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Zhou Y, Gong X, You Y. In vivo evaluation of focused ultrasound ablation surgery (FUAS)-induced coagulation using echo amplitudes of the therapeutic focused ultrasound transducer. Int J Hyperthermia 2024; 41:2325477. [PMID: 38439505 DOI: 10.1080/02656736.2024.2325477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/26/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE Monitoring sensitivity of sonography in focused ultrasound ablation surgery (FUAS) is limited (no hyperechoes in ∼50% of successful coagulation in uterine fibroids). A more accurate and sensitive approach is required. METHOD The echo amplitudes of the focused ultrasound (FUS) transducer in a testing mode (short pulse duration and low power) were found to correlate with the ex vivo coagulation. To further evaluate its coagulation prediction capabilities, in vivo experiments were carried out. The liver, kidney, and leg muscles of three adult goats were treated using clinical FUAS settings, and the echo amplitude of the FUS transducer and grayscale in sonography before and after FUAS were collected. On day 7, animals were sacrificed humanely, and the treated tissues were dissected to expose the lesion. Echo amplitude changes and lesion areas were analyzed statistically, as were the coagulation prediction metrics. RESULTS The echo amplitude changes of the FUS transducer correlate well with the lesion areas in the liver (R = 0.682). Its prediction in accuracy (94.4% vs. 50%), sensitivity (92.9% vs. 35.7%), and negative prediction (80% vs. 30.8%) is better than sonography, but similar in specificity (80% vs. 100%) and positive prediction (100% vs. 100%). In addition, the correlation between tissue depth and the lesion area is not good (|R| < 0.2). Prediction performances in kidney and leg muscles are similar. CONCLUSION The FUS echo amplitudes are sensitive to the tissue properties and their changes after FUAS. They are sensitive and reliable in evaluating and predicting FUAS outcomes.
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Affiliation(s)
- Yufeng Zhou
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- National Medical Products Administration (NMPA) Key Laboratory for Quality Evaluation of Ultrasonic Surgical Equipment, Wuhan, Hubei, China
| | - Xiaobo Gong
- Research and Development, National Engineering Research Center of Ultrasound Medicine, Chongqing, China
| | - Yaqing You
- Research and Development, National Engineering Research Center of Ultrasound Medicine, Chongqing, China
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Liao M, Du J, Chen L, Huang J, Yang R, Bao W, Zeng K, Wang W, Aphan BC, Wu Z, Ma L, Lu Q. Sono-activated materials for enhancing focused ultrasound ablation: Design and application in biomedicine. Acta Biomater 2024; 173:36-50. [PMID: 37939816 DOI: 10.1016/j.actbio.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023]
Abstract
The ablation effect of focused ultrasound (FUS) has played an increasingly important role in the biomedical field over the past decades, and its non-invasive features have great advantages, especially for clinical diseases where surgical treatment is not available or appropriate. Recently, rapid advances in the adjustable morphology, enzyme-mimetic activity, and biostability of sono-activated materials have significantly promoted the medical application of FUS ablation. However, a systematic review of sono-activated materials based on FUS ablation is not yet available. This progress review focuses on the recent design, fundamental principles, and applications of sono-activated materials in the FUS ablation biomedical field. First, the different ablation mechanisms and the key factors affecting ablation are carefully determined. Then, the design of sono-activated materials with high FUS ablation efficiencies is comprehensively discussed. Subsequently, the representative biological applications are summarized in detail. Finally, the primary challenges and future perspectives are also outlined. We believe this timely review will provide key information and insights for further exploration of focused ultrasound ablation and new inspiration for designing future sono-activated materials. STATEMENT OF SIGNIFICANCE: The ablation effect of focused ultrasound (FUS) has played an increasingly important role in the biomedical field over the past decades. However, there are also some challenges of FUS ablation, such as skin burns, tumour recurrence after thermal ablation, and difficulty in controlling cavitation ablation. The rapid advance in adjustable morphology, enzyme-mimetic activity, and biostability of sono-activated materials has significantly promoted the medical application of FUS ablation. However, the systematic review of sono-activated materials based on FUS ablation is not yet available. This progress review focuses on the recent design, fundamental principles, and applications in the FUS ablation biomedical field of sono-activated materials. We believe this timely review will provide key information and insights for further exploration of FUS ablation.
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Affiliation(s)
- Min Liao
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jinpeng Du
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Lin Chen
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Jiayan Huang
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Rui Yang
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wuyongga Bao
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Keyu Zeng
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wenhui Wang
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Benjamín Castañeda Aphan
- Department of Engineering, Medical Imaging Laboratory, Pontificia Universidad Católica del Perú, Lima, Peru
| | - Zhe Wu
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China.
| | - Lang Ma
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Qiang Lu
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Zhou H, Li F, Luo L, Xiong X, Zhou K, Zhu H, Zhang J, Li P. Safety of Sonazoid in Assisting High-Intensity Focused Ultrasound Ablation Therapy for Advanced Liver Malignant Lesions: A Single-Arm Clinical Study. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:134-141. [PMID: 37865612 DOI: 10.1016/j.ultrasmedbio.2023.09.014] [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: 03/20/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE The aim of the study described here was to evaluate the safety of Sonazoid-assisted high-intensity focused ultrasound (HIFU) in the treatment of advanced malignant liver lesions. METHODS A single-arm study was designed to enroll participants who were diagnosed with advanced primary liver cancer or liver metastases and proposed to receive Sonazoid assistance during HIFU treatment. Serological examination was conducted within 1 wk, and side effects in each patient were monitored for 1 mo. To evaluate therapeutic efficacy, the contrast-enhanced magnetic resonance imaging was performed 1 mo after treatment, and short-term follow-up was conducted a year later. RESULTS A total of 17 participants (12 male, 5 female) with an average age of 58 y (range: 46-73 y) were enrolled, including 11 patients with hepatocellular carcinoma, 2 patients with hepatic metastasis and 4 patients with cholangiocarcinoma. The total volume of tumor mass was 111.82 (11.01-272.30) cm3. The average total ablation time for a patient was 2021 ± 1030 s, and the energy efficiency factor was 5979.7 (3108.0, 45634.5) J/cm3. Immediately after HIFU treatment, 1 patient (5.9%) achieved complete response (CR), 4 patients (23.5%) had a moderate response, 8 patients (47.1%) had partial reperfusion and 4 patients (23.5%) had stable disease (SD). The average ablation rate for all the tumors was 51.5 ± 26.7%. The level of glutamic-pyruvic transaminase (ALT) was mildly increased in 71.6% (12/17) of patients after HIFU therapy. Mean ALT values before and after treatment were 22 (14, 35) U/L and 36 (25, 41) U/L, respectively (Z = 1.947, p = 0.051). Mild or obvious edema in skin and subcutaneous soft tissues were observed in 76.5% of patients, but no serious side effects were found. Twelve months after treatment, the follow-up results revealed that 1 patient (5.8%) achieved a CR, 8 patients (47.1%) had SD and 8 patients (47.1%) had progressive disease. The estimated median time to progression was 11 mo after treatment, with a 95% confidence interval of 6, 11 for all involved patients. CONCLUSION Use of Sonazoid is safe and feasible for improving HIFU ablation efficiency during the treatment of advanced malignant liver lesions. The therapeutic efficacy of Sonazoid-assisted HIFU needs to be explored in additional controlled clinical investigations.
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Affiliation(s)
- Hang Zhou
- Department of Ultrasound & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Ultrasound, Chongqing University Cancer Hospital, Chongqing, China
| | - Fang Li
- Department of Ultrasound, Chongqing University Cancer Hospital, Chongqing, China
| | - Li Luo
- Department of Ultrasound, Chongqing University Cancer Hospital, Chongqing, China
| | - Xialin Xiong
- Department of Ultrasound & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kun Zhou
- Clinical Center for Tumor Therapy, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Hui Zhu
- Clinical Center for Tumor Therapy, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jun Zhang
- Clinical Center for Tumor Therapy, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Pan Li
- Department of Ultrasound & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Hong L, Zhang W, Pan F, Xiaobo G, Huang H, You Y, Deng L, Wang Z, Zhang C. An in vitro and in vivo study on extracorporeal transducer optimization for high-intensity focused ultrasound to improve the safety and efficacy of breast tumor ablation. Int J Hyperthermia 2023; 40:2251734. [PMID: 37654021 DOI: 10.1080/02656736.2023.2251734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/24/2023] [Accepted: 08/19/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVE To observe the characteristics of a new extracorporeal high intensity focused ultrasound transducer, titled Haifu system JCQ-B, and to compare its safety and efficacy for breast ablation with the standard Haifu system JC transducer. MATERIALS AND METHODS Ox liver with pig skin and pork ribs were prepared in a semi-sphere shape, served as in vitro acoustic model. The udders of female goats were used as in vivo acoustic model. Both in vitro and in vivo models were ablated by either JCQ-B or JC transducer. The morphology of biological focal region (BFR), the coagulative necrosis volume, and the temperature increase were observed and compared. RESULTS The BFR morphology of JCQ-B transducer was circular both in vitro and in vivo, with a length-width ratio close to one. Under the same sonication parameters (sonication power, time and depth in tissue), coagulation necrosis volume caused by JCQ-B transducer was larger than that caused by JC transducer both in vitro and in vivo. The increase in temperature in the near and far acoustic pathways with JCQ-B transducer was significantly lower than that of JC transducer in vitro. After receiving high sonication energy during in vivo experimentation, there were no complications observed after the ablation of JCQ-B transducer, while small skin damage was observed after the ablation of JC transducer. CONCLUSIONS The JCQ-B transducer improved the safety and efficacy of treatment by optimizing BFR morphology and ablation efficiency, which could be applied in the treatment of breast tumor.
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Affiliation(s)
- Liu Hong
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- National Engineering Research Center of Ultrasound Medicine, Chongqing, P.R. China
| | - Wendy Zhang
- Department of Radiology, Staten Island University Hospital, Staten Island, NY, USA
| | - Feibao Pan
- Department of Cerebrovascular Disease, Suining Central Hospital, Suining, P.R. China
| | - Gong Xiaobo
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- National Engineering Research Center of Ultrasound Medicine, Chongqing, P.R. China
| | - Haoran Huang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- National Engineering Research Center of Ultrasound Medicine, Chongqing, P.R. China
- Chongqing Haifu Hospital, Chongqing, P.R. China
| | - Yaqing You
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- National Engineering Research Center of Ultrasound Medicine, Chongqing, P.R. China
| | - Lulu Deng
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- National Engineering Research Center of Ultrasound Medicine, Chongqing, P.R. China
| | - Zhibiao Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Haifu Hospital, Chongqing, P.R. China
| | - Cai Zhang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- National Engineering Research Center of Ultrasound Medicine, Chongqing, P.R. China
- Chongqing Haifu Hospital, Chongqing, P.R. China
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Holman R, Guillemin PC, Lorton O, Desgranges S, Contino-Pépin C, Salomir R. Assessing Enhanced Acoustic Absorption From Sonosensitive Perfluorocarbon Emulsion With Magnetic Resonance-Guided High-Intensity Focused Ultrasound and a Percolated Tissue-Mimicking Flow Phantom. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1510-1517. [PMID: 37117139 DOI: 10.1016/j.ultrasmedbio.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/18/2023] [Accepted: 01/25/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Sonosensitive high-boiling point perfluorocarbon F8TAC18-PFOB emulsions previously exhibited thermal enhancement during focused ultrasound heating in ex vivo pig livers, kidneys and a laminar flow phantom. The main objectives of this study were to evaluate heating under turbulent conditions, observe perfusion effects, quantify heating in terms of acoustic absorption and model the experimental data. METHODS In this study, similar perfluorocarbon emulsions were circulated at incremental concentrations of 0.07, 0.13, 0.19 and 0.25% v:v through a percolated turbulent flow phantom, more representative of the biological tissue than a laminar flow phantom. The concentrations represent the droplet content in only the perfused fluid, rather than the droplet concentration throughout the entire cross-section. The temperature was measured with magnetic resonance thermometry, during focused ultrasound sonications of 67 W, 95% duty cycle and 33 s duration. These were used in Bioheat equation simulations to investigate in silico the thermal phenomena. The temperature change was compared with the control condition by circulating de-gassed and de-ionized water through the flow phantom without droplets. RESULTS With these 1.24 µm diameter droplets at 0.25% v:v, the acoustic absorption coefficient increased from 0.93 ± 0.05 at 0.0% v:v to 1.82 ± 0.22 m-1 at 0.25% v:v using a 0.1 mL s-1 flow rate. Without perfusion at 0.25% v:v, an increase was observed from 1.23 ± 0.07 m-1 at 0.0% v:v to 1.65 ± 0.17 m-1. CONCLUSION The results further support previously reported thermal enhancement with F8TAC18-PFOB emulsion, quantified the increased absorption at small concentration intervals, illustrated that the effects can be observed in a variety of visceral tissue models and provided a method to simulate untested scenarios.
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Affiliation(s)
- Ryan Holman
- Image Guided Interventions Laboratory, Department of Radiology, University of Geneva, Geneva, Switzerland.
| | - Pauline C Guillemin
- Image Guided Interventions Laboratory, Department of Radiology, University of Geneva, Geneva, Switzerland
| | - Orane Lorton
- Image Guided Interventions Laboratory, Department of Radiology, University of Geneva, Geneva, Switzerland
| | - Stéphane Desgranges
- Equipe Systèmes Amphiphiles bioactifs et Formulations Eco-compatibles, Unité Propre de Recherche et d'Innovation (UPRI), Avignon University, Avignon, France
| | - Christiane Contino-Pépin
- Equipe Systèmes Amphiphiles bioactifs et Formulations Eco-compatibles, Unité Propre de Recherche et d'Innovation (UPRI), Avignon University, Avignon, France
| | - Rares Salomir
- Image Guided Interventions Laboratory, Department of Radiology, University of Geneva, Geneva, Switzerland; Radiology Division, University Hospitals of Geneva, Geneva, Switzerland
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Chen X, Ma Y, Zhang J, Yang W, Jin C, Ran L, Zhu H, Bai J, Zhou K. Evaluating the long-term survival benefits of high intensity focused ultrasound ablation for hepatocellular carcinoma with portal vein tumor thrombus: a single center retrospective study. Int J Hyperthermia 2022; 39:1245-1253. [PMID: 36137611 DOI: 10.1080/02656736.2022.2122595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
AIMS To evaluate the long-term survival benefits of high intensity focused ultrasound (HIFU) ablation in patients with hepatocellular carcinoma (HCC) combined with portal vein tumor thrombus (PVTT). METHODS The data of patients with HCC-PVTT treated with HIFU from January 2014 to December 2019 were retrospectively analyzed. All patients received HIFU ablation for both PVTT and liver tumor in one session. Perioperative adverse events (AEs) were recorded, and follow-up was performed postoperatively. The Kaplan-Meier method was used for survival analysis. RESULTS Median follow-up was 13.75 ± 1.31 months. A total of 144 patients (male/female: 122/22, age: 54.15 ± 11.84 years old) were included in the study. A total of 267 liver tumors (tumor number: 1.87 ± 1.65, range 1-10) were treated with HIFU. The mean ± SD diameter of viable liver tumors was 100.98 ± 61.65 mm. The reported postoperative AEs of HIFU were skin edema (93.75%), local pain (69.44%) and fever (7.64%). There was no liver failure, gastrointestinal bleeding or perioperative death. The median overall survival (OS) time was 14 months, while the cumulative survival rates of 0.5, 1, 2 and 3 years were 79.0%, 58.6%, 33.3% and 5.9%, respectively. The median OS of PVTT types I, II and III was 22, 13 and 14 months, respectively, and the difference was not statistically significant (p > 0.05). CONCLUSION HIFU is a minimally invasive method for HCC-PVTT with fewer complications, which could prolong the OS. Patients with PVTT type III could benefit more from HIFU, compared to types I and II.
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Affiliation(s)
- Xing Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Yuhong Ma
- Clinical Center for Tumor Therapy, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jun Zhang
- Clinical Center for Tumor Therapy, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Wei Yang
- Clinical Center for Tumor Therapy, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Chengbing Jin
- Clinical Center for Tumor Therapy, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Lifeng Ran
- Clinical Center for Tumor Therapy, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Hui Zhu
- Clinical Center for Tumor Therapy, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jin Bai
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Kun Zhou
- Clinical Center for Tumor Therapy, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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Holman R, Gui L, Lorton O, Guillemin P, Desgranges S, Contino-Pépin C, Salomir R. PFOB sonosensitive microdroplets: determining their interaction radii with focused ultrasound using MR thermometry and a Gaussian convolution kernel computation. Int J Hyperthermia 2022; 39:108-119. [PMID: 35000497 DOI: 10.1080/02656736.2021.2021304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Purpose: Micron-sized perfluorocarbon droplet adjuvants to focused ultrasound therapies allow lower applied power, circumvent unwanted prefocal heating, and enhance thermal dose in highly perfused tissues. The heat enhancement has been shown to saturate at increasing concentrations. Experiments were performed to empirically model the saturating heating effects during focused ultrasound.Materials and methods: The measurements were made at varying concentrations using magnetic resonance thermometry and focused ultrasound by circulating droplets of mean diameter 1.9 to 2.3 µm through a perfused phantom. A simulation was performed to estimate the interaction radius size, empirically.Results: The interaction radius, representing the radius of a sphere encompassing 90% of the probability for the transformation of acoustic energy into heat deposition around a single droplet, was determined experimentally from ultrasonic absorption coefficient measurements The simulations suggest the interaction radius was approximately 12.5-fold larger than the geometrical radius of droplets, corresponding to an interaction volume on the order of 2000 larger than the geometrical volume.Conclusions: The results provide information regarding the dose-response relationship from the droplets, a measure with 15% precision of their interaction radii with focused ultrasound, and subsequent insights into the underlying physical heating mechanism.
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Affiliation(s)
- Ryan Holman
- Image Guided Interventions Laboratory (GR-949), Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Laura Gui
- Image Guided Interventions Laboratory (GR-949), Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Orane Lorton
- Image Guided Interventions Laboratory (GR-949), Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Pauline Guillemin
- Image Guided Interventions Laboratory (GR-949), Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | | | - Rares Salomir
- Image Guided Interventions Laboratory (GR-949), Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Radiology Division, University Hospitals of Geneva, Geneva, Switzerland
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Gao H, Wang Z, Tan M, Liu W, Zhang L, Huang J, Cao Y, Li P, Wang Z, Wen J, Shang T, Ran H. pH-Responsive Nanoparticles for Enhanced Antitumor Activity by High-Intensity Focused Ultrasound Therapy Combined with Sonodynamic Therapy. Int J Nanomedicine 2022; 17:333-350. [PMID: 35115772 PMCID: PMC8800590 DOI: 10.2147/ijn.s336632] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/24/2021] [Indexed: 12/16/2022] Open
Affiliation(s)
- Hui Gao
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhaoxia Wang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Mixiao Tan
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Weiwei Liu
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Liang Zhang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Ju Huang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yang Cao
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Pan Li
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhigang Wang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jiexin Wen
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Tingting Shang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Haitao Ran
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Correspondence: Haitao Ran Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing, 400010, People’s Republic of ChinaTel +86-13-512373563 Email
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Zhang Q, Wang Y, Zhang J, Zhang W, Gong J, Ma R. TACE Combined with HIFU Versus Surgical Resection for Single Hepatocellular Carcinoma with Child-Pugh B Cirrhosis in Overall Survival and Progression-Free Survival: A Retrospective Study. Technol Cancer Res Treat 2021; 20:15330338211060180. [PMID: 34855560 PMCID: PMC8649445 DOI: 10.1177/15330338211060180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective: To compare the effectiveness, safety and survival outcome
of transcatheter arterial chemoembolization (TACE) combined with high-intensity
focused ultrasound (HIFU) versus surgical resection for treating single
hepatocellular carcinoma (HCC) with Child-Pugh B cirrhosis.
Methods: A hospital-based retrospective study with 146 patients
diagnosed with single HCC with Child-Pugh B cirrhosis from July 2010 to July
2018 was conducted in a tertiary teaching hospital. A total of 49 patients
underwent TACE combined with HIFU (the combined group), and 97 patients
underwent surgical resection (the resection group). Of them, 22 patients
undergoing TACE combined with HIFU and 45 patients undergoing surgical resection
had small HCC (tumor diameter ≤3 cm). The overall survival (OS) time,
progression-free survival (PFS) time and postoperative complications were
compared between the two groups. Results: In the single HCC tumor
cohort, there was no significant difference in OS between the two groups [hazard
ratio (HR) = 0.6379; 95% confidence interval (95% CI) = 0.3737 to 1.089;
P = .0995], while the resection group showed an obvious
superiority to the combined group regarding PFS (HR = 0.3545; 95%
CI = 0.2176-0.5775; P < .0001). The 1-year, 3-year and
5-year recurrence rates were 30.9%, 55.7%, 86.6% in the resection group and
53.1%, 77.6%, 89.8% in the combined group, respectively. In the small HCC tumor
cohort, there was also no difference in OS between the two groups (HR = 0.8808;
95% CI = 0.3295-2.355; P = .06396), while the resection group
showed an obvious superiority to the combined group regarding PFS (HR = 0.4273;
95% CI = 0.1927-0.9473; P = .0363). The 1-year, 3-year and
5-year recurrence rates were 28.9%, 53.3%, 93.3% in the resection group and
40.9%, 68.2%, 81.8% in the combined group, respectively. Furthermore, the
incidence of complications of the combined group was 38.8%, which was
significantly less than the 56.7% of the resection group
(P = .041), and the duration of general anesthesia in the
combined group was shorter than that in the resection group
(P = .001). Therein, there was no difference in the incidence
of grade I complications (Clavien-Dindo classification) between the two groups
(P = .866). Conclusion: For patients with
single or single small HCCs, TACE combined with HIFU may not be inferior to
surgical resection in terms of the long-term survival rate, while surgical
resection still has a definite advantage in terms of delaying recurrence. In
addition, the combination of TACE and HIFU has higher safety than surgical
resection.
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Affiliation(s)
- Qiwei Zhang
- People's Hospital of Chongqing Banan District, Chongqing, P. R. China
| | - Yunbing Wang
- 585250The Second Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Junyong Zhang
- 585250The Second Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Wenfeng Zhang
- 585250The Second Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Jianping Gong
- 585250The Second Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Rong Ma
- 585250The Second Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
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10
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Keller SB, Wang YN, Totten S, Yeung RS, Averkiou MA. Safety of Image-Guided Treatment of the Liver with Ultrasound and Microbubbles in an in Vivo Porcine Model. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:3211-3220. [PMID: 34362584 DOI: 10.1016/j.ultrasmedbio.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/15/2021] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
Ultrasound and microbubbles are useful for both diagnostic imaging and targeted drug delivery, making them ideal conduits for theranostic interventions. Recent reports have indicated the preclinical success of microbubble cavitation for enhancement of chemotherapy in abdominal tumors; however, there have been limited studies and variable efficacy in clinical implementation of this technique. This is likely because in contrast to the high pressures and long cycle lengths seen in successful preclinical work, current clinical implementation of microbubble cavitation for drug delivery generally involves low acoustic pressures and short cycle lengths to fit within clinical guidelines. To translate the preclinical parameter space to clinical adoption, a relevant safety study in a healthy large animal is required. Therefore, the purpose of this work was to evaluate the safety of ultrasound cavitation treatment (USCTx) in a healthy porcine model using a modified Philips EPIQ with S5-1 as the focused source. We performed USCTx on eight healthy pigs and monitored health over the course of 1 wk. We then performed an acute study of USCTx to evaluate immediate tissue damage. Contrast-enhanced ultrasound exams were performed before and after each treatment to investigate perfusion changes within the treated areas, and blood and urine were evaluated for liver damage biomarkers. We illustrate, through quantitative analysis of contrast-enhanced ultrasound data, blood and urine analyses and histology, that this technique and the parameter space considered are safe within the time frame evaluated. With its safety confirmed using a clinical-grade ultrasound scanner and contrast agent, USCTx could be easily translated into clinical trials for improvement of chemotherapy delivery. This represents the first safety study assessing the bio-effects of microbubble cavitation from relevant ultrasound parameters in a large animal model.
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Affiliation(s)
- Sara B Keller
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - Yak-Nam Wang
- Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Stephanie Totten
- Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Raymond S Yeung
- Department of Surgery, University of Washington, Seattle, Washington, USA
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11
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Choi W, Kim C. Synergistic agents for tumor-specific therapy mediated by focused ultrasound treatment. Biomater Sci 2021; 9:422-436. [PMID: 33211030 DOI: 10.1039/d0bm01364a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This minireview highlights the recent advances in the therapeutic agents that aim to provide synergistic enhancements of focused ultrasound treatment of tumors. Even though focused ultrasound therapy itself can bring therapeutic effects in cancers, many biochemical agents have been reported in the literature to enhance the treatment efficacy significantly. Until now, many mechanisms have been researched to advance the therapy, such as sonodynamic-plus-chemo-therapy, microbubble-aided therapy, localized release or delivery of nanomaterials, and multimodal image-guided therapy. Here, the novel materials adopted in each mechanism are briefly reviewed to provide a trend in the field and encourage future research towards the successful deployment of focused ultrasound therapy in real clinical environments.
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Affiliation(s)
- Wonseok Choi
- Departments of Electrical Engineering, Creative IT Engineering, Mechanical Engineering, Interdisciplinary Bioscience and Bioengineering, and Medical Device Innovation Center, Pohang University of Science and Technology (POSTECH), 37673 Republic of Korea.
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12
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Ji Y, Zhu J, Zhu L, Zhu Y, Zhao H. High-Intensity Focused Ultrasound Ablation for Unresectable Primary and Metastatic Liver Cancer: Real-World Research in a Chinese Tertiary Center With 275 Cases. Front Oncol 2020; 10:519164. [PMID: 33194582 PMCID: PMC7658544 DOI: 10.3389/fonc.2020.519164] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 09/29/2020] [Indexed: 12/12/2022] Open
Abstract
This retrospective analysis was conducted to evaluate the feasibility and safety of high-intensity focused ultrasound ablation for primary liver cancer and metastatic liver cancer. Patients with liver cancer who received high-intensity focused ultrasound were included in this analysis, including a primary liver cancer cohort (n=80) and a metastatic liver cancer cohort (n=195). The primary endpoint of our research was tumor response. The secondary endpoints included survival outcomes, visual analog scale pain scores, alpha-fetoprotein relief, and complications. Objective response rate and disease control rate were observed to be 71.8% and 81.2%, respectively, in patients with primary liver cancer and were 63.7% and 83.2% in cases with metastatic liver cancer. Alpha-fetoprotein levels and visual analogue scale levels significantly decreased after treatment compared with the baseline levels in patients with primary liver cancer (p<0.05). Median overall survival was estimated to be 13.0 and 12.0 months in the primary liver cancer and metastatic liver cancer cohorts. The 1-year survival rate was 70.69% and 48.00%, respectively. Multivariate regression analysis showed that visual analogue scale ≥ 5, longest diameter ≥ 5 cm, and portal vein invasion were the independent risk factors for poor survival in primary liver cancer. For patients with metastatic liver cancer, independent risk factors were identified as visual analogue scale ≥ 5, longest diameter ≥ 5 cm, existence of extrahepatic metastases, existence of portal vein invasion, and time to high-intensity focused ultrasound treatment from diagnosis < 3 months. Severe adverse events were rarely reported. In conclusion, high-intensity focused ultrasound might be an effective and safe option for patients with liver cancer regardless of primary and metastatic lesions.
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Affiliation(s)
| | | | | | | | - Hong Zhao
- HIFU Center of Oncology Department, Huadong Hospital Affiliated to Fudan University, Shanghai, China
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13
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Mikolajczyk A, Khosrawipour T, Kulas J, Migdal P, Arafkas M, Nicpon J, Khosrawipour V. The structural effect of high intensity ultrasound on peritoneal tissue: a potential vehicle for targeting peritoneal metastases. BMC Cancer 2020; 20:481. [PMID: 32460717 PMCID: PMC7254677 DOI: 10.1186/s12885-020-06981-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 05/20/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND High-intensity ultrasound (HIUS) has been increasingly investigated as a possible tool in the treatment of multiple tumor entities. However, there is only little knowledge on the effect of HIUS on the peritoneum. This preliminary study aims to investigate HIUS' potential for altering the peritoneal surface and potentially improving current treatments for peritoneal metastases. For this purpose, HIUS' qualitative and quantitative structural effects on the peritoneal tissue were analyzed by means of light, fluorescence and electron microscopy. METHODS Proportional sections were cut from the fresh postmortem swine peritoneum. Peritoneal surfaces were covered with a 6 mm thick liquid film of 0.9% NaCl. HIUS was applied in all tissue samples for 0 (control), 30, 60, 120 and 300 s. Peritoneal tissues were analyzed using light-, fluorescence and electron microscopy to detect possible structural changes within the tissues. RESULTS Following HIUS, a superficial disruption of peritoneal tissue was visible in light microscopy, which amplified with increased time of HIUS' application. Fluorescence microscopy showed both peritoneal and subperitoneal disruption with tissue gaps. Electron microscopy revealed structural filamentation of the peritoneal surface. CONCLUSION Our data indicate that HIUS causes a wide range of effects on the peritoneal tissue, including the formation of small ruptures in both peritoneal and subperitoneal tissues. However, according to our findings, these disruptions are limited to a microscopical level. Further studies are required to evaluate whether HIUS application can benefit current therapeutic regimens on peritoneal metastases and possibly enhance the efficacy of intraperitoneal chemotherapy.
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Affiliation(s)
- Agata Mikolajczyk
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, 50-375, Wroclaw, Poland
| | - Tanja Khosrawipour
- Division of Colorectal Surgery, Department of Surgery, University of California Irvine, California, 92868, USA.,Department of Surgery (A), University-Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Joanna Kulas
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, 50-375, Wroclaw, Poland
| | - Pawel Migdal
- Department of Environment, Hygiene and Animal Welfare, University of Environmental and Life Sciences, 51-631, Wroclaw, Poland
| | - Mohamed Arafkas
- Department of Plastic Surgery, Ortho-Klinik Dortmund, 44263, Dortmund, Germany
| | - Jakub Nicpon
- The Center of Experimental Diagnostics and Innovative Biomedical Technology, Wroclaw University of Environmental and Life Sciences, 50-375, Wroclaw, Poland
| | - Veria Khosrawipour
- Division of Colorectal Surgery, Department of Surgery, University of California Irvine, California, 92868, USA.
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14
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Yang T, Ng DM, Du N, He N, Dai X, Chen P, Wu F, Chen B, Fan X, Yan K, Zhou X, Dong M, Zheng Z, Gu L. HIFU for the treatment of difficult colorectal liver metastases with unsuitable indications for resection and radiofrequency ablation: a phase I clinical trial. Surg Endosc 2020; 35:2306-2315. [PMID: 32435962 DOI: 10.1007/s00464-020-07644-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 05/13/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND The goal of this study is to evaluate the safety and efficacy of high intensity focused ultrasound (HIFU) for patients with colorectal liver metastases (CRLM) but were contraindicated for resection and radiofrequency ablation. METHODS Patients between 20 and 80 years of age with 1-3 liver metastases from colorectal cancer were selected. Included patients have had their primary lesions removed with no evidence of extrahepatic metastasis prior to the study. Ultrasound-guided HIFU was employed and target regions' ablation was achieved with repeated sonications from the deep to shallow regions of the tumors section by section. RESULTS Thirteen patients were enrolled. The most common adverse events (AEs) were pain (n = 8), followed by fatigue (n = 7), increased aspartate aminotransferase (AST) (n = 7), increased alanine aminotransferase (ALT) (n = 5), and skin edema (n = 4). No grade ≥ 3 AEs occurred and while most patients (76.9%) achieved a complete response, three patients achieved a partial response. The objective response rate was 100% after the first HIFU treatment. Nine patients relapsed but the tumors were mostly isolated to the liver (8/9). The median follow-up period was 25 months. The 2-year progression-free survival (PFS) was 16.7%, and the median PFS was 9 months. Notably, the 2-year overall survival (OS) was 77.8%, and the median OS was 25 months. CONCLUSION This study indicates that the HIFU treatment is safe, is able to achieve a good tumor response rate and long-term prognosis even when the foci were in high-risk locations, and should be considered for patients who were considered unsuitable for other local treatments.
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Affiliation(s)
- Tong Yang
- Department of Tumor HIFU Therapy, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
- Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Haishu District, Northwest Street 41, Ningbo, 315010, Zhejiang, China
| | | | - Nannan Du
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ning He
- Department of Tumor HIFU Therapy, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Xiaoyu Dai
- Department of Anus and Intestine Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Ping Chen
- Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Haishu District, Northwest Street 41, Ningbo, 315010, Zhejiang, China
| | - Feng Wu
- Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Haishu District, Northwest Street 41, Ningbo, 315010, Zhejiang, China
| | - Bo Chen
- Department of Medical Image, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Xiaoxiang Fan
- Department of Interventional Therapy, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Kun Yan
- Department of Medical Image, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Xinfeng Zhou
- Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Haishu District, Northwest Street 41, Ningbo, 315010, Zhejiang, China
| | - Mingjun Dong
- Department of Anus and Intestine Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Zhi Zheng
- Department of Tumor HIFU Therapy, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Lihu Gu
- Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Haishu District, Northwest Street 41, Ningbo, 315010, Zhejiang, China.
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Haishu District, Northwest Street 41, Ningbo, 315010, Zhejiang, China.
- Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Haishu District, Northwest Street 41, Ningbo, 315010, Zhejiang, China.
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15
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Wu S, Zhang D, Yu J, Dou J, Li X, Mu M, Liang P. Chemotherapeutic Nanoparticle-Based Liposomes Enhance the Efficiency of Mild Microwave Ablation in Hepatocellular Carcinoma Therapy. Front Pharmacol 2020; 11:85. [PMID: 32174827 PMCID: PMC7054279 DOI: 10.3389/fphar.2020.00085] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/27/2020] [Indexed: 12/14/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the third leading cause of death from cancer, and the 5-year overall survival (OS) rate for HCC remains unsatisfying worldwide. Microwave ablation (MWA) is a minimally invasive therapy that has made progress in treating HCC. However, HCC recurrence remains problematic. Therefore, combination therapy may offer better outcomes and enhance MWA efficiency through improved tumor control. We have developed doxorubicin-loaded liposomes (DNPs) as an efficient nanoplatform to enhance MWA of hepatocellular carcinoma even at the mild ablation condition. In this study, we demonstrated that the uptake of DNPs by HCC cells was increased 1.5-fold compared with that of free DOX. Enhanced synergism was observed in the combination of DNPs and MWA, which induced nearly 80% cell death. The combination of mild MWA and DNPs enhanced the ablation efficiency of HCC with significant inhibition of liver tumors and accounted for the longest survival rate among all groups. A much higher accumulation of the DNPs was observed in the transitional zone than in the ablation zone. No apparent systemic toxicity was observed for any of the treatments after 14 days. The present work demonstrates that DNPs combined with MWA could be a promising nanoparticle-based therapeutic approach for the treatment of hepatocellular carcinoma and shows potential for future clinical applications.
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Affiliation(s)
- Songsong Wu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,Department of Ultrasonography, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Dongyun Zhang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jianping Dou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xin Li
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Mengjuan Mu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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16
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Kearns KN, Sokolowski JD, Chadwell K, Chandler M, Kiernan T, Prada F, Kalani MYS, Park MS. The role of contrast-enhanced ultrasound in neurosurgical disease. Neurosurg Focus 2019; 47:E8. [DOI: 10.3171/2019.9.focus19624] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 09/05/2019] [Indexed: 11/06/2022]
Abstract
Contrast-enhanced ultrasound (CEUS) is a relatively new imaging modality in the realm of neurosurgical disease. CEUS permits the examination of blood flow through arteries, veins, and capillaries via intravascular contrast agents and allows vascular architectural mapping with extreme sensitivity and specificity. While it has established utility in other organ systems such as the liver and kidneys, CEUS has not been studied extensively in the brain. This report presents a review of the literature on the neurosurgical applications of CEUS and provides an outline of the imaging modality’s role in the diagnosis, evaluation, and treatment of neurosurgical disease.
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Affiliation(s)
- Kathryn N. Kearns
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
| | - Jennifer D. Sokolowski
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
| | - Kimberly Chadwell
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
| | - Maureen Chandler
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
| | - Therese Kiernan
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
| | - Francesco Prada
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
- 2Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - M. Yashar S. Kalani
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
| | - Min S. Park
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
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17
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刘 敏, 谢 巍, 郑 维, 尹 丹, 罗 瑞, 郭 风. [Targeted binding of estradiol with ESR1 promotes proliferation of human chondrocytes in vitro by inhibiting activation of ERK signaling pathway]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 39:134-143. [PMID: 30890499 PMCID: PMC6765635 DOI: 10.12122/j.issn.1673-4254.2019.09.02] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the effect of estradiol (E2)/estrogen receptor 1 (ESR1) on the proliferation of human chondrocytes in vitro and explore the molecular mechanism. METHODS The Ad-Easy adenovirus packaging system was used to construct and package the ESR1-overexpressing adenovirus Ad-ESR1. Western blotting and qPCR were used to detect the expression of ESR1 protein and mRNA in human chondrocyte C28I2 cells. In the cells treated with different adenoviruses, the effects of E2 were tested on the expressions of proteins related with cell autophagy and apoptosis and the phosphorylation of ERK signaling pathway using Western blotting. Immunofluorescence assay was used to observe the intracellular autophagic flow, flow cytometry was performed to analyze the cell apoptosis rate and the cell cycle changes, and qPCR was used to detect the expressions of PCNA, cyclin B1 and cyclin D1 mRNAs. The inhibitory effect of the specific inhibitor of ERK on the expressions of autophagy- and apoptosis-related genes at both the protein and mRNA levels were detected using Western blotting and qPCR. RESULTS Transfection with the recombinant adenovirus overexpressing ESR1 and E2 treatment of C28I2 cells significantly enhanced the expressions of autophagy-related proteins LC3, ATG7, promoted the colocalization of LC3 and LAMP1 in the cytoplasm, increased the expressions of the proliferation-related marker genes PCNA, cyclin B1 and cyclin D1, and supressed the expressions of cleaved caspase-3, caspase-12 and pERK. RNA interference of ESR1 obviously lowered the expression levels of autophagy-related proteins in C28I2 cells, causing also suppression of the autophagic flow, increments of the expressions of apoptosis-related proteins and pERK, and down-regulated the expressions of the proliferation marker genes. Blocking ERK activation with the ERK inhibitor obviously inhibited the effects of E2/ESR1 on autophagy, proliferationrelated gene expressions and cell apoptosis. CONCLUSIONS The targeted binding of E2 with ESR1 promotes the proliferation of human chondrocytes in vitro possibly by inhibiting the activation of ERK signaling pathway to promote cell autophagy and induce cell apoptosis.
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Affiliation(s)
- 敏 刘
- />重庆医科大学基础医学院细胞生物学与遗传学教研室//发育生物学与模式动物平台,重庆 400016Department of Cell Biology and Genetics, Core Facility of Development Biology, Basic Medical Science of Chongqing Medical University, Chongqing 400016, China
| | - 巍伟 谢
- />重庆医科大学基础医学院细胞生物学与遗传学教研室//发育生物学与模式动物平台,重庆 400016Department of Cell Biology and Genetics, Core Facility of Development Biology, Basic Medical Science of Chongqing Medical University, Chongqing 400016, China
| | - 维 郑
- />重庆医科大学基础医学院细胞生物学与遗传学教研室//发育生物学与模式动物平台,重庆 400016Department of Cell Biology and Genetics, Core Facility of Development Biology, Basic Medical Science of Chongqing Medical University, Chongqing 400016, China
| | - 丹旸 尹
- />重庆医科大学基础医学院细胞生物学与遗传学教研室//发育生物学与模式动物平台,重庆 400016Department of Cell Biology and Genetics, Core Facility of Development Biology, Basic Medical Science of Chongqing Medical University, Chongqing 400016, China
| | - 瑞 罗
- />重庆医科大学基础医学院细胞生物学与遗传学教研室//发育生物学与模式动物平台,重庆 400016Department of Cell Biology and Genetics, Core Facility of Development Biology, Basic Medical Science of Chongqing Medical University, Chongqing 400016, China
| | - 风劲 郭
- />重庆医科大学基础医学院细胞生物学与遗传学教研室//发育生物学与模式动物平台,重庆 400016Department of Cell Biology and Genetics, Core Facility of Development Biology, Basic Medical Science of Chongqing Medical University, Chongqing 400016, China
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