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Young S, Rostambeigi N, Golzarian J. The Common but Complicated Tool: Review of Embolic Materials for the Interventional Radiologist. Semin Intervent Radiol 2021; 38:535-541. [PMID: 34853499 PMCID: PMC8612830 DOI: 10.1055/s-0041-1736658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Embolization is an important and widely utilized technique in interventional radiology. There are a variety of different categories and individual products which can be utilized to perform embolization. Understanding the different classes of embolic agents, the important features of each of these classes including strengths and limitations, and the variation in individual products within the classes is critical for interventional radiologist to practice safely and effectively. This article reviews the different kinds of embolics and relays some of the pertinent physical and chemical properties of individual products which should be considered when determining which embolic to select for a given purpose.
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Affiliation(s)
- Shamar Young
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Nassir Rostambeigi
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Jafar Golzarian
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, Minnesota
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2
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Nix HP, Momeni A, Chevrier DM, Whitman CA, Filiaggi MJ. Doxorubicin-loaded polyphosphate glass microspheres for transarterial chemoembolization. J Biomed Mater Res B Appl Biomater 2020; 108:2621-2632. [PMID: 32100967 DOI: 10.1002/jbm.b.34594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/08/2020] [Accepted: 02/15/2020] [Indexed: 11/12/2022]
Abstract
The standard of care for intermediate stage hepatocellular carcinoma is transarterial chemoembolization (TACE). Drug-eluting bead TACE (DEB-TACE) has emerged as a leading form of TACE, as it uses highly calibrated microspheres to deliver consistent embolization and controlled drug release to the tumor microenvironment. We report here on doxorubicin (DOX)-loaded polyphosphate glass microspheres (PGM) as a novel resorbable, radiopaque, preloaded DEB-TACE platform. Coacervate composed of polyphosphate chains complexed with Ba2+ , Ca2+ , and Cu2+ can be loaded with DOX prior to PGM synthesis, with PGM production achieved using a water-in-oil emulsion technique at room temperature yielding highly spherical particles in clinically relevant size fractions. In vitro, DOX release was found to be linear, pH dependent, and in accordance with Type II non-Fickian transport. PGM degradation was characterized by an initial burst release of degradation products over 7 days, followed by a plateau in mass loss at approximately 75% over a period of several weeks. in vitro studies indicate that PGM degradation products, namely Cu2+ , are cytotoxic and may interact with eluted DOX to impair its pharmacological activity. With additional compositional considerations, this approach may prove promising for DEB-TACE applications.
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Affiliation(s)
- Hayden P Nix
- School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Arash Momeni
- School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Applied Oral Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel M Chevrier
- Department of Applied Oral Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Catherine A Whitman
- Department of Applied Oral Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mark J Filiaggi
- School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Applied Oral Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
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3
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Fiorentini G, Sarti D, Nani R, Aliberti C, Fiorentini C, Guadagni S. Updates of colorectal cancer liver metastases therapy: review on DEBIRI. Hepat Oncol 2020; 7:HEP16. [PMID: 32273974 PMCID: PMC7137176 DOI: 10.2217/hep-2019-0010] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Colorectal cancer is a worldwide public health issue, presenting an advanced stage at diagnosis in more than 20% of patients. Liver metastases are the most common metastatic sites and are not indicated for resection in 80% of cases. Unresectable colorectal cancer liver metastases that are refractory to systemic chemotherapy may benefit from transarterial chembolization with irinotecan-loaded beads (DEBIRI). Several studies show the safety and efficacy of DEBIRI for the treatment of colorectal cancer liver metastases. The development of transarterial chembolization and the introduction of new embolics have contributed to better outcomes of DEBIRI. This article reviews the current literature on DEBIRI reporting its use, efficacy in terms of tumor response and survival and side effects.
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Affiliation(s)
- Giammaria Fiorentini
- Onco-Hematology Department, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', 61122 Pesaro, Italy
| | - Donatella Sarti
- Onco-Hematology Department, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', 61122 Pesaro, Italy
| | - Roberto Nani
- Department of Radiology, University Milano Bicocca, ASST Papa Giovanni XXIII, Piazza OMS - Organizzazione Mondiale della Sanità 1, 24127 Bergamo, Italy
| | - Camillo Aliberti
- Oncology Radiodiagnostics Department, Oncology Institute of Veneto, Institute for the Research & Treatment of Cancer, 35128 Padova, Italy
| | - Caterina Fiorentini
- Department of Medical Biothecnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
| | - Stefano Guadagni
- Department of Applied Clinical Sciences & Biotechnology, Section of General Surgery, University of L'Aquila, via Vetoio 67100 L'Aquila, Italy
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Zeng J, Li L, Zhang H, Li J, Liu L, Zhou G, Du Q, Zheng C, Yang X. Radiopaque and uniform alginate microspheres loaded with tantalum nanoparticles for real-time imaging during transcatheter arterial embolization. Theranostics 2018; 8:4591-4600. [PMID: 30279724 PMCID: PMC6160769 DOI: 10.7150/thno.27379] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 07/31/2018] [Indexed: 12/11/2022] Open
Abstract
One restriction to the development and application of transcatheter arterial chemoembolization (TACE) therapy is the lack of an inherently radiopaque embolic whose location and distribution can be precisely visualized in real time and be used for non-invasive examination after surgery. Methods: A one-step electrospray method was developed to fabricate calcium alginate microspheres loaded with tantalum nanoparticles (Ta@CaAlg). The parameters of electrospraying were assessed. The in vivo X-ray imaging capability and embolic effect of Ta@CaAlg microspheres were evaluated in the renal arteries of normal rabbits by digital radiography and computed tomography. Doxorubicin hydrochloride (Dox) was chosen as a model drug, and the drug loading capacity and release behavior of these microspheres was valuated in vitro.Results: Spherical Ta@CaAlg microspheres with monodisperse sizes ranging from 150 to 1200 μm were fabricated by electrospraying. The results of an in vivo study showed that Ta@CaAlg microspheres possessed the qualities of both embolic agents and contrast media. They could not only feed back the real-time location and distribution of the embolic microspheres but also maintained clear X-ray imaging of embolized sites for up to 4 weeks as assessed by digital radiography and computed tomography. Digital subtraction angiography showed that they had an excellent embolic effect. Ta@CaAlg microspheres could be loaded with Dox to form "3-in-1" embolic microspheres. The maximum Dox loading was 97.3 mg Dox per mL beads and loaded microspheres exhibited pH-dependent release profiles. Conclusion: The X-ray opacity and drug-loading capability of Ta@CaAlg microspheres offers great promise in direct, real-time, in vivo investigation for TACE and long-term non-invasive re-examination.
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Affiliation(s)
- Jian Zeng
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Ling Li
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Hongsen Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022, Wuhan, China
| | - Jianye Li
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Lingli Liu
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Guofeng Zhou
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022, Wuhan, China
| | - Qing Du
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022, Wuhan, China
| | - Xiangliang Yang
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, 430074, Wuhan, China
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Aliberti C, Carandina R, Sarti D, Pizzirani E, Ramondo G, Cillo U, Guadagni S, Fiorentini G. Transarterial chemoembolization with DC Bead LUMI™ radiopaque beads for primary liver cancer treatment: preliminary experience. Future Oncol 2017; 13:2243-2252. [DOI: 10.2217/fon-2017-0364] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Aim: Primary objectives of the study were to assess the safety of transarterial chemoembolization (TACE) using DC Bead LUMI™ for the treatment of hepatocellular carcinoma and beads distribution after TACE. Patients/methods: This was a prospective observational cohort study. The study included 44 hepatocellular carcinoma patients who were treated with TACE using DC Bead LUMI. Beads distribution was monitored 1 h after TACE by CT scan. Results: TACE had no intraprocedural complications. Observed side effects were of mild intensity and included pain in 5 (11%), fever in 4 (9%) and vomiting in 2 (5%) patients. Most patients (89%) reported no adverse event. Non-target distribution was observed in only two cases (5%). Conclusion: DC Bead LUMI allowed assessing in real time their distribution. This could prevent non-target infusion and reduce toxicity.
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Affiliation(s)
- Camillo Aliberti
- Oncology Radiodiagnostics Department, Oncology Institute of Veneto, Institute for the Research & Treatment of Cancer (IRCC), 35128 Padova, Italy
| | - Riccardo Carandina
- Oncology Radiodiagnostics Department, Oncology Institute of Veneto, Institute for the Research & Treatment of Cancer (IRCC), 35128 Padova, Italy
| | - Donatella Sarti
- Onco-Ematology Department, Azienda Ospedaliera ‘Ospedali Riuniti Marche Nord’, 61122 Pesaro, Italy
| | - Enrico Pizzirani
- Oncology Radiodiagnostics Department, Oncology Institute of Veneto, Institute for the Research & Treatment of Cancer (IRCC), 35128 Padova, Italy
| | - Gaetano Ramondo
- Oncology Radiodiagnostics Department, Oncology Institute of Veneto, Institute for the Research & Treatment of Cancer (IRCC), 35128 Padova, Italy
| | - Umberto Cillo
- Surgical and Gastroenterological Sciences Dept, University of Padova, 35128 Padova, Italy
| | - Stefano Guadagni
- Department of Applied Clinical Sciences & Biotechnology, University of L'Aquila, 7100 L'Aquila, AQ, Italy, and Alma Mater Europaea – ECM, Slovenska ulica 17, Maribor, Slovenja
| | - Giammaria Fiorentini
- Onco-Ematology Department, Azienda Ospedaliera ‘Ospedali Riuniti Marche Nord’, 61122 Pesaro, Italy
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Kilcup N, Gaynard S, Werner-Zwanziger U, Tonkopi E, Hayes J, Boyd D. Stimulation of apoptotic pathways in liver cancer cells: An alternative perspective on the biocompatibility and the utility of biomedical glasses. J Biomater Appl 2015; 30:1445-59. [DOI: 10.1177/0885328215621663] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A host of research opportunities with innumerable clinical applications are open to biomedical glasses if one considers their potential as therapeutic inorganic ion delivery systems. Generally, applications have been limited to repair and regeneration of hard tissues while compositions are largely constrained to the original bioactive glass developed in the 1960s. However, in oncology applications the therapeutic paradigm shifts from repair to targeted destruction. With this in mind, the composition–structure–property–function relationships of vanadium-containing zinc-silicate glasses (0.51SiO2–0.29Na2O–(0.20- X)ZnO– XV2O5, 0 ≤ X ≤ 0.09) were characterized in order to determine their potential as therapeutic inorganic ion delivery systems. Increased V2O5 mole fraction resulted in a linear decrease in density and glass transition temperature (Tg). 29Si MAS NMR peak maxima shifted upfield while 51V MAS NMR peak maxima were independent of V2O5 content and overlapped well with the spectra NaVO3. Increased V2O5 mole fraction caused ion release to increase. When human liver cancer cells, HepG2, were exposed to these ions they demonstrated a concentration-dependent cytotoxic response, mediated by apoptosis. This work demonstrates that the zinc-silicate system studied herein is capable of delivering therapeutic inorganic ions at concentrations that induce apoptotic cell death and provide a simple means to control therapeutic inorganic ion delivery.
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Affiliation(s)
- Nancy Kilcup
- School of Biomedical Engineering, Dalhousie University, Halifax, Canada
| | - Seán Gaynard
- Regenerative Medicine Institute, Bioscience Research Building, National University of Ireland Galway, Galway, Ireland
| | - Ulrike Werner-Zwanziger
- Department of Chemistry and Institute for Research in Materials, Dalhousie University, Halifax, Canada
| | - Elena Tonkopi
- Department of Diagnostic Imaging and Interventional Radiology, QEII Health Sciences Centre, Victoria General Hospital, Victoria Building, Halifax, Canada
- Department of Diagnostic Radiology, Dalhousie University, Halifax, Canada
| | - Jessica Hayes
- Regenerative Medicine Institute, Bioscience Research Building, National University of Ireland Galway, Galway, Ireland
| | - Daniel Boyd
- School of Biomedical Engineering, Dalhousie University, Halifax, Canada
- Department of Diagnostic Imaging and Interventional Radiology, QEII Health Sciences Centre, Victoria General Hospital, Victoria Building, Halifax, Canada
- Department of Applied Oral Sciences, Dentistry Building, Dalhousie University, Halifax, Canada
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