Technology, Beijing Institute of Technology, No. 5 South Street, Zhongguancun, Haidian District, Beijing, 100081, China
| | - Hongyou Zhao
- School of Medical Technology, Beijing Institute of Technology, No. 5 South Street, Zhongguancun, Haidian District, Beijing, 100081, China.
| | - Yuxia Zhao
- Key Laboratory of Photochemical Conversion and Optoelectronic Materials, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, No. 29 Zhongguancun East Road, Haidian District, Beijing, 100190, China; University of Chinese Academy of Sciences, No. 19A Yuquan Road, Beijing, 100049, China.
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2
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Wang Y, Li J, Zhang Y, Nan Y, Zhou X. Rational design of a meso phosphate-substituted pyronin as a type I photosensitizer for photodynamic therapy. Chem Commun (Camb) 2022; 58:7797-7800. [PMID: 35735141 DOI: 10.1039/d2cc02124b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Type I photodynamic therapy (PDT) with less oxygen consumption shows great potential to overcome the malignant hypoxia in solid tumors. Herein, a novel meso phosphate-substituted pyronin PY-P and its nanoparticles (PY-P NPs) were prepared as an efficient type I organic photosensitizer. The in vivo data prove that PY-P NPs have outstanding low dark toxicity but high photocytotoxicity under hypoxia (<1% O2).
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Affiliation(s)
- Yong Wang
- Department of Chemistry, College of Chemistry and Chemical Engineering, Qingdao University, Shandong, China.
| | - Jigai Li
- Department of Chemistry, College of Chemistry and Chemical Engineering, Qingdao University, Shandong, China.
| | - Yukun Zhang
- Cancer Institute, the Affiliated Hospital of Qingdao University, Shandong, China
| | - Yi Nan
- Department of Chemistry, Shandong University, Shandong, China
| | - Xin Zhou
- Department of Chemistry, College of Chemistry and Chemical Engineering, Qingdao University, Shandong, China. .,Cancer Institute, the Affiliated Hospital of Qingdao University, Shandong, China
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3
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Chen M, Shu G, Lv X, Xu X, Lu C, Qiao E, Fang S, Shen L, Zhang N, Wang J, Chen C, Song J, Liu Z, Du Y, Ji J. HIF-2α-targeted interventional chemoembolization multifunctional microspheres for effective elimination of hepatocellular carcinoma. Biomaterials 2022; 284:121512. [PMID: 35405577 DOI: 10.1016/j.biomaterials.2022.121512] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 03/06/2022] [Accepted: 04/01/2022] [Indexed: 01/22/2023]
Abstract
Transcatheter arterial chemoembolization (TACE) is widely used for the treatment of advanced hepatocellular carcinoma (HCC). However, the long-term hypoxic microenvironment caused by TACE seriously affects the therapeutic effect of TACE. HIF-2α plays a crucial role on the chronic hypoxia process, which might be an ideal target for TACE therapy. Herein, a multifunctional polyvinyl alcohol (PVA)/hyaluronic acid (HA)-based microsphere (PT/DOX-MS) co-loaded with doxorubicin (DOX) and PT-2385, an effective HIF-2α inhibitor, was developed for enhanced TACE treatment efficacy. In vitro and in vivo studies revealed that PT/DOX-MS had a superior ability to treat HCC by blocking the tumor cells in G2/M phase, prompting cell apoptosis, and inhibiting tumor angiogenesis. The antitumor mechanisms of PT/DOX-MS were possibly due to that the introduction of PT-2385 could effectively inhibit the expression level of HIF-2α in hypoxic HCC cells, thereby down-regulating the expression levels of Cyclin D1, VEGF and TGF-α. In addition, the combination of DOX and PT-2385 could jointly inhibit VEGF expression, which was another reason accounting for the combined anti-cancer effect of PT/DOX-MS. Overall, our study demonstrated that PT/DOX-MS is a promising embolic agent for enhanced HCC treatment via the combined effect of hypoxia microenvironment improvement, chemotherapy, and embolization.
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Affiliation(s)
- Minjiang Chen
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China; Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, China
| | - Gaofeng Shu
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, China
| | - Xiuling Lv
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, China
| | - Xiaoling Xu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Chenying Lu
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, China
| | - Enqi Qiao
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, China
| | - Shiji Fang
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, China
| | - Lin Shen
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, China
| | - Nannan Zhang
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, China
| | - Jun Wang
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Chunmiao Chen
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, China
| | - Jingjing Song
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, China
| | - Zhuang Liu
- Institute of Functional Nano & Soft Materials (FUNSOM), Key Lab Carbon Based Functional Materials and Devices, Soochow University, Suzhou, 215123, China.
| | - Yongzhong Du
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China.
| | - Jiansong Ji
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, China.
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Shah RP, Laeseke PF, Shin LK, Chin FT, Kothary N, Segall GM. Limitations of Fluorine 18 Fluoromisonidazole in Assessing Treatment-induced Tissue Hypoxia after Transcatheter Arterial Embolization of Hepatocellular Carcinoma: A Prospective Pilot Study. Radiol Imaging Cancer 2022; 4:e210094. [PMID: 35485937 PMCID: PMC9152693 DOI: 10.1148/rycan.210094] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose To determine the variance and correlation with tumor viability of fluorine 18 (18F) fluoromisonidazole (FMISO) uptake in hepatocellular carcinoma (HCC) prior to and after embolization treatment. Materials and Methods In this single-arm, single-center, prospective pilot study between September 2016 and March 2017, participants with at least one tumor measuring 1.5 cm or larger with imaging or histologic findings diagnostic for HCC were enrolled (five men; mean age, 68 years; age range, 61-76 years). Participants underwent 18F-FMISO PET/CT before and after bland embolization of HCC. A tumor-to-liver ratio (TLR) was calculated by using standardized uptake values of tumor and liver. The difference in mean TLR before and after treatment was compared by using a Wilcoxon rank sum test, and correlation between TLR and tumor viability was assessed by using the Spearman rank correlation coefficient. Results Four participants with five tumors were included in the final analysis. The median tumor diameter was 3.2 cm (IQR, 3.0-3.9 cm). The median TLR before treatment was 0.97 (IQR, 0.88-0.98), with a variance of 0.02, and the median TLR after treatment was 0.85 (IQR, 0.79-1), with a variance of 0.01; both findings indicate a narrow range of 18F-FMISO uptake in HCC. The Spearman rank correlation coefficient was 0.87, indicating a high correlation between change in TLR and nonviable tumor. Conclusion Although there was a correlation between change in TLR and response to treatment, the low signal-to-noise ratio of 18F-FMISO in the liver limited its use in HCC. Keywords: Molecular Imaging-Clinical Translation, Embolization, Abdomen/Gastrointestinal, Liver Clinical trial registration no. NCT02695628 © RSNA, 2022.
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Affiliation(s)
- Rajesh P Shah
- From the Department of Radiology, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, MC 114, Palo Alto, CA 94304 (R.P.S., G.M.S.); Department of Radiology, Stanford University, Stanford, Calif (R.P.S., N.K., G.M.S.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (P.F.L.); Department of Radiology, Banner MD Anderson Cancer Center, Gilbert, Ariz (L.K.S.); and Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, Calif (F.T.C.)
| | - Paul F Laeseke
- From the Department of Radiology, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, MC 114, Palo Alto, CA 94304 (R.P.S., G.M.S.); Department of Radiology, Stanford University, Stanford, Calif (R.P.S., N.K., G.M.S.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (P.F.L.); Department of Radiology, Banner MD Anderson Cancer Center, Gilbert, Ariz (L.K.S.); and Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, Calif (F.T.C.)
| | - Lewis K Shin
- From the Department of Radiology, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, MC 114, Palo Alto, CA 94304 (R.P.S., G.M.S.); Department of Radiology, Stanford University, Stanford, Calif (R.P.S., N.K., G.M.S.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (P.F.L.); Department of Radiology, Banner MD Anderson Cancer Center, Gilbert, Ariz (L.K.S.); and Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, Calif (F.T.C.)
| | - Frederick T Chin
- From the Department of Radiology, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, MC 114, Palo Alto, CA 94304 (R.P.S., G.M.S.); Department of Radiology, Stanford University, Stanford, Calif (R.P.S., N.K., G.M.S.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (P.F.L.); Department of Radiology, Banner MD Anderson Cancer Center, Gilbert, Ariz (L.K.S.); and Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, Calif (F.T.C.)
| | - Nishita Kothary
- From the Department of Radiology, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, MC 114, Palo Alto, CA 94304 (R.P.S., G.M.S.); Department of Radiology, Stanford University, Stanford, Calif (R.P.S., N.K., G.M.S.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (P.F.L.); Department of Radiology, Banner MD Anderson Cancer Center, Gilbert, Ariz (L.K.S.); and Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, Calif (F.T.C.)
| | - George M Segall
- From the Department of Radiology, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, MC 114, Palo Alto, CA 94304 (R.P.S., G.M.S.); Department of Radiology, Stanford University, Stanford, Calif (R.P.S., N.K., G.M.S.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (P.F.L.); Department of Radiology, Banner MD Anderson Cancer Center, Gilbert, Ariz (L.K.S.); and Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, Calif (F.T.C.)
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5
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Tischfield DJ, Gurevich A, Johnson O, Gatmaytan I, Nadolski GJ, Soulen MC, Kaplan DE, Furth E, Hunt SJ, Gade TPF. Transarterial Embolization Modulates the Immune Response within Target and Nontarget Hepatocellular Carcinomas in a Rat Model. Radiology 2022; 303:215-225. [PMID: 35014906 PMCID: PMC8962821 DOI: 10.1148/radiol.211028] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 10/12/2021] [Accepted: 10/28/2021] [Indexed: 12/24/2022]
Abstract
Background Transarterial embolization (TAE) is the most common treatment for hepatocellular carcinoma (HCC); however, there remain limited data describing the influence of TAE on the tumor immune microenvironment. Purpose To characterize TAE-induced modulation of the tumor immune microenvironment in a rat model of HCC and identify factors that modulate this response. Materials and Methods TAE was performed on autochthonous HCCs induced in rats with use of diethylnitrosamine. CD3, CD4, CD8, and FOXP3 lymphocytes, as well as programmed cell death protein ligand-1 (PD-L1) expression, were examined in three cohorts: tumors from rats that did not undergo embolization (control), embolized tumors (target), and nonembolized tumors from rats that had a different target tumor embolized (nontarget). Differences in immune cell recruitment associated with embolic agent type (tris-acryl gelatin microspheres [TAGM] vs hydrogel embolics) and vascular location were examined in rat and human tissues. A generalized estimating equation model and t, Mann-Whitney U, and χ2 tests were used to compare groups. Results Cirrhosis-induced alterations in CD8, CD4, and CD25/CD4 lymphocytes were partially normalized following TAE (CD8: 38.4%, CD4: 57.6%, and CD25/CD4: 21.1% in embolized liver vs 47.7% [P = .02], 47.0% [P = .01], and 34.9% [P = .03], respectively, in cirrhotic liver [36.1%, 59.6%, and 4.6% in normal liver]). Embolized tumors had a greater number of CD3, CD4, and CD8 tumor-infiltrating lymphocytes relative to controls (191.4 cells/mm2 vs 106.7 cells/mm2 [P = .03]; 127.8 cells/mm2 vs 53.8 cells/mm2 [P < .001]; and 131.4 cells/mm2 vs 78.3 cells/mm2 [P = .01]) as well as a higher PD-L1 expression score (4.1 au vs 1.9 au [P < .001]). A greater number of CD3, CD4, and CD8 lymphocytes were found near TAGM versus hydrogel embolics (4.1 vs 2.0 [P = .003]; 3.7 vs 2.0 [P = .01]; and 2.2 vs 1.1 [P = .03], respectively). The number of lymphocytes adjacent to embolics differed based on vascular location (17.9 extravascular CD68+ peri-TAGM cells vs 7.0 intravascular [P < .001]; 6.4 extravascular CD68+ peri-hydrogel embolic cells vs 3.4 intravascular [P < .001]). Conclusion Transarterial embolization-induced dynamic alterations of the tumor immune microenvironment are influenced by underlying liver disease, embolic agent type, and vascular location. © RSNA, 2022 Online supplemental material is available for this article. See also the editorials by Kennedy et al and by White in this issue.
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Affiliation(s)
| | | | - Omar Johnson
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - Isabela Gatmaytan
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - Gregory J. Nadolski
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - Michael C. Soulen
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - David E. Kaplan
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - Emma Furth
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - Stephen J. Hunt
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - Terence P. F. Gade
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
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Cortes AC, Nishiofuku H, Polak U, Minhaj AA, Lopez MS, Kichikawa K, Qayyum A, Whitley EM, Avritscher R. Effect of bead size and doxorubicin loading on tumor cellular injury after transarterial embolization and chemoembolization in a rat model of hepatocellular carcinoma. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2022; 39:102465. [PMID: 34571240 PMCID: PMC9206412 DOI: 10.1016/j.nano.2021.102465] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/08/2021] [Accepted: 09/01/2021] [Indexed: 01/03/2023]
Abstract
Embolic agents used in transarterial embolization for intermediate stage hepatocellular carcinoma reduce blood flow into tumors and can deliver anticancer drugs. Tumor blood supply can be interrupted using doxorubicin-eluting beads (DEB-TACE) or non-loaded beads (TAE) of different calibers. In this preclinical study, we characterized the extent of remaining stressed tumor cells after treatment, hypoxia within the surviving tumor regions, and inflammatory immune cell infiltrates after embolization with 40-60 or 70-150 μm with non-loaded or doxorubicin-loaded beads at 3 and 7 days after treatment. TAE-treated tumors had more stressed and surviving tumor cells after 3 days, irrespective of bead size, compared with DEB-TACE-treated tumors. Hypoxic stress of residual cells increased after treatment with 70-150 μm beads without or with doxorubicin. Treatment with DEB-TACE of 70-150 μm resulted in increased inflammation and proliferation in the adjacent parenchyma. Inflammatory cell infiltrates were reduced at the periphery of tumors treated with 40-60 μm DEB-TACE.
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Affiliation(s)
- Andrea C Cortes
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Hideyuki Nishiofuku
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX,Department of Radiology, IVR Center, Nara Medical University, Kashihara, Japan
| | - Urszula Polak
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Adeeb A Minhaj
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Mirtha S Lopez
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kimihiko Kichikawa
- Department of Radiology, IVR Center, Nara Medical University, Kashihara, Japan
| | - Aliya Qayyum
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Elizabeth M. Whitley
- Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rony Avritscher
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX,Corresponding author at: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX. (R. Avritscher)
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7
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Hypoxia-Induced Cancer Cell Responses Driving Radioresistance of Hypoxic Tumors: Approaches to Targeting and Radiosensitizing. Cancers (Basel) 2021; 13:cancers13051102. [PMID: 33806538 PMCID: PMC7961562 DOI: 10.3390/cancers13051102] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/21/2021] [Accepted: 02/25/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Some regions of aggressive malignancies experience hypoxia due to inadequate blood supply. Cancer cells adapting to hypoxic conditions somehow become more resistant to radiation exposure and this decreases the efficacy of radiotherapy toward hypoxic tumors. The present review article helps clarify two intriguing points: why hypoxia-adapted cancer cells turn out radioresistant and how they can be rendered more radiosensitive. The critical molecular targets associated with intratumoral hypoxia and various approaches are here discussed which may be used for sensitizing hypoxic tumors to radiotherapy. Abstract Within aggressive malignancies, there usually are the “hypoxic zones”—poorly vascularized regions where tumor cells undergo oxygen deficiency through inadequate blood supply. Besides, hypoxia may arise in tumors as a result of antiangiogenic therapy or transarterial embolization. Adapting to hypoxia, tumor cells acquire a hypoxia-resistant phenotype with the characteristic alterations in signaling, gene expression and metabolism. Both the lack of oxygen by itself and the hypoxia-responsive phenotypic modulations render tumor cells more radioresistant, so that hypoxic tumors are a serious challenge for radiotherapy. An understanding of causes of the radioresistance of hypoxic tumors would help to develop novel ways for overcoming this challenge. Molecular targets for and various approaches to radiosensitizing hypoxic tumors are considered in the present review. It is here analyzed how the hypoxia-induced cellular responses involving hypoxia-inducible factor-1, heat shock transcription factor 1, heat shock proteins, glucose-regulated proteins, epigenetic regulators, autophagy, energy metabolism reprogramming, epithelial–mesenchymal transition and exosome generation contribute to the radioresistance of hypoxic tumors or may be inhibited for attenuating this radioresistance. The pretreatments with a multitarget inhibition of the cancer cell adaptation to hypoxia seem to be a promising approach to sensitizing hypoxic carcinomas, gliomas, lymphomas, sarcomas to radiotherapy and, also, liver tumors to radioembolization.
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Mikhail AS, Negussie AH, Mauda-Havakuk M, Owen JW, Pritchard WF, Lewis AL, Wood BJ. Drug-eluting embolic microspheres: State-of-the-art and emerging clinical applications. Expert Opin Drug Deliv 2021; 18:383-398. [PMID: 33480306 PMCID: PMC11247414 DOI: 10.1080/17425247.2021.1835858] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Drug-eluting embolic (DEE) microspheres, or drug-eluting beads (DEB), delivered by transarterial chemoembolization (TACE) serve as a therapeutic embolic to stop blood flow to tumors and a drug delivery vehicle. New combinations of drugs and DEE microspheres may exploit the potential synergy between mechanisms of drug activity and local tissue responses generated by TACE to enhance the efficacy of this mainstay therapy. AREAS COVERED This review provides an overview of key drug delivery concepts related to DEE microspheres with a focus on recent technological developments and promising emerging clinical applications as well as speculation into the future. EXPERT OPINION TACE has been performed for nearly four decades by injecting chemotherapy drugs into the arterial supply of tumors while simultaneously cutting off their blood supply, trying to starve and kill cancer cells, with varying degrees of success. The practice has evolved over the decades but has yet to fulfill the promise of truly personalized therapies envisioned through rational selection of drugs and real-time multi-parametric image guidance to target tumor clonality or heterogeneity. Recent technologic and pharmacologic developments have opened the door for potentially groundbreaking advances in how TACE with DEE microspheres is performed with the goal of achieving advancements that benefit patients.
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Affiliation(s)
- Andrew S Mikhail
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Ayele H Negussie
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Michal Mauda-Havakuk
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Joshua W Owen
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - William F Pritchard
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Andrew L Lewis
- Interventional Medicine Innovation Group, Biocompatibles UK, Ltd. (Now Boston Scientific Corp.), Camberley, UK
| | - Bradford J Wood
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
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9
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Sheth RA, Wen X, Li J, Melancon MP, Ji X, Wang YA, Hsiao CH, Chow DSL, Whitley EM, Li C, Gupta S. Doxorubicin-loaded hollow gold nanospheres for dual photothermal ablation and chemoembolization therapy. Cancer Nanotechnol 2020; 11. [PMID: 34335988 DOI: 10.1186/s12645-020-00062-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Doxorubicin-loaded hollow gold nanospheres (Dox@HAuNS) are a promising technology for simultaneous trans-arterial tumor-targeted chemotherapy delivery and thermal ablation. We evaluated the efficacy of intra-arterial delivery of Dox@HAuNS followed by photothermal ablation (PTA) in a rabbit model of liver cancer. Adult New Zealand white rabbits (N=25) were inoculated with VX2 tumors into the left lobe of the liver. The animals were then randomized to sham surgery (N=5), PTA only (N=3), Dox@HAuNS only (N=5), HAuNS + PTA (N=5), and Dox@HAuNS + PTA (N=7). Nanoparticles were delivered as an emulsion with Lipiodol (Guerbet, France) via a trans-arterial approach. Following nanoparticle delivery, PTA was performed using an 808nm fibered laser at 1.5W for 3 minutes. Thermography during PTA demonstrated a sustained elevation in tumoral temperature in both HAuNS + laser and Dox@HAuNS + laser treatment groups relative to animals that underwent laser treatment without prior nanoparticle delivery. Results There was a significant decrease in tumor volumes in all three treatment arms relative to control arms (P = 0.004). Concentrations of intratumoral doxorubicin were significantly greater in animals treated with laser compared to those that were not treated with laser (P< 0.01). Conclusions Doxorubicin-loaded HAuNS is a promising therapeutic agent for dual ablation/chemoembolization treatment of liver cancer.
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Affiliation(s)
- Rahul A Sheth
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xiaoxia Wen
- Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Junjie Li
- Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Marites P Melancon
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xin Ji
- Ocean Nanotech, San Diego, CA 92126, USA
| | | | - Cheng-Hui Hsiao
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, Houston, Texas 77030, USA
| | - Diana S-L Chow
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, Houston, Texas 77030, USA
| | - Elizabeth M Whitley
- Department of Veterinary Medicine & Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Chun Li
- Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sanjay Gupta
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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10
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Lewis AL, Hall B. Toward a better understanding of the mechanism of action for intra-arterial delivery of irinotecan from DC Bead (TM) (DEBIRI). Future Oncol 2019; 15:2053-2068. [PMID: 30942614 DOI: 10.2217/fon-2019-0071] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
DC Bead is designed for the embolization of liver malignancies combined with local sustained chemotherapy delivery. It was first demonstrated around a decade ago that irinotecan could be loaded into DC Bead and used in a transarterially directed procedure to treat colorectal liver metastases, commonly referred to as drug-eluting bead with irinotecan (DEBIRI). Despite numerous reports of its safe and effective use in treating colorectal liver metastases patients, there remains a perceived fundamental paradox as to how this treatment works. This review of the mechanism of action of DEBIRI provides a rationale for why intra-arterial delivery of this prodrug from an embolic bead provides for enhanced tumor selectivity, sparing the normal liver while reducing adverse side effects associated with the irinotecan therapy.
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Affiliation(s)
- Andrew L Lewis
- Biocompatibles UK Ltd, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Brenda Hall
- Biocompatibles UK Ltd, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
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11
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Zener R, Yoon H, Ziv E, Covey A, Brown KT, Sofocleous CT, Thornton RH, Boas FE. Outcomes After Transarterial Embolization of Neuroendocrine Tumor Liver Metastases Using Spherical Particles of Different Sizes. Cardiovasc Intervent Radiol 2019; 42:569-576. [PMID: 30627774 DOI: 10.1007/s00270-018-02160-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/31/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE To evaluate initial response and overall survival of neuroendocrine tumor (NET) liver metastases initially treated with transarterial embolization (TAE) using spherical particles of different sizes. METHODS A single-institution retrospective review was performed of 160 patients with NET liver metastases initially treated with TAE using < 100 µm (n = 77) or only ≥ 100 µm (n = 83) spherical particles. For each patient, we evaluated: initial response by mRECIST, time to progression, overall survival, complications, primary site, tumor grade and degree of differentiation, volume of liver disease, extrahepatic disease, NET-related symptoms, comorbidities, Child-Pugh score, performance status, lobar versus selective embolization, and arteriovenous shunting. RESULTS Initial response was higher for TAE using particles < 100 versus TAE using only particles ≥ 100 μm (64 vs 42%, p = 0.007). Multivariate logistic regression showed that use of particles < 100 μm and liver < 50% replaced with tumor were independent predictors of a better initial response rate. There was no difference in major or minor complications between the two particle size groups. Median overall survival after TAE was 55 months for well- to moderately differentiated NET and 13 months for poorly differentiated or undifferentiated NET. There was no significant difference in survival between TAE patients treated with < 100 versus only ≥ 100-μm particles. CONCLUSION NET patients treated with TAE using particles < 100 μm had better initial response, but the same overall survival, compared to TAE using only particles ≥ 100 μm.
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Affiliation(s)
- Rebecca Zener
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Hyukjun Yoon
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Etay Ziv
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Anne Covey
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Karen T Brown
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Constantinos T Sofocleous
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Raymond H Thornton
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - F Edward Boas
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA.
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12
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Mikhail AS, Pritchard WF, Negussie AH, Krishnasamy VP, Amchin DB, Thompson JG, Wakim PG, Woods D, Bakhutashvili I, Esparza-Trujillo JA, Karanian JW, Willis SL, Lewis AL, Levy EB, Wood BJ. Mapping Drug Dose Distribution on CT Images Following Transarterial Chemoembolization with Radiopaque Drug-Eluting Beads in a Rabbit Tumor Model. Radiology 2018; 289:396-404. [PMID: 30106347 PMCID: PMC6219695 DOI: 10.1148/radiol.2018172571] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 05/30/2018] [Accepted: 06/14/2018] [Indexed: 12/15/2022]
Abstract
Purpose To correlate bead location and attenuation on CT images with the quantity and distribution of drug delivered to the liver following transarterial chemoembolization (TACE) with radiopaque drug-eluting beads (DEB) in a rabbit tumor model. Materials and Methods All procedures were performed with a protocol approved by the Institutional Animal Care and Use Committee. TACE was performed in rabbits (n = 4) bearing VX2 liver tumors by using radiopaque DEB (70-150 µm) loaded with doxorubicin (DOX). Livers were resected 1 hour after embolization, immediately frozen, and cut by using liver-specific three-dimensional-printed molds for colocalization of liver specimens and CT imaging. DOX penetration into tissue surrounding beads was evaluated with fluorescence microscopy. DOX levels in liver specimens were predicted by using statistical models correlating DOX content measured in tissue with bead volume and attenuation measured on CT images. Model predictions were then compared with actual measured DOX concentrations to assess the models' predictive power. Results Eluted DOX remained in close proximity (<600 µm) to beads in the liver 1 hour after TACE. Bead volume and attenuation measured on CT images demonstrated positive linear correlations (0.950 and 0.965, respectively) with DOX content in liver specimens. DOX content model predictions based on CT images were accurate compared with actual liver DOX levels at 1 hour. Conclusion CT may be used to estimate drug dose delivery and distribution in the liver following transarterial chemoembolization (TACE) with doxorubicin-loaded radiopaque drug-eluting beads (DEB). Although speculative, this informational map might be helpful in planning and understanding the spatial effects of TACE with DEB. © RSNA, 2018.
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Affiliation(s)
- Andrew S. Mikhail
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - William F. Pritchard
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Ayele H. Negussie
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Venkatesh P. Krishnasamy
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Daniel B. Amchin
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - John G. Thompson
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Paul G. Wakim
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - David Woods
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Ivane Bakhutashvili
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Juan A. Esparza-Trujillo
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - John W. Karanian
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Sean L. Willis
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Andrew L. Lewis
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Elliot B. Levy
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Bradford J. Wood
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
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Mahalingam SM, Chu H, Liu X, Leamon CP, Low PS. Carbonic Anhydrase IX-Targeted Near-Infrared Dye for Fluorescence Imaging of Hypoxic Tumors. Bioconjug Chem 2018; 29:3320-3331. [PMID: 30185025 DOI: 10.1021/acs.bioconjchem.8b00509] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Use of tumor-targeted fluorescence dyes to help surgeons identify otherwise undetected tumor nodules, decrease the incidence of cancer-positive margins, and facilitate localization of malignant lymph nodes has demonstrated considerable promise for improving cancer debulking surgery. Unfortunately, the repertoire of available tumor-targeted fluorescent dyes does not permit identification of all cancer types, raising the need to develop additional tumor-specific fluorescent dyes to ensure localization of all malignant lesions during cancer surgeries. By comparing the mRNA levels of the hypoxia-induced plasma membrane protein carbonic anhydrase IX (CA IX) in 13 major human cancers with the same mRNA levels in corresponding normal tissues, we document that CA IX constitutes a nearly universal marker for the design of tumor-targeted fluorescent dyes. Motivated by this expression profile, we synthesize two new CA IX-targeted near-infrared (NIR) fluorescent imaging agents and characterize their physical and biological properties both in vitro and in vivo. We report that conjugation of either acetazolamide or 6-aminosaccharin (i.e., two CA-IX-specific ligands) to the NIR fluorescent dye, S0456, via an extended phenolic spacer creates a brightly fluorescent dye that binds CA IX with high affinity and allows rapid visualization of hypoxic regions of solid tumors at depths >1 cm beneath a tissue surface. Taken together, these data suggest that a CA IX-targeted NIR dye can constitute a useful addition to a cocktail of tumor-targeted NIR dyes designed to image all human cancers.
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Affiliation(s)
| | - Haiyan Chu
- Endocyte Inc. , 3000 Kent Avenue , West Lafayette , Indiana 47906 , United States
| | | | - Christopher P Leamon
- Endocyte Inc. , 3000 Kent Avenue , West Lafayette , Indiana 47906 , United States
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14
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Fu Y, Weiss CR, Paudel K, Shin EJ, Kedziorek D, Arepally A, Anders RA, Kraitchman DL. Bariatric Arterial Embolization: Effect of Microsphere Size on the Suppression of Fundal Ghrelin Expression and Weight Change in a Swine Model. Radiology 2018; 289:83-89. [PMID: 29989526 DOI: 10.1148/radiol.2018172874] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose To determine whether microsphere size effects ghrelin expression and weight gain after selective bariatric arterial embolization (BAE) in swine. Materials and Methods BAE was performed in 10 swine by using smaller (100-300 μm; n = 5) or larger (300-500 μm; n = 5) calibrated microspheres into gastric arteries. Nine control pigs underwent a sham procedure. Weight and fasting plasma ghrelin levels were measured at baseline and weekly for 16 weeks. Ghrelin-expressing cells (GECs) in the stomach were assessed by using immunohistochemical staining and analyzed by using the Wilcoxon rank-sum test. Results In pigs treated with smaller microspheres, mean weight gain at 16 weeks (106.9% ± 15.0) was less than in control pigs (131.9% ± 11.6) (P < .001). Mean GEC density was lower in the gastric fundus (14.8 ± 6.3 vs 25.0 ± 6.9, P < .001) and body (27.5 ± 12.3 vs 37.9 ± 11.8, P = .004) but was not significantly different in the gastric antrum (28.2 ± 16.3 vs 24.3 ± 11.6, P = .84) and duodenum (9.2 ± 3.8 vs 8.7 ± 2.9, P = .66) versus in control pigs. BAE with larger microspheres failed to suppress weight gain or GECs in any stomach part compared with results in control swine. Plasma ghrelin levels were similar between BAE pigs and control pigs, regardless of microsphere size. Week 1 endoscopic evaluation for gastric ulcers revealed none in control pigs, five ulcers in five pigs embolized by using smaller microspheres, and three ulcers in five pigs embolized by using larger microspheres. Conclusion In bariatric arterial embolization, smaller microspheres rather than larger microspheres showed greater weight gain suppression and fundal ghrelin expression with more gastric ulceration in a swine model. © RSNA, 2018.
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Affiliation(s)
- Yingli Fu
- From the Russell H. Morgan Department of Radiology and Radiological Science (Y.F., C.R.W., K.P., D.K., D.L.K.), Department of Gastroenterology (E.J.S.), and Department of Pathology (R.A.A.), the Johns Hopkins University School of Medicine, 1800 Orleans St, Zayed Tower 7203, Baltimore, MD 21287; and Department of Radiology, Piedmont Healthcare, Atlanta, Ga (A.A.)
| | - Clifford R Weiss
- From the Russell H. Morgan Department of Radiology and Radiological Science (Y.F., C.R.W., K.P., D.K., D.L.K.), Department of Gastroenterology (E.J.S.), and Department of Pathology (R.A.A.), the Johns Hopkins University School of Medicine, 1800 Orleans St, Zayed Tower 7203, Baltimore, MD 21287; and Department of Radiology, Piedmont Healthcare, Atlanta, Ga (A.A.)
| | - Kalyan Paudel
- From the Russell H. Morgan Department of Radiology and Radiological Science (Y.F., C.R.W., K.P., D.K., D.L.K.), Department of Gastroenterology (E.J.S.), and Department of Pathology (R.A.A.), the Johns Hopkins University School of Medicine, 1800 Orleans St, Zayed Tower 7203, Baltimore, MD 21287; and Department of Radiology, Piedmont Healthcare, Atlanta, Ga (A.A.)
| | - Eun-Ji Shin
- From the Russell H. Morgan Department of Radiology and Radiological Science (Y.F., C.R.W., K.P., D.K., D.L.K.), Department of Gastroenterology (E.J.S.), and Department of Pathology (R.A.A.), the Johns Hopkins University School of Medicine, 1800 Orleans St, Zayed Tower 7203, Baltimore, MD 21287; and Department of Radiology, Piedmont Healthcare, Atlanta, Ga (A.A.)
| | - Dorota Kedziorek
- From the Russell H. Morgan Department of Radiology and Radiological Science (Y.F., C.R.W., K.P., D.K., D.L.K.), Department of Gastroenterology (E.J.S.), and Department of Pathology (R.A.A.), the Johns Hopkins University School of Medicine, 1800 Orleans St, Zayed Tower 7203, Baltimore, MD 21287; and Department of Radiology, Piedmont Healthcare, Atlanta, Ga (A.A.)
| | - Aravind Arepally
- From the Russell H. Morgan Department of Radiology and Radiological Science (Y.F., C.R.W., K.P., D.K., D.L.K.), Department of Gastroenterology (E.J.S.), and Department of Pathology (R.A.A.), the Johns Hopkins University School of Medicine, 1800 Orleans St, Zayed Tower 7203, Baltimore, MD 21287; and Department of Radiology, Piedmont Healthcare, Atlanta, Ga (A.A.)
| | - Robert A Anders
- From the Russell H. Morgan Department of Radiology and Radiological Science (Y.F., C.R.W., K.P., D.K., D.L.K.), Department of Gastroenterology (E.J.S.), and Department of Pathology (R.A.A.), the Johns Hopkins University School of Medicine, 1800 Orleans St, Zayed Tower 7203, Baltimore, MD 21287; and Department of Radiology, Piedmont Healthcare, Atlanta, Ga (A.A.)
| | - Dara L Kraitchman
- From the Russell H. Morgan Department of Radiology and Radiological Science (Y.F., C.R.W., K.P., D.K., D.L.K.), Department of Gastroenterology (E.J.S.), and Department of Pathology (R.A.A.), the Johns Hopkins University School of Medicine, 1800 Orleans St, Zayed Tower 7203, Baltimore, MD 21287; and Department of Radiology, Piedmont Healthcare, Atlanta, Ga (A.A.)
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Caine M, Carugo D, Zhang X, Hill M, Dreher MR, Lewis AL. Review of the Development of Methods for Characterization of Microspheres for Use in Embolotherapy: Translating Bench to Cathlab. Adv Healthc Mater 2017; 6. [PMID: 28218823 DOI: 10.1002/adhm.201601291] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/04/2017] [Indexed: 12/25/2022]
Abstract
Therapeutic embolotherapy is the deliberate occlusion of a blood vessel within the body, which can be for the prevention of internal bleeding, stemming of flow through an arteriovenous malformation, or occlusion of blood vessels feeding a tumor. This is achieved using a wide selection of embolic devices such as balloons, coils, gels, glues, and particles. Particulate embolization is often favored for blocking smaller vessels, particularly within hypervascularized tumors, as they are available in calibrated sizes and can be delivered distally via microcatheters for precise occlusion with associated locoregional drug delivery. Embolic performance has been traditionally evaluated using animal models, but with increasing interest in the 3R's (replacement, reduction, refinement), manufacturers, regulators, and clinicians have shown interest in the development of more sophisticated in vitro methods for evaluation and prediction of in vivo performance. Herein the current progress in developing bespoke techniques incorporating physical handling, fluid dynamics, occlusive behavior, and sustained drug elution kinetics within vascular systems is reviewed. While it is necessary to continue to validate the safety of such devices in vivo, great strides have been made in the development of bench tests that better predict the behavior of these products aligned with the principles of the 3R's.
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Affiliation(s)
- Marcus Caine
- Faculty of Engineering and the Environment; University of Southampton; University Road Highfield Southampton SO17 1BJ UK
- Biocompatibles UK Ltd., Lakeview; Riverside Way, Watchmoor Park Camberley GU15 3YL UK
| | - Dario Carugo
- Faculty of Engineering and the Environment; University of Southampton; University Road Highfield Southampton SO17 1BJ UK
| | - Xunli Zhang
- Faculty of Engineering and the Environment; University of Southampton; University Road Highfield Southampton SO17 1BJ UK
| | - Martyn Hill
- Faculty of Engineering and the Environment; University of Southampton; University Road Highfield Southampton SO17 1BJ UK
| | - Matthew R. Dreher
- Biocompatibles UK Ltd., Lakeview; Riverside Way, Watchmoor Park Camberley GU15 3YL UK
| | - Andrew L. Lewis
- Biocompatibles UK Ltd., Lakeview; Riverside Way, Watchmoor Park Camberley GU15 3YL UK
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16
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Ashrafi K, Tang Y, Britton H, Domenge O, Blino D, Bushby AJ, Shuturminska K, den Hartog M, Radaelli A, Negussie AH, Mikhail AS, Woods DL, Krishnasamy V, Levy EB, Wood BJ, Willis SL, Dreher MR, Lewis AL. Characterization of a novel intrinsically radiopaque Drug-eluting Bead for image-guided therapy: DC Bead LUMI™. J Control Release 2017; 250:36-47. [PMID: 28188808 DOI: 10.1016/j.jconrel.2017.02.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 02/01/2017] [Indexed: 02/07/2023]
Abstract
We have developed a straightforward and efficient method of introducing radiopacity into Polyvinyl alcohol (PVA)-2-Acrylamido-2-methylpropane sulfonic acid (AMPS) hydrogel beads (DC Bead™) that are currently used in the clinic to treat liver malignancies. Coupling of 2,3,5-triiodobenzaldehyde to the PVA backbone of pre-formed beads yields a uniformly distributed level of iodine attached throughout the bead structure (~150mg/mL) which is sufficient to be imaged under standard fluoroscopy and computed tomography (CT) imaging modalities used in treatment procedures (DC Bead LUMI™). Despite the chemical modification increasing the density of the beads to ~1.3g/cm3 and the compressive modulus by two orders of magnitude, they remain easily suspended, handled and administered through standard microcatheters. As the core chemistry of DC Bead LUMI™ is the same as DC Bead™, it interacts with drugs using ion-exchange between sulfonic acid groups on the polymer and the positively charged amine groups of the drugs. Both doxorubicin (Dox) and irinotecan (Iri) elution kinetics for all bead sizes evaluated were within the parameters already investigated within the clinic for DC Bead™. Drug loading did not affect the radiopacity and there was a direct relationship between bead attenuation and Dox concentration. The ability (Dox)-loaded DC Bead LUMI™ to be visualized in vivo was demonstrated by the administration of into hepatic arteries of a VX2 tumor-bearing rabbit under fluoroscopy, followed by subsequent CT imaging.
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Affiliation(s)
- Koorosh Ashrafi
- Biocompatibles UK Ltd., a BTG International group company, Lakeview, Riverside Way, Watchmoor Park, Camberley GU15 3YL, UK
| | - Yiqing Tang
- Biocompatibles UK Ltd., a BTG International group company, Lakeview, Riverside Way, Watchmoor Park, Camberley GU15 3YL, UK
| | - Hugh Britton
- Biocompatibles UK Ltd., a BTG International group company, Lakeview, Riverside Way, Watchmoor Park, Camberley GU15 3YL, UK
| | - Orianne Domenge
- Biocompatibles UK Ltd., a BTG International group company, Lakeview, Riverside Way, Watchmoor Park, Camberley GU15 3YL, UK
| | - Delphine Blino
- Biocompatibles UK Ltd., a BTG International group company, Lakeview, Riverside Way, Watchmoor Park, Camberley GU15 3YL, UK
| | - Andrew J Bushby
- School of Engineering and Materials Science, Queen Mary University, Mile End Road, London, E1 4NS, UK
| | - Kseniya Shuturminska
- School of Engineering and Materials Science, Queen Mary University, Mile End Road, London, E1 4NS, UK
| | | | | | - Ayele H Negussie
- The Center for Interventional Oncology Radiology and Imaging Sciences, Clinical Center, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Building 10, Bethesda, MD, USA
| | - Andrew S Mikhail
- The Center for Interventional Oncology Radiology and Imaging Sciences, Clinical Center, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Building 10, Bethesda, MD, USA
| | - David L Woods
- The Center for Interventional Oncology Radiology and Imaging Sciences, Clinical Center, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Building 10, Bethesda, MD, USA
| | - Venkatesh Krishnasamy
- The Center for Interventional Oncology Radiology and Imaging Sciences, Clinical Center, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Building 10, Bethesda, MD, USA
| | - Elliot B Levy
- The Center for Interventional Oncology Radiology and Imaging Sciences, Clinical Center, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Building 10, Bethesda, MD, USA
| | - Bradford J Wood
- The Center for Interventional Oncology Radiology and Imaging Sciences, Clinical Center, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Building 10, Bethesda, MD, USA
| | - Sean L Willis
- Biocompatibles UK Ltd., a BTG International group company, Lakeview, Riverside Way, Watchmoor Park, Camberley GU15 3YL, UK
| | - Matthew R Dreher
- Biocompatibles UK Ltd., a BTG International group company, Lakeview, Riverside Way, Watchmoor Park, Camberley GU15 3YL, UK
| | - Andrew L Lewis
- Biocompatibles UK Ltd., a BTG International group company, Lakeview, Riverside Way, Watchmoor Park, Camberley GU15 3YL, UK.
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Hou H, Khan N, Kuppusamy P. Measurement of pO2 in a Pre-clinical Model of Rabbit Tumor Using OxyChip, a Paramagnetic Oxygen Sensor. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 977:313-318. [DOI: 10.1007/978-3-319-55231-6_41] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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