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Mak NL, Ng WH, Ooi EH, Lau EV, Pamidi N, Foo JJ, Ooi ET, Ali AFM. Enlarging the thermal coagulation volume during thermochemical ablation with alternating acid-base injection by shortening the injection interval: A computational study. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 243:107866. [PMID: 37865059 DOI: 10.1016/j.cmpb.2023.107866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND AND OBJECTIVES Thermochemical ablation (TCA) is a cancer treatment that utilises the heat released from the neutralisation of acid and base to raise tissue temperature to levels sufficient to induce thermal coagulation. Computational studies have demonstrated that the coagulation volume produced by sequential injection is smaller than that with simultaneous injection. By injecting the reagents in an ensuing manner, the region of contact between acid and base is limited to a thin contact layer sandwiched between the distribution of acid and base. It is hypothesised that increasing the frequency of acid-base injections into the tissue by shortening the injection interval for each reagent can increase the effective area of contact between acid and base, thereby intensifying neutralisation and the exothermic heat released into the tissue. METHODS To verify this hypothesis, a computational model was developed to simulate the thermochemical processes involved during TCA with sequential injection. Four major processes that take place during TCA were considered, i.e., the flow of acid and base, their neutralisation, the release of exothermic heat and the formation of thermal damage inside the tissue. Equimolar acid and base at 7.5 M was injected into the tissue intermittently. Six injection intervals, namely 3, 6, 15, 20, 30 and 60 s were investigated. RESULTS Shortening of the injection interval led to the enlargement of coagulation volume. If one considers only the coagulation volume as the determining factor, then a 15 s injection interval was found to be optimum. Conversely, if one places priority on safety, then a 3 s injection interval would result in the lowest amount of reagent residue inside the tissue after treatment. With a 3 s injection interval, the coagulation volume was found to be larger than that of simultaneous injection with the same treatment parameters. Not only that, the volume also surpassed that of radiofrequency ablation (RFA); a conventional thermal ablation technique commonly used for liver cancer treatment. CONCLUSION The numerical results verified the hypothesis that shortening the injection interval will lead to the formation of larger thermal coagulation zone during TCA with sequential injection. More importantly, a 3 s injection interval was found to be optimum for both efficacy (large coagulation volume) and safety (least amount of reagent residue).
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Affiliation(s)
- Nguoy L Mak
- Department of Mechanical Engineering, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Wen H Ng
- Department of Mechanical Engineering, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ean H Ooi
- Department of Mechanical Engineering, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia.
| | - Ee V Lau
- Department of Mechanical Engineering, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - N Pamidi
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ji J Foo
- Department of Mechanical Engineering, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ean T Ooi
- School of Engineering and Information Technology, Faculty of Science and Technology, Federation University, VIC 3350, Australia
| | - Ahmad F Mohd Ali
- MSU Medical Centre, Management and Science University, University Drive, Off Persiaran Olahraga, 40100 Shah Alam, Selangor, Malaysia
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Remlova E, Feig VR, Kang Z, Patel A, Ballinger I, Ginzburg A, Kuosmanen J, Fabian N, Ishida K, Jenkins J, Hayward A, Traverso G. Activated Metals to Generate Heat for Biomedical Applications. ACS MATERIALS LETTERS 2023; 5:2508-2517. [PMID: 37680546 PMCID: PMC10481395 DOI: 10.1021/acsmaterialslett.3c00581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/10/2023] [Indexed: 09/09/2023]
Abstract
Delivering heat in vivo could enhance a wide range of biomedical therapeutic and diagnostic technologies, including long-term drug delivery devices and cancer treatments. To date, providing thermal energy is highly power-intensive, rendering it oftentimes inaccessible outside of clinical settings. We developed an in vivo heating method based on the exothermic reaction between liquid-metal-activated aluminum and water. After establishing a method for consistent activation, we characterized the heat generation capabilities with thermal imaging and heat flux measurements. We then demonstrated one application of this reaction: to thermally actuate a gastric resident device made from a shape-memory alloy called Nitinol. Finally, we highlight the advantages and future directions for leveraging this novel in situ heat generation method beyond the showcased example.
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Affiliation(s)
- Eva Remlova
- Division
of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Health Sciences and Technology, Eidgenössische
Technische Hochschule Zürich, Universitätstrasse 2, 8092 Zürich, Switzerland
| | - Vivian Rachel Feig
- Division
of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- The
David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Ziliang Kang
- Division
of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Mechanical Engineering, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Ashka Patel
- Division
of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Bioengineering, Northeastern University, Boston, Massachusetts 02115, United States
| | - Ian Ballinger
- Division
of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Anna Ginzburg
- Division
of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Cell/Cellular and Molecular Biology, Northeastern University, Boston, Massachusetts 02115, United States
| | - Johannes Kuosmanen
- Department
of Mechanical Engineering, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Niora Fabian
- Department
of Mechanical Engineering, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
- Division
of Comparative Medicine, Massachusetts Institute
of Technology, Cambridge, Massachusetts 02139, United States
| | - Keiko Ishida
- Division
of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- The
David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Joshua Jenkins
- Division
of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Mechanical Engineering, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Alison Hayward
- Division
of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Mechanical Engineering, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
- Division
of Comparative Medicine, Massachusetts Institute
of Technology, Cambridge, Massachusetts 02139, United States
| | - Giovanni Traverso
- Division
of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- The
David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Department
of Mechanical Engineering, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
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Cressman ENK, Guo C. Feasibility study using tissue as reagent for cancer therapy: endovascular ablation via thermochemistry. CONVERGENT SCIENCE PHYSICAL ONCOLOGY 2018. [DOI: 10.1088/2057-1739/aab905] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Wang W, Liu Y, Liu H, An Y, Wang Q, Liu J. NaK alloy-induced in vivo tumor ablation therapy. MINIM INVASIV THER 2017; 27:90-96. [PMID: 28604147 DOI: 10.1080/13645706.2017.1330758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Alkali metal ablation is newly emerging as an effective, economic and minimally invasive ablation therapy. This study is dedicated to demonstrate the high efficiency of NaK alloy ablation on in vivo tumors with different stages in mice. MATERIAL AND METHODS Panc02 tumor cells were injected into 21 female C57B/L mice, which were divided into three groups. Two experimental groups of mice received the same percutaneous NaK alloy injection for a week apart. The inner temperature response and surface temperature distribution were measured using a thermal couple and an infrared camera. After each ablation experiment, two mice in each group were chosen randomly to make pathological sections. The tumor volumes were measured once every two days. At the end, all tumors were cut off to calculate the tumor inhibition rates. RESULTS The NaK alloy-induced ablation therapy produced an obvious temperature increase (85 °C) in the ablation region and the high temperature distribution was relatively concentrated. The histopathology sections showed that developing stage tumors received incomplete destruction of the malignant cells compared with early stage tumors. The tumor inhibition rate in the early and developing tumor treatment groups were 88.5% and 67.6%, respectively. CONCLUSIONS This technology provides a nearly thorough ablation treatment for early stage tumors and also a palliative treatment for developing tumors.
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Affiliation(s)
- Wei Wang
- a The First Hospital of Hebei Medical University , Shijiazhuang , China
| | - Ying Liu
- a The First Hospital of Hebei Medical University , Shijiazhuang , China
| | - Huan Liu
- a The First Hospital of Hebei Medical University , Shijiazhuang , China
| | - Yonghui An
- a The First Hospital of Hebei Medical University , Shijiazhuang , China
| | - Qian Wang
- b Technical Institute of Physics and Chemistry, Chinese Academy of Sciences , Beijing , China
| | - Jing Liu
- b Technical Institute of Physics and Chemistry, Chinese Academy of Sciences , Beijing , China.,c Department of Biomedical Engineering, School of Medicine , Tsinghua University , Beijing , China
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Guo Z, Zhang Q, Li X, Jing Z. Thermochemical ablation therapy of VX2 tumor using a permeable oil-packed liquid alkali metal. PLoS One 2015; 10:e0123196. [PMID: 25885926 PMCID: PMC4401739 DOI: 10.1371/journal.pone.0123196] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 02/18/2015] [Indexed: 12/02/2022] Open
Abstract
Objective Alkali metal appears to be a promising tool in thermochemical ablation, but, it requires additional data on safety is required. The objective of this study was to explore the effectiveness of permeable oil-packed liquid alkali metal in the thermochemical ablation of tumors. Methods Permeable oil-packed sodium–potassium (NaK) was prepared using ultrasonic mixing of different ratios of metal to oil. The thermal effect of the mixture during ablation of muscle tissue ex vivo was evaluated using the Fluke Ti400 Thermal Imager. The thermochemical effect of the NaK-oil mixture on VX2 tumors was evaluated by performing perfusion CT scans both before and after treatment in 10 VX2 rabbit model tumors. VX2 tumors were harvested from two rabbits immediately after treatment to assess their viability using trypan blue and hematoxylin and eosin (H.E.) staining. Results The injection of the NaK–oil mixture resulted in significantly higher heat in the ablation areas. The permeable oil controlled the rate of heat released during the NaK reaction with water in the living tissue. Perfusion computed tomography and its parameter map confirmed that the NaK–oil mixture had curative effects on VX2 tumors. Both trypan blue and H.E. staining showed partial necrosis of the VX2 tumors. Conclusions The NaK–oil mixture may be used successfully to ablate tumor tissue in vivo. With reference to the controlled thermal and chemical lethal injury to tumors, using a liquid alkali in ablation is potentially an effective and safe method to treat malignant tumors.
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Affiliation(s)
- Ziyi Guo
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Radiology, Haikou People's Hospital, Xiangya Medical School Central South University, Haikou City, Hainan, China
| | - Qiang Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoguang Li
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- * E-mail: (ZJ); (XL)
| | - Zhengyu Jing
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- * E-mail: (ZJ); (XL)
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Deng ZS, Liu J. Chemothermal therapy for localized heating and ablation of tumor. JOURNAL OF HEALTHCARE ENGINEERING 2013; 4:409-26. [PMID: 23965596 DOI: 10.1260/2040-2295.4.3.409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Chemothermal therapy is a new hyperthermia treatment on tumor using heat released from exothermic chemical reaction between the injected reactants and the diseased tissues. With the highly minimally invasive feature and localized heating performance, this method is expected to overcome the ubiquitous shortcomings encountered by many existing hyperthermia approaches in ablating irregular tumor. This review provides a relatively comprehensive review on the latest advancements and state of the art in chemothermal therapy. The basic principles and features of two typical chemothermal ablation strategies (acid-base neutralization-reaction-enabled thermal ablation and alkali-metal-enabled thermal/chemical ablation) are illustrated. The prospects and possible challenges facing chemothermal ablation are analyzed. The chemothermal therapy is expected to open many clinical possibilities for precise tumor treatment in a minimally invasive way.
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Affiliation(s)
- Zhong-Shan Deng
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing, China.
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Cressman ENK, Jahangir DA. Dual mode single agent thermochemical ablation by simultaneous release of heat energy and acid: hydrolysis of electrophiles. Int J Hyperthermia 2013; 29:71-8. [PMID: 23311380 DOI: 10.3109/02656736.2012.756124] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE This study aimed to investigate two readily available electrophilic reagents, acetyl chloride (AcCl), and acetic anhydride (Ac(2)O), for their potential in tissue ablation. MATERIALS AND METHODS Reagents were diluted in diglyme as solutions up to 8 mol/L and tested in a gel phantom with NaOH solutions and ex vivo in porcine liver. Temperature, pH, and volume measurements were obtained. Infrared and gross pathological images were obtained in bisected specimens immediately after injection. RESULTS AcCl was much more reactive than Ac(2)O and AcCl was therefore used in the tissue studies. Temperature increases of up to 37°C were noted in vitro and 30°C in ex vivo tissues using 4 mol/L AcCl solutions. Experiments at 8 mol/L were abandoned due to the extreme reactivity at this higher concentration. A change in pH of up to 4 log units was noted with 4 mol/L solutions of AcCl with slight recovery over time. Ablated volumes were consistently higher than injected volumes. CONCLUSIONS Reaction of electrophiles in tissues shows promise as a new thermochemical ablation technique by means of only a single reagent. Further studies in this area are warranted.
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Affiliation(s)
- Erik N K Cressman
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA.
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Wang Q, Xie L, He Z, Di D, Liu J. Biodegradable magnesium nanoparticle-enhanced laser hyperthermia therapy. Int J Nanomedicine 2012; 7:4715-25. [PMID: 22956872 PMCID: PMC3431971 DOI: 10.2147/ijn.s34902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Recently, nanoparticles have been demonstrated to have tremendous merit in terms of improving the treatment specificity and thermal ablation effect on tumors. However, the potential toxicity and long-term side effects caused by the introduced nanoparticles and by expelling them out of the body following surgery remain a significant challenge. Here, we propose for the first time to directly adopt magnesium nanoparticles as the heating enhancer in laser thermal ablation to avoid these problems by making full use of the perfect biodegradable properties of this specific material. Methods To better understand the new nano “green” hyperthermia modality, we evaluated the effects of magnesium nanoparticles on the temperature transients inside the human body subject to laser interstitial heating. Further, we experimentally investigated the heating enhancement effects of magnesium nanoparticles on a group of biological samples: oil, egg white, egg yolk, in vitro pig tissues, and the in vivo hind leg of rabbit when subjected to laser irradiation. Results Both the theoretical simulations and experimental measurements demonstrated that the target tissues injected with magnesium nanoparticles reached much higher temperatures than tissues without magnesium nanoparticles. This revealed the enhancing behavior of the new nanohyperthermia method. Conclusion Given the unique features of magnesium nanoparticles – their complete biological safety and ability to enhance heating – which most other advanced metal nanoparticles do not possess, the use of magnesium nanoparticles in hyperthermia therapy offers an important “green” nanomedicine modality for treating tumors. This method has the potential to be used in clinics in the near future.
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Affiliation(s)
- Qian Wang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, People's Republic of China
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Cressman ENK, Tseng HJ, Talaie R, Henderson BM. A new heat source for thermochemical ablation based on redox chemistry: Initial studies using permanganate. Int J Hyperthermia 2010; 26:327-37. [DOI: 10.3109/02656731003614516] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Erik N. K. Cressman
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
| | - Hsiang-Jer Tseng
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
| | - Reza Talaie
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
| | - Brett M. Henderson
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
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