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Lin J, Wu Y, Liu G, Cui R, Xu Y. Advances of ultrasound in tumor immunotherapy. Int Immunopharmacol 2024; 134:112233. [PMID: 38735256 DOI: 10.1016/j.intimp.2024.112233] [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: 01/09/2024] [Revised: 04/11/2024] [Accepted: 05/07/2024] [Indexed: 05/14/2024]
Abstract
Immunotherapy has become a revolutionary method for treating tumors, offering new hope to cancer patients worldwide. Immunotherapy strategies such as checkpoint inhibitors, chimeric antigen receptor T-cell (CAR-T) therapy, and cancer vaccines have shown significant potential in clinical trials. Despite the promising results, there are still limitations that impede the overall effectiveness of immunotherapy; the response to immunotherapy is uneven, the response rate of patients is still low, and systemic immune toxicity accompanied with tumor cell immune evasion is common. Ultrasound technology has evolved rapidly in recent years and has become a significant player in tumor immunotherapy. The introductions of high intensity focused ultrasound and ultrasound-stimulated microbubbles have opened doors for new therapeutic strategies in the fight against tumor. This paper explores the revolutionary advancements of ultrasound combined with immunotherapy in this particular field.
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Affiliation(s)
- Jing Lin
- Department of Ultrasound, Guangdong Provincial Hospital of Chinese Medicine-Zhuhai Hospital, Zhuhai, PR China.
| | - Yuwei Wu
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Taipa, Macao, PR China
| | - Guangde Liu
- Department of Ultrasound, Guangdong Provincial Hospital of Chinese Medicine-Zhuhai Hospital, Zhuhai, PR China
| | - Rui Cui
- Department of Ultrasonography, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, PR China; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, PR China
| | - Youhua Xu
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Taipa, Macao, PR China; Macau University of Science and Technology Zhuhai MUST Science and Technology Research Institute, Hengqin, Zhuhai, PR China.
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2
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Falatah HA, Lacerda Q, Wessner CE, Lo S, Wheatley MA, Liu JB, Eisenbrey JR. Influence of Phase Change Droplet Activation and Microbubble Cavitation on the Microenvironment of Hepatocellular Carcinoma. ULTRASOUND IN MEDICINE & BIOLOGY 2024:S0301-5629(24)00220-5. [PMID: 38876912 DOI: 10.1016/j.ultrasmedbio.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/07/2024] [Accepted: 05/15/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE Both microbubble ultrasound contrast agents and acoustic phase change droplets (APCD) have been explored in hepatocellular carcinoma (HCC). This work aimed to evaluate changes to the HCC microenvironment following either microbubble or APCD destruction in a syngeneic pre-clinical model. METHODS Mouse RIL-175 HCC tumors were grown in the right flank of 64 immunocompetent mice. Pre-treatment, photoacoustic volumetric tumor oxygenation, and power Doppler measurements were obtained using a Vevo 3100 system (VisualSonics, Toronto, Canada). The experimental groups received a 0.1 mL bolus injection of either Definity ultrasound contrast agent (Lantheus Medical Imaging) or APCD fabricated by condensing Definity. Following injection, ultrasound destruction was performed using flash-replenishment sequences on a Sequoia with a 10L4 probe (Siemens) for the duration of enhancement. Tumor oxygenation and power Doppler measurements were then repeated immediately post-ultrasound treatment. Twenty-four hours post-treatment, animals were euthanized, and tumors were harvested and stained for CD31, Cleaved Caspase 3 and CD45. RESULTS Imaging biomarkers demonstrated a significant reduction in percent vascularity following either microbubble or APCD destruction in the tumor microenvironment ( p < 0.022) but no significant changes in tumor oxygenation (p = 0.12). Similarly, immunohistochemistry data demonstrated a significant decrease in CD31 expression (p < 0.042) and an increase in apoptosis (p < 0.014) in tumors treated with destroyed microbubbles or APCD relative to controls. Finally, a significant increase in CD45 expression was observed in tumors treated with APCD (p = 0.046), indicating an increase in tumor immune response. CONCLUSION Ultrasound-triggered destruction of both microbubbles and APCD reduces vascularity, increases apoptosis, and may also increase immune response in this HCC model.
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Affiliation(s)
- Hebah A Falatah
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA; School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA; College of Applied Medical Sciences King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Quezia Lacerda
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA; School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA
| | - Corinne E Wessner
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA; School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA
| | - Standley Lo
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Margaret A Wheatley
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA
| | - Ji-Bin Liu
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - John R Eisenbrey
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA.
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Fu M, Wang Y, Wang J, Hao Y, Zeng F, Zhang Z, Du J, Long H, Yan F. Genetic Modulation of Biosynthetic Gas Vesicles for Ultrasound Imaging. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024:e2310008. [PMID: 38533968 DOI: 10.1002/smll.202310008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/11/2024] [Indexed: 03/28/2024]
Abstract
Gas vesicles (GVs) from microorganisms are genetically air-filled protein nanostructures, and serve as a new class of nanoscale contrast agents for ultrasound imaging. Recently, the genetically encoded GV gene clusters have been heterologously expressed in Escherichia coli, allowing these genetically engineered bacteria to be visualized in vivo in a real-time manner by ultrasound. However, most of the GV genes remained functionally uncharacterized, which makes it difficult to regulate and modify GVs for broad medical applications. Here, the impact of GV proteins on GV formation is systematically investigated. The results first uncovered that the deletions of GvpR or GvpU resulted in the formation of a larger proportion of small, biconical GVs compared to the full-length construct, and the deletion of GvpT resulted in a larger portion of large GVs. Meanwhile, the combination of gene deletions has resulted in several genotypes of ultrasmall GVs that span from 50 to 20 nm. Furthermore, the results showed that E. coli carrying the ΔGvpCRTU mutant can produce strong ultrasound contrast signals in mouse liver. In conclusion, the study provides new insights into the roles of GV proteins in GV formation and produce ultrasmall GVs with a wide range of in vivo research.
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Affiliation(s)
- Meijun Fu
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yuanyuan Wang
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Jieqiong Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 201206, China
| | - Yongsheng Hao
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Fengyi Zeng
- Department of Ultrasound, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518061, China
| | | | - Jianxiong Du
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Huan Long
- Key Laboratory of Algal Biology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, Hubei Province, 430072, China
| | - Fei Yan
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
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Shakya G, Cattaneo M, Guerriero G, Prasanna A, Fiorini S, Supponen O. Ultrasound-responsive microbubbles and nanodroplets: A pathway to targeted drug delivery. Adv Drug Deliv Rev 2024; 206:115178. [PMID: 38199257 DOI: 10.1016/j.addr.2023.115178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/21/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024]
Abstract
Ultrasound-responsive agents have shown great potential as targeted drug delivery agents, effectively augmenting cell permeability and facilitating drug absorption. This review focuses on two specific agents, microbubbles and nanodroplets, and provides a sequential overview of their drug delivery process. Particular emphasis is given to the mechanical response of the agents under ultrasound, and the subsequent physical and biological effects on the cells. Finally, the state-of-the-art in their pre-clinical and clinical implementation are discussed. Throughout the review, major challenges that need to be overcome in order to accelerate their clinical translation are highlighted.
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Affiliation(s)
- Gazendra Shakya
- Institute of Fluid Dynamics, D-MAVT, Sonneggstrasse 3, ETH Zurich, Zurich, 8092, Switzerland
| | - Marco Cattaneo
- Institute of Fluid Dynamics, D-MAVT, Sonneggstrasse 3, ETH Zurich, Zurich, 8092, Switzerland
| | - Giulia Guerriero
- Institute of Fluid Dynamics, D-MAVT, Sonneggstrasse 3, ETH Zurich, Zurich, 8092, Switzerland
| | - Anunay Prasanna
- Institute of Fluid Dynamics, D-MAVT, Sonneggstrasse 3, ETH Zurich, Zurich, 8092, Switzerland
| | - Samuele Fiorini
- Institute of Fluid Dynamics, D-MAVT, Sonneggstrasse 3, ETH Zurich, Zurich, 8092, Switzerland
| | - Outi Supponen
- Institute of Fluid Dynamics, D-MAVT, Sonneggstrasse 3, ETH Zurich, Zurich, 8092, Switzerland.
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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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Abstract
The conventional microbubble-based ultrasound biomedicine clinically plays a vital role in providing the dynamic detection of macro and microvasculature and disease theranostics. However, the intrinsic limitation of particle size severely decreases the treatment effectiveness due to their vascular transport characteristics, which promotes the development and application of multifunctional ultrasound-responsive nanomaterials. Herein, we put forward a research field of "ultrasound nanomedicine and materdicine", referring to the interdiscipline of ultrasound, nanobiotechnology and materials, which seeks to produce specific biological effects for addressing the challenges faced and dilemma of conventional ultrasound medicine. We comprehensively summarize the state-of-the-art scientific advances in the latest progress in constructing ultrasound-based platforms and ultrasound-activated sonosensitizers, ranging from the synthesis strategies, biological functions to ultrasound-triggered therapeutic applications. Ultimately, the unresolved challenges and clinical-translation potentials of ultrasound nanomedicine and materdicine are discussed and prospected in this evolving field.
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Affiliation(s)
- Zeyu Wang
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China.
| | - Xue Wang
- Department of Shanghai Lung Cancer Center, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, P. R. China
| | - Meiqi Chang
- Central Laboratory of Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P. R. China.
| | - Jia Guo
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, P. R. China.
| | - Yu Chen
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China.
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7
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Microbubbles for human diagnosis and therapy. Biomaterials 2023; 294:122025. [PMID: 36716588 DOI: 10.1016/j.biomaterials.2023.122025] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 01/26/2023]
Abstract
Microbubbles (MBs) were observed for the first time in vivo as a curious consequence of quick saline injection during ultrasound (US) imaging of the aortic root, more than 50 years ago. From this serendipitous event, MBs are now widely used as contrast enhancers for US imaging. Their intrinsic properties described in this review, allow a multitude of designs, from shell to gas composition but also from grafting targeting agents to drug payload encapsulation. Indeed, the versatile MBs are deeply studied for their dual potential in imaging and therapy. As presented in this paper, new generations of MBs now opens perspectives for targeted molecular imaging along with the development of new US imaging systems. This review also presents an overview of the different therapeutic strategies with US and MBs for cancer, cardiovascular diseases, and inflammation. The overall aim is to overlap those fields in order to find similarities in the MBs application for treatment enhancement associated with US. To conclude, this review explores the new scales of MBs technologies with nanobubbles development, and along concurrent advances in the US imaging field. This review ends by discussing perspectives for the booming future uses of MBs.
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8
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Xu M, Long W, Ling X, Hu X, Hong H, Peng Y, Cai T. Multifunctional theragnostic ultrasmall gold nanodot-encapsuled perfluorocarbon nanodroplets for laser-focused ultrasound sequence irradiation (LFSI)-based enhanced tumor ablation. J Mater Chem B 2022; 10:9816-9829. [PMID: 36426923 DOI: 10.1039/d2tb01775j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Despite the substantial potential of focused ultrasound therapy, its efficacy in cancer therapy has been limited due to the high cavitation threshold and safety concerns regarding the use of high-intensity energy pulses. Here, ultrasmall Au nanodot-loaded PEG-modified perfluorocarbon nanodroplets (Au-PFCnDs) were prepared and used as a therapeutic enhancer. A LFSI method was designed to achieve enhanced tumor ablation at a mild focused ultrasound (FUS) energy pulse with the assistance of the instinct photothermal effect of intratumor-permeable ultrasmall Au nanodots under 808 nm NIR laser irradiation. In addition to their therapeutic function, Au-PFCnDs can also generate multimodal images to provide information for tumor surveillance and treatment guidance. The experimental results also showed that the cRGD-targeted Au-PFCnDs could be more efficiently delivered into the tumor and selectively destroy tumors with no observable side effects on normal tissue under LFSI treatment.
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Affiliation(s)
- Menghan Xu
- State Key Laboratory of Natural Medicines, Department of Pharmaceutics, China Pharmaceutical University, Nanjing 210009, China.
| | - Wei Long
- State Key Laboratory of Natural Medicines, Department of Pharmaceutics, China Pharmaceutical University, Nanjing 210009, China.
| | - Xiang Ling
- State Key Laboratory of Natural Medicines, Department of Pharmaceutics, China Pharmaceutical University, Nanjing 210009, China.
| | - Xiongwei Hu
- State Key Laboratory of Natural Medicines, Department of Pharmaceutics, China Pharmaceutical University, Nanjing 210009, China.
| | - Hao Hong
- State Key Laboratory of Pharmaceutical Biotechnology, Jiangsu Key Laboratory of Molecular Medicine and School of Medicine, Medical School of Nanjing University, Nanjing 210093, China
| | - Yayun Peng
- State Key Laboratory of Natural Medicines, Department of Pharmaceutics, China Pharmaceutical University, Nanjing 210009, China.
| | - Ting Cai
- State Key Laboratory of Natural Medicines, Department of Pharmaceutics, China Pharmaceutical University, Nanjing 210009, China.
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9
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Barzegar-Fallah A, Gandhi K, Rizwan SB, Slatter TL, Reynolds JNJ. Harnessing Ultrasound for Targeting Drug Delivery to the Brain and Breaching the Blood–Brain Tumour Barrier. Pharmaceutics 2022; 14:pharmaceutics14102231. [PMID: 36297666 PMCID: PMC9607160 DOI: 10.3390/pharmaceutics14102231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/11/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Despite significant advances in developing drugs to treat brain tumours, achieving therapeutic concentrations of the drug at the tumour site remains a major challenge due to the presence of the blood–brain barrier (BBB). Several strategies have evolved to enhance brain delivery of chemotherapeutic agents to treat tumours; however, most approaches have several limitations which hinder their clinical utility. Promising studies indicate that ultrasound can penetrate the skull to target specific brain regions and transiently open the BBB, safely and reversibly, with a high degree of spatial and temporal specificity. In this review, we initially describe the basics of therapeutic ultrasound, then detail ultrasound-based drug delivery strategies to the brain and the mechanisms by which ultrasound can improve brain tumour therapy. We review pre-clinical and clinical findings from ultrasound-mediated BBB opening and drug delivery studies and outline current therapeutic ultrasound devices and technologies designed for this purpose.
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Affiliation(s)
- Anita Barzegar-Fallah
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand
- Brain Health Research Centre, University of Otago, Dunedin 9016, New Zealand
| | - Kushan Gandhi
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand
- Brain Health Research Centre, University of Otago, Dunedin 9016, New Zealand
| | - Shakila B. Rizwan
- Brain Health Research Centre, University of Otago, Dunedin 9016, New Zealand
- School of Pharmacy, University of Otago, Dunedin 9016, New Zealand
| | - Tania L. Slatter
- Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin 9016, New Zealand
| | - John N. J. Reynolds
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand
- Brain Health Research Centre, University of Otago, Dunedin 9016, New Zealand
- Correspondence: ; Tel.: +64-3-479-5781; Fax: +64-3-479-7254
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Yamamoto K, Sarica C, Loh A, Vetkas A, Samuel N, Milano V, Zemmar A, Germann J, Cheyuo C, Boutet A, Elias GJ, Ito H, Taira T, Lozano AM. Magnetic resonance-guided focused ultrasound for the treatment of tremor. Expert Rev Neurother 2022; 22:849-861. [PMID: 36469578 DOI: 10.1080/14737175.2022.2147826] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Magnetic resonance-guided focused ultrasound (MRgFUS) is an emerging treatment for tremor and other movement disorders. An incisionless therapy, it is becoming increasingly common worldwide. However, given MRgFUS' relative novelty, there remain limited data on its benefits and adverse effects. AREAS COVERED We review the current state of evidence of MRgFUS for tremor, highlight its challenges, and discuss future perspectives. EXPERT OPINION Essential tremor (ET) has been the major indication for MRgFUS since a milestone randomized controlled trial (RCT) in 2016, with substantial evidence attesting to the efficacy and acceptable safety profile of this treatment. Patients with other tremor etiologies are also being treated with MRgFUS, with studies - including an RCT - suggesting parkinsonian tremor in particular responds well to this intervention. Additionally, targets other than the ventral intermediate nucleus, such as the subthalamic nucleus and internal segment of the globus pallidus, have been reported to improve parkinsonian symptoms beyond tremor, including rigidity and bradykinesia. Although MRgFUS is encumbered by certain unique technical challenges, it nevertheless offers significant advantages compared to alternative neurosurgical interventions for tremor. The fast-growing interest in this treatment modality will likely lead to further scientific and technological advancements that could optimize and expand its therapeutic potential.
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Affiliation(s)
- Kazuaki Yamamoto
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada
| | - Can Sarica
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada
| | - Aaron Loh
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada
| | - Artur Vetkas
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada.,Department of Neurosurgery, School of Medicine, University of Tartu, Estonia
| | - Nardin Samuel
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada
| | - Vanessa Milano
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada
| | - Ajmal Zemmar
- Department of Neurosurgery, University of Louisville, School of Medicine, KY, USA.,Department of Neurosurgery, Henan University People's Hospital, Henan University School of Medicine, China
| | - Jürgen Germann
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada
| | - Cletus Cheyuo
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada
| | - Alexandre Boutet
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada.,Joint Department of Medical Imaging, University of Toronto, Ontario, Canada
| | - Gavin Jb Elias
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada
| | - Hisashi Ito
- Department of Neurology, Shonantobu General Hospital, Japan.,Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Takaomi Taira
- Department of Neurosurgery, Tokyo Women's Medical University, Japan
| | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada.,Krembil Research Institute, Toronto, Ontario, Canada
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11
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Welch PJ, Li DS, Forest CR, Pozzo LD, Shi C. Perfluorocarbon nanodroplet size, acoustic vaporization, and inertial cavitation affected by lipid shell composition in vitro. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:2493. [PMID: 36319242 PMCID: PMC9812515 DOI: 10.1121/10.0014934] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/17/2022] [Accepted: 10/04/2022] [Indexed: 05/25/2023]
Abstract
Perfluorocarbon nanodroplets (PFCnDs) are ultrasound contrast agents that phase-transition from liquid nanodroplets to gas microbubbles when activated by laser irradiation or insonated with an ultrasound pulse. The dynamics of PFCnDs can vary drastically depending on the nanodroplet composition, including the lipid shell properties. In this paper, we investigate the effect of varying the ratio of PEGylated to non-PEGylated phospholipids in the outer shell of PFCnDs on the acoustic nanodroplet vaporization (liquid to gas phase transition) and inertial cavitation (rapid collapse of the vaporized nanodroplets) dynamics in vitro when insonated with focused ultrasound. Nanodroplets with a high concentration of PEGylated lipids had larger diameters and exhibited greater variance in size distribution compared to nanodroplets with lower proportions of PEGylated lipids in the lipid shell. PFCnDs with a lipid shell composed of 50:50 PEGylated to non-PEGylated lipids yielded the highest B-mode image intensity and duration, as well as the greatest pressure difference between acoustic droplet vaporization onset and inertial cavitation onset. We demonstrate that slight changes in lipid shell composition of PFCnDs can significantly impact droplet phase transitioning and inertial cavitation dynamics. These findings can help guide researchers to fabricate PFCnDs with optimized compositions for their specific applications.
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Affiliation(s)
- Phoebe J Welch
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | | | - Craig R Forest
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | - Lilo D Pozzo
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, USA
| | - Chengzhi Shi
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332, USA
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12
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Kagami S, Kanagawa T. Weakly nonlinear propagation of focused ultrasound in bubbly liquids with a thermal effect: Derivation of two cases of Khokolov-Zabolotskaya-Kuznetsoz equations. ULTRASONICS SONOCHEMISTRY 2022; 88:105911. [PMID: 35810619 PMCID: PMC9696949 DOI: 10.1016/j.ultsonch.2022.105911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 05/06/2023]
Abstract
A physico-mathematical model composed of a single equation that consistently describes nonlinear focused ultrasound, bubble oscillations, and temperature fluctuations is theoretically proposed for microbubble-enhanced medical applications. The Khokhlov-Zabolotskaya-Kuznetsov (KZK) equation that has been widely used as a simplified model for nonlinear propagation of focused ultrasound in pure liquid is extended to that in liquid containing many spherical microbubbles, by applying the method of multiple scales to the volumetric averaged basic equations for bubbly liquids. As a result, for two-dimensional and three-dimensional cases, KZK equations composed of the linear combination of nonlinear, dissipation, dispersion, and focusing terms are derived. Especially, the dissipation term depends on three factors, i.e., interfacial liquid viscosity, liquid compressibility, and thermal conductivity of gas inside bubbles; the thermal conduction is evaluated by using four types of temperature gradient models. Finally, we numerically solve the derived KZK equation and show a moderate temperature rise appropriate to medical applications.
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Affiliation(s)
- Shunsuke Kagami
- Department of Engineering Mechanics and Energy, Graduate School of Systems and Information Engineering, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8573, Japan
| | - Tetsuya Kanagawa
- Department of Engineering Mechanics and Energy, Faculty of Engineering, Information and Systems, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8573, Japan.
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13
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Durham PG, Kim J, Eltz KM, Caskey CF, Dayton PA. Polyvinyl Alcohol Cryogels for Acoustic Characterization of Phase-Change Contrast Agents. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:954-960. [PMID: 35246338 PMCID: PMC9012345 DOI: 10.1016/j.ultrasmedbio.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 01/10/2022] [Accepted: 01/14/2022] [Indexed: 05/03/2023]
Abstract
Phase-change contrast agents (PCCAs) consisting of lipid-encapsulated low-boiling-point perfluorocarbons can be used in conjunction with ultrasound for diagnostic and therapeutic applications. One benefit of PCCAs is site-specific activation, whereby the liquid core is acoustically vaporized into a bubble detectable via ultrasound imaging. For further evaluation of PCCAs in a variety of applications, it is useful to disperse these nanodroplets into an acoustically compatible stationary matrix. However, many traditional phantom preparations require heating, which causes premature thermal activation of low-boiling-point PCCAs. Polyvinyl alcohol (PVA) cryogels do not require heat to set. Here we propose a simple method for the incorporation of the low-boiling-point PCCAs using octafluoropropane (OFP) and decafluorobutane (DFB) into PVA cryogels for a variety of acoustic characterization applications. We determined the utility of the phantoms by activating droplets with a focused transducer, visualizing the lesions with ultrasound imaging. At 1 MHz, droplet activation was consistently observed at 2.0 and 4.0 MPa for OFP and DFB, respectively.
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Affiliation(s)
- Phillip G Durham
- Department of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina, USA; Joint Department of Biomedical Engineering, University of North Carolina and North Carolina State University, Chapel Hill, North Carolina, USA.
| | - Jinwook Kim
- Joint Department of Biomedical Engineering, University of North Carolina and North Carolina State University, Chapel Hill, North Carolina, USA
| | - Katherine M Eltz
- Joint Department of Biomedical Engineering, University of North Carolina and North Carolina State University, Chapel Hill, North Carolina, USA
| | - Charles F Caskey
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Paul A Dayton
- Department of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina, USA; Joint Department of Biomedical Engineering, University of North Carolina and North Carolina State University, Chapel Hill, North Carolina, USA
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14
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Lu S, Zhao P, Deng Y, Liu Y. Mechanistic Insights and Therapeutic Delivery through Micro/Nanobubble-Assisted Ultrasound. Pharmaceutics 2022; 14:pharmaceutics14030480. [PMID: 35335857 PMCID: PMC8954263 DOI: 10.3390/pharmaceutics14030480] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/12/2022] [Accepted: 02/19/2022] [Indexed: 02/05/2023] Open
Abstract
Ultrasound with low frequency (20–100 kHz) assisted drug delivery has been widely investigated as a non-invasive method to enhance the permeability and retention effect of drugs. The functional micro/nanobubble loaded with drugs could provide an unprecedented opportunity for targeted delivery. Then, ultrasound with higher intensity would locally burst bubbles and release agents, thus avoiding side effects associated with systemic administration. Furthermore, ultrasound-mediated destruction of micro/nanobubbles can effectively increase the permeability of vascular membranes and cell membranes, thereby not only increasing the distribution concentration of drugs in the interstitial space of target tissues but also promoting the penetration of drugs through cell membranes into the cytoplasm. These advancements have transformed ultrasound from a purely diagnostic utility into a promising theragnostic tool. In this review, we first discuss the structure and generation of micro/nanobubbles. Second, ultrasound parameters and mechanisms of therapeutic delivery are discussed. Third, potential biomedical applications of micro/nanobubble-assisted ultrasound are summarized. Finally, we discuss the challenges and future directions of ultrasound combined with micro/nanobubbles.
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15
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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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16
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Holman R, Lorton O, Guillemin PC, Desgranges S, Contino-Pépin C, Salomir R. Perfluorocarbon Emulsion Contrast Agents: A Mini Review. Front Chem 2022; 9:810029. [PMID: 35083198 PMCID: PMC8785234 DOI: 10.3389/fchem.2021.810029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/09/2021] [Indexed: 12/31/2022] Open
Abstract
Perfluorocarbon emulsions offer a variety of applications in medical imaging. The substances can be useful for most radiological imaging modalities; including, magnetic resonance imaging, ultrasonography, computed tomography, and positron emission tomography. Recently, the substance has gained much interest for theranostics, with both imaging and therapeutic potential. As MRI sequences improve and more widespread access to 19F-MRI coils become available, perfluorocarbon emulsions have great potential for new commercial imaging agents, due to high fluorine content and previous regulatory approval as antihypoxants and blood substitutes. This mini review aims to discuss the chemistry and physics of these contrast agents, in addition to highlighting some of the past, recent, and potential applications.
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Affiliation(s)
- Ryan Holman
- Image Guided Interventions Laboratory (GR-949), Faculty of Medicine, University of Geneva, Geneva, Switzerland
- *Correspondence: Ryan Holman,
| | - Orane Lorton
- Image Guided Interventions Laboratory (GR-949), Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Pauline C. 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 Department, University Hospitals of Geneva, Geneva, Switzerland
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17
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Zhao LY, Chao X, Yang BS, Wang GG, Zou JZ, Wu F. Phase-shift Perfluoropentane Nanoemulsions Enhance Pulsed High-intensity Focused Ultrasound Ablation in an Isolated Perfused Liver System and Their Potential Value for Cancer Therapy. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:107-121. [PMID: 33724514 DOI: 10.1002/jum.15686] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/26/2021] [Accepted: 02/13/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE To investigate whether phase-shift perfluoropetane (PFP) nanoemulsions can enhance pulsed high-intensity focused ultrasound (HIFU) ablation. METHODS PFP was encapsulated by poly(lactic-co-glycolic acid) (PLGA) to form a nanometer-sized droplet (PLGA-PFP), which was added to an isolated perfused liver system. Meanwhile, phosphate-buffered saline (PBS) was used as a control. The perfused liver was exposed to HIFU (150 W, t = 3/5/10 s) at various duty cycles (DCs). The ultrasound images, cavitation emissions, and temperature were recorded. Rabbits with subcutaneous VX2 tumors were exposed to HIFU (150 W) at various DCs with or without PLGA-PFP. After ablation, necrosis volume and energy efficiency factor were calculated. Pathologic characteristics were observed. RESULTS Compared to the PBS control, PLGA-PFP nanoemulsions markedly enhanced HIFU-induced necrosis volume in both perfused livers and subcutaneous VX2 tumor-bearing rabbits (P <.05). Inertial cavitation was much stronger in the pulsed-HIFU exposure at 10% than that in the continuous-wave HIFU exposure (P <.01). Peak temperature at 100% DC was significantly higher than that at 10% (P <.05). Compared to 100% DC HIFU exposure, the mean necrosis volume induced by 10 s exposure at 50% DC was significantly larger (P <.005) but lower at 10% DC in the isolated perfused livers (P <.05). In addition, the mean necrosis volume in subcutaneous VX2 tumor-bearing rabbits was significantly increased after HIFU exposure at 10% DC when compared to those at 100% DC (P <.05). Histopathologic analysis showed liquefaction necrosis in pulsed HIFU. CONCLUSION PLGA-PFP nanoemulsions can enhance HIFU ablation in the isolated perfused livers and promote tumor ablation in the subcutaneous xenograft rabbit model. Appropriate pulsed HIFU exposure may increase the necrosis volume and reduce total ultrasound energy required for HIFU ablation.
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Affiliation(s)
- Lu-Yan Zhao
- Transformational Medical Center, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
- The College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Xu Chao
- The College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Bing-She Yang
- Transformational Medical Center, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Guo-Guan Wang
- The College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Jian-Zhong Zou
- College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Feng Wu
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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18
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Namen AV, Jandhyala S, Jordan T, Luke GP. Repeated Acoustic Vaporization of Perfluorohexane Nanodroplets for Contrast-Enhanced Ultrasound Imaging. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:3497-3506. [PMID: 34191726 PMCID: PMC8667194 DOI: 10.1109/tuffc.2021.3093828] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Superheated perfluorocarbon nanodroplets are emerging ultrasound imaging contrast agents that boast biocompatible components, unique phase-change dynamics, and therapeutic loading capabilities. Upon exposure to a sufficiently high-intensity pulse of acoustic energy, the nanodroplet's perfluorocarbon core undergoes a liquid-to-gas phase change and becomes an echogenic microbubble, providing ultrasound contrast. The controllable activation leads to high-contrast images, while the small size of the nanodroplets promotes longer circulation times and better in vivo stability. One drawback, however, is that the nanodroplets can only be vaporized a single time, limiting their versatility. Recently, we and others have addressed this issue by using a perfluorohexane core, which has a boiling point above body temperature. Thus after vaporization, the microbubbles recondense back into their stable nanodroplet form. Previous work with perfluorohexane nanodroplets relied on optical activation via pulsed laser absorption of an encapsulated dye. This strategy limits the imaging depth and temporal resolution of the method. In this study, we overcome these limitations by demonstrating acoustic droplet vaporization with 1.1-MHz high-intensity focused ultrasound (HIFU). A short-duration, high-amplitude pulse of focused ultrasound provides a sufficiently strong peak negative pressure to initiate vaporization. A custom imaging sequence was developed to enable the synchronization of a HIFU transducer and a linear array imaging transducer. We show a visualization of repeated acoustic activation of perfluorohexane nanodroplets in polyacrylamide tissue-mimicking phantoms. We further demonstrate the detection of hundreds of vaporization events from individual nanodroplets with activation thresholds well below the tissue cavitation limit. Overall, this approach has the potential to result in reliable and repeatable contrast-enhanced ultrasound imaging at clinically relevant depths.
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19
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Yao R, Zhao W, Gao B, Hu J, Wang T. Microbubble contrast agent SonoVue combined with oxytocin improves the efficiency of high-intensity focused ultrasound ablation for adenomyosis. Int J Hyperthermia 2021; 38:1601-1608. [PMID: 34763594 DOI: 10.1080/02656736.2021.1993357] [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
BACKGROUND To investigate the combined enhancing effects of microbubble-contrast SonoVue and oxytocin on high-intensity focused ultrasound (HIFU) ablation of adenomyosis. METHODS 330 patients with adenomyosis were randomly assigned to SonoVue and oxytocin group (group A, n = 82), oxytocin (group B, n = 85), SonoVue (group C, n = 81), or the control (group D, n = 82) for HIFU ablation. In group A, oxytocin was dripped 0.32 IU/min, and HIFU ablation was started one minute after SonoVue injection. In group B, oxytocin was dripped 0.32 IU/min during ablation. In group C, HIFU ablation was started one minute after SonoVue injection. In group D, neither oxytocin nor SonoVue was applied. The clinical data, treatment results, and complications were analyzed. RESULTS All participants underwent HIFU treatment safely, and the mean energy efficiency factor (EEF) in the four groups was 4.7 ± 0.9J/mm3, 8.5 ± 0.6J/mm3, 8.9 ± 0.7J/mm3, and 12.6 ± 1.8J/mm3, respectively, with the mean ablation time (AT) of 633.7 ± 55.1 s, 874.2 ± 65.6 s, 936.3 ± 85.2 s, and 1103.2 ± 96.2 s, respectively. The non-perfused volume ratios (NPVR) were 90.4 ± 8.8%, 88.7 ± 9.1%, 89.4 ± 7.2%, 80.5 ± 7.9%, respectively. In addition, EEF and AT were the shortest in group A (p < 0.05). NPVR was significantly higher in group A than in the control group D (p < 0.05). The incidence rates of adverse events were not significantly different in the four groups (p > 0.05). CONCLUSIONS Compared to the control group, oxytocin combined with SonoVue in HIFU for adenomyosis can significantly decrease the energy and time needed for the ablation and safely enhance the treatment efficiency by improving the cavitation and heating of HIFU ablation and increasing the non-perfused volume ratio.
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Affiliation(s)
- Ruihong Yao
- Medical Imaging Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wei Zhao
- Medical Imaging Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Bulang Gao
- Medical Imaging Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jihong Hu
- Medical Imaging Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Tao Wang
- Medical Imaging Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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20
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Wang Y, Cong H, Wang S, Yu B, Shen Y. Development and application of ultrasound contrast agents in biomedicine. J Mater Chem B 2021; 9:7633-7661. [PMID: 34586124 DOI: 10.1039/d1tb00850a] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
With the rapid development of molecular imaging, ultrasound (US) medicine has evolved from traditional imaging diagnosis to integrated diagnosis and treatment at the molecular level. Ultrasound contrast agents (UCAs) play a crucial role in the integration of US diagnosis and treatment. As the micro-bubbles (MBs) in UCAs can enhance the cavitation effect and promote the biological effect of US, UCAs have also been studied in the fields of US thrombolysis, mediated gene transfer, drug delivery, and high intensity focused US. The application range of UCAs is expanding, and the value of their applications is improving. This paper reviews the development and application of UCAs in biomedicine in recent years, and the existing problems and prospects are pointed out.
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Affiliation(s)
- Yu Wang
- Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, Qingdao University, Building D, Science Park, Qingdao 266071, China.
| | - Hailin Cong
- Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, Qingdao University, Building D, Science Park, Qingdao 266071, China. .,State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China
| | - Song Wang
- Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, Qingdao University, Building D, Science Park, Qingdao 266071, China.
| | - Bing Yu
- Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, Qingdao University, Building D, Science Park, Qingdao 266071, China. .,State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China
| | - Youqing Shen
- Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, Qingdao University, Building D, Science Park, Qingdao 266071, China. .,Center for Bionanoengineering and Key Laboratory of Biomass Chemical Engineering of Ministry of Education, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou 310027, China
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21
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Zhang B, Wu H, Goel L, Kim H, Peng C, Kim J, Dayton PA, Gao Y, Jiang X. Magneto-sonothrombolysis with combination of magnetic microbubbles and nanodroplets. ULTRASONICS 2021; 116:106487. [PMID: 34119875 PMCID: PMC8645658 DOI: 10.1016/j.ultras.2021.106487] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/25/2021] [Accepted: 05/31/2021] [Indexed: 05/07/2023]
Abstract
This paper reports a novel technique using the rotational magnetic field oscillation and low-intensity sub-megahertz ultrasound stimulation of magnetic microbubbles (MMBs) to promote the nanodroplets (NDs) phase transition and improve the permeation of NDs into the blood clot fibrin network to enhance the sonothrombolysis efficiency. In this study, the influence of different treatment methods with a combination of MMBs and NDs on the thrombolysis rate of both unretracted and retracted clots were investigated, including the stable and inertial cavitation, tPA effects, MMBs/NDs concentration ratio, sonication factors (input voltage, duty cycle) and rotational magnetic field factors (flux density, frequency). We demonstrated that tPA-mediated magneto-sonothrombolysis in combining NDs with MMBs could significantly enhance in vitro lysis of both unretracted clots (85 ± 8.3%) and retracted clots (57 ± 6.5%) in a flow model with 30 min treatment. The results showed that the combination of MMBs and NDs substantially improves in vitro lysis of blood clots with an unprecedented lysis rate.
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Affiliation(s)
- Bohua Zhang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA
| | - Huaiyu Wu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA
| | - Leela Goel
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA; The Joint Department of Biomedical Engineering, The University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC 27599, USA
| | - Howuk Kim
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA
| | - Chang Peng
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA
| | - Jinwook Kim
- The Joint Department of Biomedical Engineering, The University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC 27599, USA
| | - Paul A Dayton
- The Joint Department of Biomedical Engineering, The University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC 27599, USA
| | - Yu Gao
- Institute of Advanced Materials, Nanjing University of Posts and Telecommunications, Nanjing 210023, China
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA.
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22
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Krafft MP, Riess JG. Therapeutic oxygen delivery by perfluorocarbon-based colloids. Adv Colloid Interface Sci 2021; 294:102407. [PMID: 34120037 DOI: 10.1016/j.cis.2021.102407] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 03/18/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023]
Abstract
After the protocol-related indecisive clinical trial of Oxygent, a perfluorooctylbromide/phospholipid nanoemulsion, in cardiac surgery, that often unduly assigned the observed untoward effects to the product, the development of perfluorocarbon (PFC)-based O2 nanoemulsions ("blood substitutes") has come to a low. Yet, significant further demonstrations of PFC O2-delivery efficacy have continuously been reported, such as relief of hypoxia after myocardial infarction or stroke; protection of vital organs during surgery; potentiation of O2-dependent cancer therapies, including radio-, photodynamic-, chemo- and immunotherapies; regeneration of damaged nerve, bone or cartilage; preservation of organ grafts destined for transplantation; and control of gas supply in tissue engineering and biotechnological productions. PFC colloids capable of augmenting O2 delivery include primarily injectable PFC nanoemulsions, microbubbles and phase-shift nanoemulsions. Careful selection of PFC and other colloid components is critical. The basics of O2 delivery by PFC nanoemulsions will be briefly reminded. Improved knowledge of O2 delivery mechanisms has been acquired. Advanced, size-adjustable O2-delivering nanoemulsions have been designed that have extended room-temperature shelf-stability. Alternate O2 delivery options are being investigated that rely on injectable PFC-stabilized microbubbles or phase-shift PFC nanoemulsions. The latter combine prolonged circulation in the vasculature, capacity for penetrating tumor tissues, and acute responsiveness to ultrasound and other external stimuli. Progress in microbubble and phase-shift emulsion engineering, control of phase-shift activation (vaporization), understanding and control of bubble/ultrasound/tissue interactions is discussed. Control of the phase-shift event and of microbubble size require utmost attention. Further PFC-based colloidal systems, including polymeric micelles, PFC-loaded organic or inorganic nanoparticles and scaffolds, have been devised that also carry substantial amounts of O2. Local, on-demand O2 delivery can be triggered by external stimuli, including focused ultrasound irradiation or tumor microenvironment. PFC colloid functionalization and targeting can help adjust their properties for specific indications, augment their efficacy, improve safety profiles, and expand the range of their indications. Many new medical and biotechnological applications involving fluorinated colloids are being assessed, including in the clinic. Further uses of PFC-based colloidal nanotherapeutics will be briefly mentioned that concern contrast diagnostic imaging, including molecular imaging and immune cell tracking; controlled delivery of therapeutic energy, as for noninvasive surgical ablation and sonothrombolysis; and delivery of drugs and genes, including across the blood-brain barrier. Even when the fluorinated colloids investigated are designed for other purposes than O2 supply, they will inevitably also carry and deliver a certain amount of O2, and may thus be considered for O2 delivery or co-delivery applications. Conversely, O2-carrying PFC nanoemulsions possess by nature a unique aptitude for 19F MR imaging, and hence, cell tracking, while PFC-stabilized microbubbles are ideal resonators for ultrasound contrast imaging and can undergo precise manipulation and on-demand destruction by ultrasound waves, thereby opening multiple theranostic opportunities.
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Affiliation(s)
- Marie Pierre Krafft
- University of Strasbourg, Institut Charles Sadron (CNRS), 23 rue du Loess, 67034 Strasbourg, France.
| | - Jean G Riess
- Harangoutte Institute, 68160 Ste Croix-aux-Mines, France
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23
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Zeng Z, Liu JB, Peng CZ. Phase-changeable nanoparticle-mediated energy conversion promotes highly efficient high-intensity focused ultrasound ablation. Curr Med Chem 2021; 29:1369-1378. [PMID: 34238143 DOI: 10.2174/0929867328666210708085110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/14/2021] [Accepted: 05/09/2021] [Indexed: 11/22/2022]
Abstract
This review describes how phase-changeable nanoparticles enable highly efficient high-intensity focused ultrasound ablation (HIFU). HIFU is effective in the clinical treatment of solid malignant tumors. However, it has intrinsic disadvantages for treating some deep lesions, such as damage to surrounding normal tissues. When phase-changeable nanoparticles are used in HIFU treatment, they could serve as good synergistic agents because they are transported in the blood and permeated and accumulated effectively in tissues. HIFU's thermal effects can trigger nanoparticles to undergo a special phase transition, thus enhancing HIFU ablation efficiency. Nanoparticles can also carry anticancer agents and release them in the targeted area to achieve chemo-synergistic therapy response. Although the formation of nanoparticles is complicated and HIFU applications are still in an early stage, the potential for their use in synergy with HIFU treatment shows promising results.
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Affiliation(s)
- Zeng Zeng
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Ji-Bin Liu
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, United States
| | - Cheng-Zhong Peng
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
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24
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Qin D, Zou Q, Lei S, Wang W, Li Z. Predicting initial nucleation events occurred in a metastable nanodroplet during acoustic droplet vaporization. ULTRASONICS SONOCHEMISTRY 2021; 75:105608. [PMID: 34119737 PMCID: PMC8207230 DOI: 10.1016/j.ultsonch.2021.105608] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/16/2021] [Accepted: 05/21/2021] [Indexed: 06/12/2023]
Abstract
Acoustic droplet vaporization (ADV) capable of converting liquid perfluorocarbon (PFC) micro/nanodroplets into gaseous microbubbles has gained much attention due to its medical potentials. However, its physical mechanisms for nanodroplets have not been well understood due to the disappeared superharmonic focusing effect and the prominent Laplace pressure compared to microdroplets, especially for the initial ADV nucleation occurring in a metastable PFC nanodroplet. The classical nucleation theory (CNT) was modified to describe the ADV nucleation via combining the phase-change thermodynamics of perfluoropentane (PFP) and the Laplace pressure effect on PFP nanodroplets. The thermodynamics was exactly predicted by the Redlich-Kwong equation of state (EoS) rather than the van der Waals EoS, based on which the surface tension of the vapor nucleus as a crucial parameter in the CNT was successfully obtained to modify the CNT. Compared to the CNT, the modified CNT eliminated the intrinsic limitations of the CNT, and it predicted a larger nucleation rate and a lower ADV nucleation threshold, which agree much better with experimental results. Furthermore, it indicated that the nanodroplet properties exert very strong influences on the nucleation threshold instead of the acoustic parameters, providing a potential strategy with an appropriate droplet design to reduce the ADV nucleation threshold. This study may contribute to further understanding the ADV mechanism for PFC nanodroplets and promoting its potential theranostic applications in clinical practice.
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Affiliation(s)
- Dui Qin
- Chongqing Engineering Research Center of Medical Electronics and Information Technology, Department of Biomedical Engineering, School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing 400065, PR China.
| | - Qingqin Zou
- Chongqing Engineering Research Center of Medical Electronics and Information Technology, Department of Biomedical Engineering, School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing 400065, PR China
| | - Shuang Lei
- Chongqing Engineering Research Center of Medical Electronics and Information Technology, Department of Biomedical Engineering, School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing 400065, PR China
| | - Wei Wang
- Chongqing Engineering Research Center of Medical Electronics and Information Technology, Department of Biomedical Engineering, School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing 400065, PR China
| | - Zhangyong Li
- Chongqing Engineering Research Center of Medical Electronics and Information Technology, Department of Biomedical Engineering, School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing 400065, PR China.
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25
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Joiner JB, Pylayeva-Gupta Y, Dayton PA. Focused Ultrasound for Immunomodulation of the Tumor Microenvironment. THE JOURNAL OF IMMUNOLOGY 2021; 205:2327-2341. [PMID: 33077668 DOI: 10.4049/jimmunol.1901430] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 07/10/2020] [Indexed: 02/06/2023]
Abstract
Focused ultrasound (FUS) has recently emerged as a modulator of the tumor microenvironment, paving the way for FUS to become a safe yet formidable cancer treatment option. Several mechanisms have been proposed for the role of FUS in facilitating immune responses and overcoming drug delivery barriers. However, with the wide variety of FUS parameters used in diverse tumor types, it is challenging to pinpoint FUS specifications that may elicit the desired antitumor response. To clarify FUS bioeffects, we summarize four mechanisms of action, including thermal ablation, hyperthermia/thermal stress, mechanical perturbation, and histotripsy, each inducing unique vascular and immunological effects. Notable tumor responses to FUS include enhanced vascular permeability, increased T cell infiltration, and tumor growth suppression. In this review, we have categorized and reviewed recent methods of using therapeutic ultrasound to elicit an antitumor immune response with examples that reveal specific solutions and challenges in this new research area.
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Affiliation(s)
- Jordan B Joiner
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Yuliya Pylayeva-Gupta
- Department of Genetics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599; .,Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599; and
| | - Paul A Dayton
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599; .,Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599; and.,Joint Department of Biomedical Engineering, The University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC 27599
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26
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Loskutova K, Nimander D, Gouwy I, Chen H, Ghorbani M, Svagan AJ, Grishenkov D. A Study on the Acoustic Response of Pickering Perfluoropentane Droplets in Different Media. ACS OMEGA 2021; 6:5670-5678. [PMID: 33681606 PMCID: PMC7931408 DOI: 10.1021/acsomega.0c06115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/12/2021] [Indexed: 06/12/2023]
Abstract
Acoustic droplet vaporization (ADV) is the physical process of liquid-to-gas phase transition mediated by pressure variations in an ultrasound field. In this study, the acoustic response of novel particle-stabilized perfluoropentane droplets was studied in bulk and confined media. The oil/water interface was stabilized by cellulose nanofibers. First, their acoustic responses under idealized conditions were examined to assess their susceptibility to undergo ADV. Second, the droplets were studied in a more realistic setting and placed in a confined medium. Lastly, an imaging setup was developed and tested on the droplets. The acoustic response could be seen when the amplitude of the peak negative pressure (PNP) was above 200 kPa, suggesting that this is the vaporization pressure threshold for these droplets. Increasing the PNP resulted in a decrease in signal intensity over time, suggesting a more destructive behavior. The imaging setup was able to differentiate between the droplets and the surrounding tissue. Results obtained within this study suggest that these droplets have potential in terms of ultrasound-mediated diagnostics and therapy.
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Affiliation(s)
- Ksenia Loskutova
- Department
of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm 14157, Sweden
| | - Didrik Nimander
- Department
of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm 14157, Sweden
| | - Isabelle Gouwy
- Department
of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm 14157, Sweden
| | - Hongjian Chen
- Department
of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm 14157, Sweden
| | - Morteza Ghorbani
- Department
of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm 14157, Sweden
- Sabanci
University Nanotechnology Research and Application Center, Istanbul 34956, Turkey
| | - Anna J. Svagan
- Department
of Fibre and Polymer Technology, KTH Royal
Institute of Technology, Stockholm 10044, Sweden
| | - Dmitry Grishenkov
- Department
of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm 14157, Sweden
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27
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Singh A, Nyankima AG, Anthony Phipps M, Chaplin V, Dayton PA, Caskey C. Improving the heating efficiency of high intensity focused ultrasound ablation through the use of phase change nanodroplets and multifocus sonication. Phys Med Biol 2020; 65:205004. [PMID: 32438353 DOI: 10.1088/1361-6560/ab9559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Thermal ablation by ultrasound is being explored as a local therapy for cancers of soft tissue, such as the liver or breast. One challenge for these treatments are off-target effects, including heating outside of the intended region or skin burns. Improvements in heating efficiency can mitigate these undesired outcomes, and here, we describe methods for using phase-shift nanodroplets (PSNDs) with multi-focus sonications to enhance volumetric ablation and ablation efficiency at constant powers while increasing the pre-focal temperature by less than 6 [Formula: see text]C. Multi-focus ablation with 4 foci performed the best and achieved a mean ablation volume of 120.2 ± 22.4 mm3 and ablation efficiency of 0.04 mm3 J-1 versus an ablation volume of 61.2 ± 21.16 mm3 and ablation efficiency of 0.02 mm3 J-1 in single focus case. The combined use of PSNDs with multi-focal ultrasound presented here is a new approach to increasing ablation efficiency while reducing off-target effects and could be generally applied in various focused ultrasound thermal ablation treatments.
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Affiliation(s)
- Aparna Singh
- Department of Biomedical Engineering, Vanderbilt University, Nashville Tennessee 37212, United States of America
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28
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Lorton O, Guillemin P, Holman R, Desgranges S, Gui L, Crowe LA, Terraz S, Nastasi A, Lazeyras F, Contino-Pépin C, Salomir R. Enhancement of HIFU thermal therapy in perfused tissue models using micron-sized FTAC-stabilized PFOB-core endovascular sonosensitizers. Int J Hyperthermia 2020; 37:1116-1130. [PMID: 32990101 PMCID: PMC8352380 DOI: 10.1080/02656736.2020.1817575] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND High intensity focused ultrasound (HIFU) is clinically accepted for the treatment of solid tumors but remains challenging in highly perfused tissue due to the heat sink effect. Endovascular liquid-core sonosensitizers have been previously suggested to enhance the thermal energy deposition at the focal area and to lower the near-/far-field heating. We are investigating the therapeutic potential of PFOB-FTAC micro-droplets in a perfused tissue-mimicking model and postmortem excised organs. METHOD A custom-made in vitro perfused tissue-mimicking model, freshly excised pig kidneys (n = 3) and liver (n = 1) were perfused and subjected to focused ultrasound generated by an MR-compatible HIFU transducer. PFOB-FTAC sonosensitizers were injected in the perfusion fluid up to 0.235% v/v ratio. Targeting and on-line PRFS thermometry were performed on a 3 T MR scanner. Assessment of the fluid perfusion was performed with pulsed color Doppler in vitro and with dynamic contrast-enhanced (DCE)-MRI in excised organs. RESULTS Our in vitro model of perfused tissue demonstrated re-usability. Sonosensitizer concentration and perfusion rate were tunable in situ. Differential heating under equivalent HIFU sonications demonstrated a dramatic improvement in the thermal deposition due to the sonosensitizers activity. Typically, the energy deposition was multiplied by a factor between 2.5 and 3 in perfused organs after the administration of micro-droplets, while DCE-MRI indicated an effective perfusion. CONCLUSION The current PFOB-FTAC micro-droplet sonosensitizers provided a large and sustained enhancement of the HIFU thermal deposition at the focal area, suggesting solutions for less technological constraints, lower risk for the near-/far- field heating. We also report a suitable experimental model for other MRgHIFU studies.
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Affiliation(s)
- 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
| | - 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
| | - Lindsey A Crowe
- Radiology Department, University Hospitals of Geneva, Geneva, Switzerland
| | - Sylvain Terraz
- Radiology Department, University Hospitals of Geneva, Geneva, Switzerland
| | - Antonio Nastasi
- Visceral and Transplantation Division, University Hospitals, Geneva, Switzerland
| | - François Lazeyras
- Radiology Department, University Hospitals of Geneva, Geneva, Switzerland.,Center for Biomedical Imaging (CIBM), Geneva, Switzerland
| | | | - Rares Salomir
- Image Guided Interventions Laboratory (GR-949), Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Radiology Department, University Hospitals of Geneva, Geneva, Switzerland
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29
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Xu T, Cui Z, Li D, Cao F, Xu J, Zong Y, Wang S, Bouakaz A, Wan M, Zhang S. Cavitation characteristics of flowing low and high boiling-point perfluorocarbon phase-shift nanodroplets during focused ultrasound exposures. ULTRASONICS SONOCHEMISTRY 2020; 65:105060. [PMID: 32199255 DOI: 10.1016/j.ultsonch.2020.105060] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 01/15/2020] [Accepted: 03/07/2020] [Indexed: 06/10/2023]
Abstract
This work investigated and compared the dynamic cavitation characteristics between low and high boiling-point phase-shift nanodroplets (NDs) under physiologically relevant flow conditions during focused ultrasound (FUS) exposures at different peak rarefactional pressures. A passive cavitation detection (PCD) system was used to monitor cavitation activity during FUS exposure at various acoustic pressure levels. Root mean square (RMS) amplitudes of broadband noise, spectrograms of the passive cavitation detection signals, and normalized inertial cavitation dose (ICD) values were calculated. Cavitation activity of low-boiling-point perfluoropentane (PFP) NDs and high boiling-point perfluorohexane (PFH) NDs flowing at in vitro mean velocities of 0-15 cm/s were compared in a 4-mm diameter wall-less vessel in a transparent tissue-mimicking phantom. In the static state, both types of phase-shift NDs exhibit a sharp rise in cavitation intensity during initial FUS exposure. Under flow conditions, cavitation activity of the PFH NDs reached the steady state less rapidly compared to PFP NDs under the lower acoustic pressure (1.35 MPa); at the higher acoustic pressure (1.65 MPa), the RMS amplitude increased more sharply during the initial FUS exposure period. In particular, the RMS-time curves of the PFP NDs shifted upward as the mean flow velocity increased from 0 to 15 cm/s; the RMS amplitude of the PFH ND solution increased from 0 to 10 cm/s and decreased at 15 cm/s. Moreover, amplitudes of the echo signal for the low boiling-point PFP NDs were higher compared to the high boiling-point PFH NDs in the lower frequency range, whereas the inverse occurred in the higher frequency range. Both PFP and PFH NDs showed increased cavitation activity in the higher frequency under the flow condition compared to the static state, especially PFH NDs. At 1.65 MPa, normalized ICD values for PFH increased from 0.93 ± 0.03 to 0.96 ± 0.04 and from 0 to 10 cm/s, then decreased to 0.86 ± 0.05 at 15 cm/s. This work contributes to our further understanding of cavitation characteristics of phase-shift NDs under physiologically relevant flow conditions during FUS exposure. In addition, the results provide a reference for selecting suitable phase-shift NDs to enhance the efficiency of cavitation-mediated ultrasonic applications.
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Affiliation(s)
- Tianqi Xu
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, People's Republic of China
| | - Zhiwei Cui
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, People's Republic of China
| | - Dapeng Li
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, People's Republic of China
| | - Fangyuan Cao
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, People's Republic of China
| | - Jichen Xu
- Institute of Artificial Intelligence and Robotics, Xi'an Jiaotong University, Xi'an 710049, People's Republic of China; National Engineering Laboratory for Visual Information Processing and Applications, Xi'an Jiaotong University, Xi'an 710049, People's Republic of China
| | - Yujin Zong
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, People's Republic of China
| | - Supin Wang
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, People's Republic of China
| | | | - Mingxi Wan
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, People's Republic of China.
| | - Siyuan Zhang
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, People's Republic of China.
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30
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Zhong X, Zhang M, Tian Z, Wang Q, Wang Z. The Study of Enhanced High-Intensity Focused Ultrasound Therapy by Sonodynamic N 2O Microbubbles. NANOSCALE RESEARCH LETTERS 2019; 14:381. [PMID: 31845016 PMCID: PMC6915195 DOI: 10.1186/s11671-019-3219-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/27/2019] [Indexed: 05/13/2023]
Abstract
High-intensity focused ultrasound (HIFU) is a representative non-invasive method of cancer therapy, but its low therapeutic efficacy and risk of damage to surrounding normal tissue hinder its further clinical development and application. Sonodynamic therapy (SDT) kills tumor cells through reactive oxygen molecules produced by sonosensitizers during ultrasound treatment. SDT can enhance HIFU efficacy like microbubbles. In this work, we developed nanoscale N2O microbubbles (N2O-mbs) by an improved mechanical oscillation method. These microbubbles showed good biocompatibility and tumor cell binding. The sonosensitivity of the N2O-mbs was detected both extracellularly and intracellularly through the detection of reactive oxygen species generation. The toxic effects of these sonodynamic microbubbles on tumor cells and the synergistic effect on HIFU treatment were evaluated. Significant apoptosis was caused by reactive oxygen species produced by N2O-mbs under ultrasound irradiation. N2O-mbs combined with HIFU increased tumor cell necrosis and apoptosis in vitro and the coagulative necrotic volume and echo intensity in the bovine liver target area ex vivo. These sonodynamic microbubbles have been also demonstrated to efficiently inhibit tumor growth in vivo. N2O-mbs have a significant impact on the treatment and ablation effect of HIFU due to the advantages of microbubble and extraordinary sonosensitivity. This finding suggests that N2O-mbs may be a novel auxiliary agent for ultrasound that can be used to promote HIFU tumor thermal ablation.
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Affiliation(s)
- Xiaowen Zhong
- The Department of Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Yuzhong District, Chongqing, 400010, People's Republic of China
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China
| | - Mei Zhang
- The Department of Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Yuzhong District, Chongqing, 400010, People's Republic of China
| | - Zedan Tian
- The Department of Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Yuzhong District, Chongqing, 400010, People's Republic of China.
| | - Qi Wang
- Institute of Ultrasonic Engineering in Medical, Chongqing Medical University, Chongqing, 400010, China
| | - Zhigang Wang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China
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31
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Xu M, Wang M, Cheng Y, Ni X, Xu Y, Wang Q, Yuan S. Diagnosis and treatment of intermuscular venous malformations: A retrospective study in one center. Phlebology 2019; 35:384-393. [PMID: 31663826 DOI: 10.1177/0268355519885216] [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: 11/16/2022]
Abstract
OBJECTIVES Intermuscular venous malformations are common vascular malformation, do not have typical symptoms, and are difficult to diagnose. This article is a retrospective analysis of the diagnostic and therapeutic measures of intermuscular venous malformations. METHODS From January 2013 to June 2018, 21 patients were included in this study. The clinical presentations, managements, and follow-up results were retrospectively analyzed. The indications and potential risks of different treatments were summarized. RESULTS The complaints of patients with intermuscular venous malformations included local pain, swelling, discomfort, or aggravation after activity. Ultrasound, phlebography, magnetic resonance imaging, percutaneous sinus angiography, and three-dimensional computed tomography imaging were performed. The patients received surgical excision, sclerotherapy, or the combinational therapy of intralesional copper wires retention and ethanol injection and were followed for six months to five years. All patients' symptoms were relieved largely. The lesions evaluated by magnetic resonance imaging decreased apparently or disappeared. CONCLUSIONS Imaging examinations are necessary in the diagnosis of intermuscular venous malformations and can guide the choice of treatment. Individualized treatment for intermuscular venous malformations should be made to achieve good effect and avoid adverse effects.
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Affiliation(s)
- Mengnan Xu
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Min Wang
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Yenwen Cheng
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Xiaodong Ni
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Yuan Xu
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Qian Wang
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Siming Yuan
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
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32
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Blum NT, Gyorkos CM, Narowetz SJ, Mueller EN, Goodwin AP. Phospholipid-Coated Hydrophobic Mesoporous Silica Nanoparticles Enhance Thrombectomy by High-Intensity Focused Ultrasound with Low Production of Embolism-Inducing Clot Debris. ACS APPLIED MATERIALS & INTERFACES 2019; 11:36324-36332. [PMID: 31556582 PMCID: PMC8051144 DOI: 10.1021/acsami.9b11095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Here we report the efficacy of a nanoparticle-assisted high-intensity focused ultrasound (HIFU) treatment that selectively destroys blood clots while minimizing generation of microparticles, or microemboli, that can cause further complications postsurgery. Treatment of malignant blood clots (thrombi) and the resulting emboli are critical problems for numerous patients, and treatments addressing these conditions would benefit from advancements in noninvasive procedures such as HIFU. While recanalization of occlusive blood clots is currently addressed with surgical intervention that seeks to minimize formation of large emboli, there is a danger of microemboli (micrometer-size particles) that have been theorized to be responsible for the poor correlation between apparent surgical success and patient outcome. Here, the addition of phospholipid-coated hydrophobically modified silica nanoparticles (P@hMSNs) improved the efficacy of HIFU treatment by serving as cavitation nuclei for mechanical disruption of thrombi. This treatment was evaluated for the ability to clear the HIFU focal area of a thick and dense thrombus within 10 min. Moreover, it was found that the use of P@hMSN+HIFU treatment generated a significantly smaller microembolic load as compared to comparison techniques, including a HIFU + microbubble contrast agent, HIFU alone, and direct mechanical disruption. This reduction in the microembolic load can occur either with primary removal of the clot by P@hMSN+HIFU or by insonation of the clot fragments after mechanical thrombectomy. Lastly, this method was evaluated in a flow model, where nonocclusive model thrombi and model emboli were mechanically ablated within the focal area within 15 s. Together, these results represent a combination therapy capable of resolving thrombi and microembolisms resulting from thrombectomy through localized destruction of clotted material.
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Choi H, Choi W, Kim J, Kong WH, Kim KS, Kim C, Hahn SK. Multifunctional Nanodroplets Encapsulating Naphthalocyanine and Perfluorohexane for Bimodal Image-Guided Therapy. Biomacromolecules 2019; 20:3767-3777. [PMID: 31483619 DOI: 10.1021/acs.biomac.9b00842] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Although nanocarriers containing perfluorocarbon (PFC) have been widely investigated as an ultrasound (US) imaging agent and a high intensity focused ultrasound (HIFU) agent, these carriers have suffered from low stability and biocompatibility limiting their further biomedical applications. Here, we developed surface cross-linked polymer nanodroplets as a HIFU therapeutic agent guided by bimodal photoacoustic (PA) and US imaging. Pluronic F127 was reacted with 4-nitrophenyl chloroformate (NPC) and mixed with naphthalocyanine (Nc) in dichloromethane, which was added into the aqueous solution of amine-functionalized six-arm-branched poly(ethylene glycol) (PEG) to form an oil-in-water emulsion for the cross-linking reaction between the terminal NPC of Pluronic F127 and the primary amine of six-arm PEG. The resulting solution was sonicated with liquid perfluorohexane (PFH) to prepare PEG cross-linked Pluronic F127 nanoparticles encapsulating Nc and PFH (Nc/PFH@PCPN). Nc/PFH@PCPN appeared to be stable without any coalescence or vaporization in the physiological condition. Upon the application of HIFU, Nc/PFH@PCPN was vaporized and showed increased US intensity for 180 min. The Nc dye in the nanodroplets enabled the stable encapsulation of PFH and the bimodal US/PA imaging. In vivo PA/US image-guided HIFU ablation therapy confirmed that the nanodroplets increased the cavitation effect, induced necrosis and apoptosis of tumor cells, and reduced tumor growth significantly for 12 days. Taken together, the multifunctional Nc/PFH@PCPN was successfully developed as a new platform for PA/US image-guided HIFU therapy.
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Affiliation(s)
- Hyunsik Choi
- Department of Materials Science and Engineering , Pohang University of Science and Technology (POSTECH) , 77 Cheongam-ro, Nam-gu , Pohang , Gyeongbuk 37673 , Korea
| | - Wonseok Choi
- Department of Electrical Engineering , Pohang University of Science and Technology (POSTECH) , 77 Cheongam-ro, Nam-gu , Pohang , Gyeongbuk 37673 , Korea
| | - Jeesu Kim
- Department of Electrical Engineering , Pohang University of Science and Technology (POSTECH) , 77 Cheongam-ro, Nam-gu , Pohang , Gyeongbuk 37673 , Korea
| | - Won Ho Kong
- Pohang Technopark , 394 Jigok-ro, Nam-gu , Pohang , Gyeongbuk 37668 , Korea
| | - Ki Su Kim
- Department of Organic Materials Science and Engineering, College of Engineering , Pusan National University , 2 Busandaehak-ro 63 beon-gil, Gumjeong-gu , Busan 46241 , Korea.,PHI Biomed Co. , #613, 12 Gangnam-daero 65-gil, Seocho-gu , Seoul 066 12 , Korea
| | - Chulhong Kim
- Department of Creative IT Engineering , Pohang University of Science and Technology (POSTECH) , 77 Cheongam-ro, Nam-gu , Pohang , Gyeongbuk 37673 , Korea
| | - Sei Kwang Hahn
- Department of Materials Science and Engineering , Pohang University of Science and Technology (POSTECH) , 77 Cheongam-ro, Nam-gu , Pohang , Gyeongbuk 37673 , Korea.,PHI Biomed Co. , #613, 12 Gangnam-daero 65-gil, Seocho-gu , Seoul 066 12 , Korea
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34
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Mercado-Shekhar KP, Su H, Kalaikadal DS, Lorenz JN, Manglik RM, Holland CK, Redington AN, Haworth KJ. Acoustic droplet vaporization-mediated dissolved oxygen scavenging in blood-mimicking fluids, plasma, and blood. ULTRASONICS SONOCHEMISTRY 2019; 56:114-124. [PMID: 31101245 PMCID: PMC6659737 DOI: 10.1016/j.ultsonch.2019.03.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/20/2018] [Accepted: 03/27/2019] [Indexed: 05/20/2023]
Abstract
Acoustic droplet vaporization (ADV) has been shown to reduce the partial pressure of oxygen (PO2) in a fluid. The goals of this study were three-fold: 1) to determine the ADV pressure amplitude threshold in fluids that had physiologically relevant values for surface tension, protein concentration, and viscosity; 2) to assess whether these parameters and fluid mixing affect ADV-mediated PO2 reduction; and 3) to assess the feasibility of ADV-mediated PO2 reduction in plasma and whole blood. In vitro ADV experiments were conducted using perfluoropentane droplets (number density: 5 × 106 ± 0.2 × 106/mL) dispersed in fluids (saline, polyvinylpyrrolidone solutions, porcine plasma, or porcine whole blood) that had a physiological range of surface tensions (62-68 mN/m), protein concentrations (0 and 68.7 mg/mL), and viscosities (0.7-4 cP). Droplets were exposed to pulsed ultrasound (5 MHz, 4.25 MPa peak negative pressure) while passing through a 37 °C flow system with inline PO2 sensors. In select experiments, the fluid also passed through mixing channels after ultrasound exposure. Our results revealed that the ADV pressure thresholds were the same for all fluids. Surface tension and protein concentration had no effect on PO2 reduction. Increasing viscosity attenuated PO2 reduction. However, the attenuated effect was absent after fluid mixing. Furthermore, ADV-mediated PO2 reduction in whole blood (30.8 ± 3.2 mmHg) was less than that in a polyvinylpyrrolidone solution (40.2 ± 2.1 mmHg) with equal viscosity. These findings should be considered when planning clinical studies of ADV-mediated PO2 reduction and other biomedical applications of ADV.
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Affiliation(s)
| | - Haili Su
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Deepak S Kalaikadal
- Department of Mechanical and Materials Engineering, University of Cincinnati, Cincinnati, OH, USA
| | - John N Lorenz
- Department of Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, OH, USA
| | - Raj M Manglik
- Department of Mechanical and Materials Engineering, University of Cincinnati, Cincinnati, OH, USA
| | - Christy K Holland
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
| | - Andrew N Redington
- Division of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kevin J Haworth
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA; Division of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
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Devarakonda SB, Stringer K, Rao M, Myers M, Banerjee R. Assessment of Enhanced Thermal Effect Due to Gold Nanoparticles during MR-Guided High-Intensity Focused Ultrasound (HIFU) Procedures Using a Mouse-Tumor Model. ACS Biomater Sci Eng 2019; 5:4102-4111. [PMID: 33448811 DOI: 10.1021/acsbiomaterials.9b00368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
An in vivo study was conducted using a mouse tumor model, to assess the utility of using gold nanoparticles (gNPs) during HIFU procedures to locally enhance heating at low powers. Tumors were grown using melanoma tumor cells (B16/F10) subcutaneously on the right flanks of mice (C57Bl/6J). Physiologically relevant concentrations (0 and 0.125%) of gNPs were directly injected into the tumors. Sonications at acoustic powers of 10 and 30 W were performed for a duration of 16 s inside a magnetic-resonance system. Temperature increases and lesion volumes were calculated and compared for procedures with and without gNPs. Histopathology study was conducted using a cleaved caspase 3 antibody and hematoxylin and eosin staining after removing the tumors from the mice. For an acoustic power of 30 W, end-of-sonication temperature increases of 25.4 ± 3.8 °C (0% gNP) and 42.2 ± 4.6 °C (0.125% gNP) were measured. Using cleaved caspase 3 antibody, it was observed that more than 1% of nuclei are affected in the case of 0.125% and 30 W but only 0.01% of nuclei are affected in the 0% case. For 30 W and a gNP concentration of 0.125%, a lesion volume of 0.33 ± 0.22 mm3 was obtained, while no lesion was observed without gNP's.
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Affiliation(s)
- Surendra B Devarakonda
- Department of Mechanical, Materials Engineering, College of Engineering and Applied Science, University of Cincinnati, 593 Rhodes Hall, Cincinnati, Ohio 45221, United States
| | - Keith Stringer
- Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio 45229, United States
| | - Marepalli Rao
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio 45221, United States
| | - Matthew Myers
- Division of Solid and Fluid Mechanics, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryland 20993, United States
| | - Rupak Banerjee
- Department of Mechanical, Materials Engineering, College of Engineering and Applied Science, University of Cincinnati, 593 Rhodes Hall, Cincinnati, Ohio 45221, United States
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Peng C, Sun T, Vykhodtseva N, Power C, Zhang Y, Mcdannold N, Porter T. Intracranial Non-thermal Ablation Mediated by Transcranial Focused Ultrasound and Phase-Shift Nanoemulsions. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2104-2117. [PMID: 31101446 PMCID: PMC6591088 DOI: 10.1016/j.ultrasmedbio.2019.04.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 03/18/2019] [Accepted: 04/07/2019] [Indexed: 05/09/2023]
Abstract
High intensity focused ultrasound (HIFU) mechanical ablation is an emerging technique for non-invasive transcranial surgery. Lesions are created by driving inertial cavitation in tissue, which requires significantly less peak pressure and time-averaged power compared with traditional thermal ablation. The utility of mechanical ablation could be extended to the brain provided the pressure threshold for inertial cavitation can be reduced. In this study, the utility of perfluorobutane (PFB)-based phase-shift nanoemulsions (PSNEs) for lowering the inertial cavitation threshold and enabling focal mechanical ablation in the brain was investigated. We successfully achieved vaporization of PFB-based PSNEs at 1.8 MPa with a 740 kHz focused transducer with a pulsed sonication protocol (duty cycle = 1.5%, 10 min sonication) within intact CD-1 mice brains. Evidence is provided showing that a single bolus injection of PSNEs could be used to initiate and sustain inertial cavitation in cerebrovasculature for at least 10 min. Histologic analysis of brain slices after HIFU exposure revealed ischemic and hemorrhagic lesions with dimensions that were comparable to the focal zone of the transducer. These results suggest that PFB-based PSNEs may be used to significantly reduce the inertial cavitation threshold in the cerebrovasculature and, when combined with transcranial focused ultrasound, enable focal intracranial mechanical ablation.
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Affiliation(s)
- Chenguang Peng
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA; Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
| | - Tao Sun
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Natalia Vykhodtseva
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Chanikarn Power
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Yongzhi Zhang
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Nathan Mcdannold
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Tyrone Porter
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
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Loskutova K, Grishenkov D, Ghorbani M. Review on Acoustic Droplet Vaporization in Ultrasound Diagnostics and Therapeutics. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9480193. [PMID: 31392217 PMCID: PMC6662494 DOI: 10.1155/2019/9480193] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/10/2019] [Accepted: 06/20/2019] [Indexed: 02/06/2023]
Abstract
Acoustic droplet vaporization (ADV) is the physical process in which liquid undergoes phase transition to gas after exposure to a pressure amplitude above a certain threshold. In recent years, new techniques in ultrasound diagnostics and therapeutics have been developed which utilize microformulations with various physical and chemical properties. The purpose of this review is to give the reader a general idea on how ADV can be implemented for the existing biomedical applications of droplet vaporization. In this regard, the recent developments in ultrasound therapy which shed light on the ADV are considered. Modern designs of capsules and nanodroplets (NDs) are shown, and the material choices and their implications for function are discussed. The influence of the physical properties of the induced acoustic field, the surrounding medium, and thermophysical effects on the vaporization are presented. Lastly, current challenges and potential future applications towards the implementation of the therapeutic droplets are discussed.
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Affiliation(s)
- Ksenia Loskutova
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, SE-141 57 Huddinge, Sweden
| | - Dmitry Grishenkov
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, SE-141 57 Huddinge, Sweden
| | - Morteza Ghorbani
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, SE-141 57 Huddinge, Sweden
- Mechatronics Engineering Program, Faculty of Engineering and Natural Science, Sabanci University, Istanbul 34956, Turkey
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Zhang Y, Yong L, Luo Y, Ding X, Xu D, Gao X, Yan S, Wang Q, Luo J, Pu D, Zou J. Enhancement of HIFU ablation by sonosensitizer-loading liquid fluorocarbon nanoparticles with pre-targeting in a mouse model. Sci Rep 2019; 9:6982. [PMID: 31061456 PMCID: PMC6502828 DOI: 10.1038/s41598-019-43416-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 04/23/2019] [Indexed: 01/09/2023] Open
Abstract
High intensity focused ultrasound (HIFU) is a noninvasive thermal ablation technique for the treatment of benign and malignant solid masses. To improve the efficacy of HIFU ablation, we developed poly (lactide-co-glycolide) (PLGA) nanoparticles encapsulating perfluoropentane (PFP) and hematoporphyrin monomethyl ether (HMME) as synergistic agents (HMME+PFP/PLGA). Two-step biotin-avidin pre-targeting technique was applied for the HIFU ablation. We further modified the nanoparticles with streptavidin (HMME+PFP/PLGA-SA). HMME+PFP/PLGA-SA were highly dispersed with spherical morphology (477.8 ± 81.8 nm in diameter). The encapsulation efficiency of HMME and PFP were 46.6 ± 3.3% and 40.1 ± 2.6%, respectively. The binding efficiency of nanoparticles to streptavidin was 95.5 ± 2.5%. The targeting ability of the HMME+PFP/PLGA-SA nanoparticles was tested by parallel plate flow chamber in vitro. In the pre-targeting group (HMME+PFP/PLGA-SA), a large number of nanoparticles bound to the peripheral and surface of the cell. In the HIFU ablation experiment in vivo, compared with the other groups, the largest gray-scale changes and coagulation necrosis areas were observed in the pre-targeting (HMME+PFP/PLGA-SA) group, with the lowest energy efficiency factor value. Moreover, the microvessel density and proliferation index declined, while the apoptotic index increased, in the tumor tissue surrounding the coagulation necrosis area in the pre-targeting group. Meanwhile, the survival time of the tumor-bearing nude mice in the pre-targeting group was significantly longer than that in the HIFU treatment group. These results suggest that HMME+PFP/PLGA-SA have high potential to act as synergistic agents in HIFU ablation.
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Affiliation(s)
- Yong Zhang
- State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing, 400016, China
- Department of Ultrasound, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400042, China
| | - Lijun Yong
- Department of Obstetrics, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Yong Luo
- State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing, 400016, China
| | - Xiaoya Ding
- State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing, 400016, China
| | - Die Xu
- State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing, 400016, China
| | - Xuan Gao
- State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing, 400016, China
| | - Sijing Yan
- State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing, 400016, China
- Department of Ultrasound, Chongqing Traditional Chinese Medicine Hospital, Chongqing, 400021, China
| | - Qi Wang
- State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing, 400016, China
| | - Jie Luo
- Department of Ultrasound, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400042, China
| | - Darong Pu
- Department of Ultrasound, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400042, China
| | - Jianzhong Zou
- State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing, 400016, China.
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39
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Fluorinated MRI contrast agents and their versatile applications in the biomedical field. Future Med Chem 2019; 11:1157-1175. [DOI: 10.4155/fmc-2018-0463] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
MRI has been recognized as one of the most applied medical imaging techniques in clinical practice. However, the presence of background signal coming from water protons in surrounding tissues makes sometimes the visualization of local contrast agents difficult. To remedy this, fluorine has been introduced as a reliable perspective, thanks to its magnetic properties being relatively close to those of protons. In this review, we aim to give an overall description of fluorine incorporation in contrast agents for MRI. The different kinds of fluorinated probes such as perfluorocarbons, fluorinated dendrimers, polymers and paramagnetic probes will be described, as will their imaging applications such as chemical exchange saturation transfer (CEST) imaging, physico-chemical changes detection, drug delivery, cell tracking and inflammation or tumors detection.
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40
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Zhang G, Lin S, Leow CH, Pang KT, Hernández-Gil J, Long NJ, Eckersley R, Matsunaga T, Tang MX. Quantification of Vaporised Targeted Nanodroplets Using High-Frame-Rate Ultrasound and Optics. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1131-1142. [PMID: 30827708 DOI: 10.1016/j.ultrasmedbio.2019.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 01/08/2019] [Accepted: 01/11/2019] [Indexed: 06/09/2023]
Abstract
Molecular targeted nanodroplets that can extravasate beyond the vascular space have great potential to improve tumor detection and characterisation. High-frame-rate ultrasound, on the other hand, is an emerging tool for imaging at a frame rate one to two orders of magnitude higher than those of existing ultrasound systems. In this study, we used high-frame-rate ultrasound combined with optics to study the acoustic response and size distribution of folate receptor (FR)-targeted versus non-targeted (NT)-nanodroplets in vitro with MDA-MB-231 breast cancer cells immediately after ultrasound activation. A flow velocity mapping technique, Stokes' theory and optical microscopy were used to estimate the size of both floating and attached vaporised nanodroplets immediately after activation. The floating vaporised nanodroplets were on average more than seven times larger than vaporised nanodroplets attached to the cells. The results also indicated that the acoustic signal of vaporised FR-targeted-nanodroplets persisted after activation, with 70% of the acoustic signals still present 1 s after activation, compared with the vaporised NT-nanodroplets, for which only 40% of the acoustic signal remained. The optical microscopic images revealed on average six times more vaporised FR-targeted-nanodroplets generated with a wider range of diameters (from 4 to 68 µm) that were still attached to the cells, compared with vaporised NT-nanodroplets (from 1 to 7 µm) with non-specific binding after activation. The mean size of attached vaporised FR-targeted-nanodroplets was on average about threefold larger than that of attached vaporised NT-nanodroplets. Taking advantage of high-frame-rate contrast-enhanced ultrasound and optical microscopy, this study offers an improved understanding of the vaporisation of the targeted nanodroplets in terms of their size and acoustic response in comparison with NT-nanodroplets. Such understanding would help in the design of optimised methodology for imaging and therapeutic applications.
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Affiliation(s)
- Ge Zhang
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Shengtao Lin
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Chee Hao Leow
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Kuin Tian Pang
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | | | - Nicholas J Long
- Department of Chemistry, Imperial College London, London, United Kingdom
| | - Robert Eckersley
- Division of Imaging Sciences & Biomedical Engineering Department, King's College London, United Kingdom
| | - Terry Matsunaga
- Department of Medical Imaging, University of Arizona, Tucson, Arizona, USA
| | - Meng-Xing Tang
- Department of Bioengineering, Imperial College London, London, United Kingdom.
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41
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Yildirim A, Blum NT, Goodwin AP. Colloids, nanoparticles, and materials for imaging, delivery, ablation, and theranostics by focused ultrasound (FUS). Theranostics 2019; 9:2572-2594. [PMID: 31131054 PMCID: PMC6525987 DOI: 10.7150/thno.32424] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/25/2019] [Indexed: 12/15/2022] Open
Abstract
This review focuses on different materials and contrast agents that sensitize imaging and therapy with Focused Ultrasound (FUS). At high intensities, FUS is capable of selectively ablating tissue with focus on the millimeter scale, presenting an alternative to surgical intervention or management of malignant growth. At low intensities, FUS can be also used for other medical applications such as local delivery of drugs and blood brain barrier opening (BBBO). Contrast agents offer an opportunity to increase selective acoustic absorption or facilitate destructive cavitation processes by converting incident acoustic energy into thermal and mechanical energy. First, we review the history of FUS and its effects on living tissue. Next, we present different colloidal or nanoparticulate approaches to sensitizing FUS, for example using microbubbles, phase-shift emulsions, hollow-shelled nanoparticles, or hydrophobic silica surfaces. Exploring the science behind these interactions, we also discuss ways to make stimulus-responsive, or "turn-on" contrast agents for improved selectivity. Finally, we discuss acoustically-active hydrogels and membranes. This review will be of interest to those working in materials who wish to explore new applications in acoustics and those in acoustics who are seeking new agents to improve the efficacy of their approaches.
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Affiliation(s)
- Adem Yildirim
- Department of Chemical and Biological Engineering, University of Colorado Boulder, Boulder, CO 80303 USA
- Present address: CEDAR, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, 97239 USA
| | - Nicholas T. Blum
- Department of Chemical and Biological Engineering, University of Colorado Boulder, Boulder, CO 80303 USA
| | - Andrew P. Goodwin
- Department of Chemical and Biological Engineering, University of Colorado Boulder, Boulder, CO 80303 USA
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Mou C, Yang Y, Bai Y, Yuan P, Wang Y, Zhang L. Hyaluronic acid and polydopamine functionalized phase change nanoparticles for ultrasound imaging-guided photothermal-chemotherapy. J Mater Chem B 2019; 7:1246-1257. [DOI: 10.1039/c8tb03056a] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Hyaluronic acid and polydopamine functionalized phase change nanoparticles for ultrasound imaging-guided photothermal-chemotherapy.
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Affiliation(s)
- Chongyan Mou
- Chongqing Research Center for Pharmaceutical Engineering
- Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology
- College of Pharmacy
- Chongqing Medical University
- Chongqing 400016
| | - Yang Yang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging
- Institute of Ultrasound Imaging
- Chongqing Medical University
- Chongqing 400016
- P. R. China
| | - Yan Bai
- Chongqing Research Center for Pharmaceutical Engineering
- Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology
- College of Pharmacy
- Chongqing Medical University
- Chongqing 400016
| | - Pei Yuan
- Chongqing Research Center for Pharmaceutical Engineering
- Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology
- College of Pharmacy
- Chongqing Medical University
- Chongqing 400016
| | - Yiwu Wang
- Experimental Teaching and Management Center
- Chongqing Medical University
- Chongqing 400016
- P. R. China
| | - Liangke Zhang
- Chongqing Research Center for Pharmaceutical Engineering
- Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology
- College of Pharmacy
- Chongqing Medical University
- Chongqing 400016
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43
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Desgranges S, Lorton O, Gui-Levy L, Guillemin P, Celicanin Z, Hyacinthe JN, Breguet R, Crowe LA, Becker CD, Soulié M, Taulier N, Contino-Pépin C, Salomir R. Micron-sized PFOB liquid core droplets stabilized with tailored-made perfluorinated surfactants as a new class of endovascular sono-sensitizers for focused ultrasound thermotherapy. J Mater Chem B 2019; 7:927-939. [DOI: 10.1039/c8tb01491d] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The effect of micro-droplet concentration on HIFU beam absorption.
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44
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Jingqi W, Lu Z, Jun Z, Yuhong M, Wei Y, Lifeng R, Chengbing J, Dobromir DD, Hui Z, Kun Z. Clinical Usefulness of the Microbubble Contrast Agent SonoVue in Enhancing the Effects of High-Intensity Focused Ultrasound for the Treatment of Adenomyosis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:2811-2819. [PMID: 29689636 DOI: 10.1002/jum.14638] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 01/26/2018] [Accepted: 02/25/2018] [Indexed: 05/19/2023]
Abstract
OBJECTIVE To evaluate the clinical usefulness of the microbubble contrast agent SonoVue in enhancing high-intensity focused ultrasound (HIFU) for the treatment of adenomyosis. METHODS A total of 102 patients with adenomyosis, assessed from August 2015 to April 2017, were randomly divided into 1-minute (A) and 10-minute (B) groups, respectively. In groups A and B, HIFU started 1 minute and 10 minutes, respectively, after SonoVue injection. All patients underwent a magnetic resonance imaging scan before and after HIFU treatment. RESULTS The occurrence rates of massive gray scale change, nonperfused volume, and fractional ablation were similar in both groups (P > .05). Meanwhile, sonication time to massive gray scale change was reduced in group A compared with group B (P < .05). In addition, mean power, total energy, and energy efficiency factor were lower in group A than group B (all P < .05). The incidence rates of most perioperative and all postoperative adverse events were similar in both groups (P > .05). The incidence rates of pain in the treated region, leg pain, and sciatic or buttock pain during HIFU were substantially lower in group A than group B (P < .05). CONCLUSIONS Overall, starting HIFU sonication at 1 minute after SonoVue injection enhances HIFU ablation by cavitation and heating and is safe. Early massive gray scale change, lower total energy, and reduced mean power are potential safety factors.
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Affiliation(s)
- Wang Jingqi
- State Key Laboratory of Ultrasound Engineering in Medicines Co-Found by Chongqing and the Ministry of Science and Technology Chongqing Key Laboratory of Biomedical Engineering College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Chongqing Collaborative Innovation Center for Minimally Invasive and Noninvasive Medicine, Chongqing, China
| | - Zhang Lu
- State Key Laboratory of Ultrasound Engineering in Medicines Co-Found by Chongqing and the Ministry of Science and Technology Chongqing Key Laboratory of Biomedical Engineering College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Chongqing Collaborative Innovation Center for Minimally Invasive and Noninvasive Medicine, Chongqing, China
| | - Zhang Jun
- Clinical Center for Tumor Therapy of the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ma Yuhong
- Clinical Center for Tumor Therapy of the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Wei
- Clinical Center for Tumor Therapy of the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ran Lifeng
- Clinical Center for Tumor Therapy of the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jin Chengbing
- Clinical Center for Tumor Therapy of the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | | | - Zhu Hui
- Clinical Center for Tumor Therapy of the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhou Kun
- Clinical Center for Tumor Therapy of the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Kotewall N, Lang BHH. High-intensity focused ultrasound ablation as a treatment for benign thyroid diseases: the present and future. Ultrasonography 2018; 38:135-142. [PMID: 30690961 PMCID: PMC6443589 DOI: 10.14366/usg.18040] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/09/2018] [Indexed: 12/13/2022] Open
Abstract
High-intensity focused ultrasound (HIFU) is a promising ablation technique for benign thyroid nodules. Current evidence has found good short- to medium-term outcomes, similar to those of better-established ablation techniques such as radiofrequency and laser ablation. The fact that it does not require insertion of a needle into the target makes HIFU a truly non-invasive treatment. Although it is not without risks, its low risk profile makes it an attractive alternative to surgery. There is much room for future development, starting from expanding the current indications to enhancing energy delivery. Relapsed Graves disease and papillary microcarcinoma are diseases that can benefit from HIFU treatment. Its role in the mediation of immune responses and synergistic effects with immunotherapy are promising in the fight against metastatic cancers.
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Affiliation(s)
- Nicholas Kotewall
- Department of Surgery, The University of Hong Kong, Hong Kong SAR, China
| | - Brian H H Lang
- Department of Surgery, The University of Hong Kong, Hong Kong SAR, China
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Xin Y, Zhang A, Xu LX, Fowlkes JB. The effects on thermal lesion shape and size from bubble clouds produced by acoustic droplet vaporization. Biomed Eng Online 2018; 17:163. [PMID: 30373677 PMCID: PMC6206628 DOI: 10.1186/s12938-018-0596-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 10/25/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bubbles formed by acoustic droplet vaporization (ADV) have proven to be an effective method for significant enlargement of the thermal lesions produced by high intensity focused ultrasound (HIFU). We investigated the influences of bubble cloud shape and droplet concentration on HIFU thermal lesions, as these relate to the ADV technique. METHODS Unlike previous studies where the droplets were simultaneously vaporized with the HIFU exposure for thermal lesion formation, droplets were vaporized by pulse wave (PW) ultrasound prior to continuous wave (CW) ultrasound heating in this experimental study. Under different experimental conditions, we recorded and quantified by the image processing methods the morphology and size of the bubble clouds created and the corresponding thermal lesions formed. RESULTS The results demonstrated that different ADV droplet concentrations produced a variety of thermal lesion shapes and sizes. The lesion volume could be increased using PW ultrasound followed by CW exposure, especially for higher droplet concentrations, e.g. 3.41 × 106/mL yielded a tenfold increase over that seen using CW alone. CONCLUSION These findings could lead to optimization of HIFU therapy by selecting a bubble forming strategy and droplet concentrations, especially using lower ultrasound powers which is desirable in clinical applications.
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Affiliation(s)
- Ying Xin
- School of Biomedical Engineering, 400 Med-X Research Institute, Shanghai Jiao Tong University, 1954 Huashan Rd, Shanghai, China
| | - Aili Zhang
- School of Biomedical Engineering, 400 Med-X Research Institute, Shanghai Jiao Tong University, 1954 Huashan Rd, Shanghai, China.
| | - Lisa X Xu
- School of Biomedical Engineering, 400 Med-X Research Institute, Shanghai Jiao Tong University, 1954 Huashan Rd, Shanghai, China
| | - J Brian Fowlkes
- Department of Radiology, University of Michigan Health System, 3226C Medical Sciences Building I, 1301 Catherine Street, Ann Arbor, MI, USA.
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Qin D, Zhang L, Chang N, Ni P, Zong Y, Bouakaz A, Wan M, Feng Y. In situ observation of single cell response to acoustic droplet vaporization: Membrane deformation, permeabilization, and blebbing. ULTRASONICS SONOCHEMISTRY 2018; 47:141-150. [PMID: 29678490 DOI: 10.1016/j.ultsonch.2018.02.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 01/07/2018] [Accepted: 02/05/2018] [Indexed: 05/19/2023]
Abstract
In this study, the bioeffects of acoustic droplet vaporization (ADV) on adjacent cells were investigated by evaluating the real-time cell response at the single-cell level in situ, using a combined ultrasound-exposure and optical imaging system. Two imaging modalities, high-speed and fluorescence imaging, were used to observe ADV bubble dynamics and to evaluate the impact on cell membrane permeabilization (i.e., sonoporation) using propidium iodide (PI) uptake as an indicator. The results indicated that ADV mainly led to irreversible rather than reversible sonoporation. Further, the rate of irreversible sonoporation significantly increased with increasing nanodroplet concentration, ultrasound amplitude, and pulse duration. The results suggested that sonoporation is correlated to the rapid formation, expansion, and contraction of ADV bubbles near cells, and strongly depends on ADV bubble size and bubble-to-cell distance when subjected to short ultrasound pulses (1 μs). Moreover, the displacement of ADV bubbles was larger when using a long ultrasound pulse (20 μs), resulting in considerable cell membrane deformation and a more irreversible sonoporation rate. During sonoporation, cell membrane blebbing as a recovery manoeuvre was also investigated, indicating the essential role of Ca2+ influx in the membrane blebbing response. This study has helped us gain further insights into the dynamic behavior of ADV bubbles near cells, ADV bubble-cell interactions, and real-time cell response, which are invaluable in the development of optimal approaches for ADV-associated theranostic applications.
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Affiliation(s)
- Dui Qin
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, and Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Lei Zhang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, and Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Nan Chang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, and Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Pengying Ni
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, and Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Yujin Zong
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, and Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Ayache Bouakaz
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, and Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China; UMR Inserm U930, Université François-Rabelais de Tours, Tours, France
| | - Mingxi Wan
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, and Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China.
| | - Yi Feng
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, and Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China.
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Chang N, Lu S, Qin D, Xu T, Han M, Wang S, Wan M. Efficient and controllable thermal ablation induced by short-pulsed HIFU sequence assisted with perfluorohexane nanodroplets. ULTRASONICS SONOCHEMISTRY 2018; 45:57-64. [PMID: 29705325 DOI: 10.1016/j.ultsonch.2018.02.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/05/2018] [Accepted: 02/19/2018] [Indexed: 06/08/2023]
Abstract
A HIFU sequence with extremely short pulse duration and high pulse repetition frequency can achieve thermal ablation at a low acoustic power using inertial cavitation. Because of its cavitation-dependent property, the therapeutic outcome is unreliable when the treatment zone lacks cavitation nuclei. To overcome this intrinsic limitation, we introduced perfluorocarbon nanodroplets as extra cavitation nuclei into short-pulsed HIFU-mediated thermal ablation. Two types of nanodroplets were used with perfluorohexane (PFH) as the core material coated with bovine serum albumin (BSA) or an anionic fluorosurfactant (FS) to demonstrate the feasibility of this study. The thermal ablation process was recorded by high-speed photography. The inertial cavitation activity during the ablation was revealed by sonoluminescence (SL). The high-speed photography results show that the thermal ablation volume increased by ∼643% and 596% with BSA-PFH and FS-PFH, respectively, than the short-pulsed HIFU alone at an acoustic power of 19.5 W. Using nanodroplets, much larger ablation volumes were created even at a much lower acoustic power. Meanwhile, the treatment time for ablating a desired volume significantly reduced in the presence of nanodroplets. Moreover, by adjusting the treatment time, lesion migration towards the HIFU transducer could also be avoided. The SL results show that the thermal lesion shape was significantly dependent on the inertial cavitation in this short-pulsed HIFU-mediated thermal ablation. The inertial cavitation activity became more predictable by using nanodroplets. Therefore, the introduction of PFH nanodroplets as extra cavitation nuclei made the short-pulsed HIFU thermal ablation more efficient by increasing the ablation volume and speed, and more controllable by reducing the acoustic power and preventing lesion migration.
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Affiliation(s)
- Nan Chang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Shukuan Lu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Dui Qin
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Tianqi Xu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Meng Han
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Supin Wang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China.
| | - Mingxi Wan
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China.
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Chong WK, Papadopoulou V, Dayton PA. Imaging with ultrasound contrast agents: current status and future. Abdom Radiol (NY) 2018; 43:762-772. [PMID: 29508011 DOI: 10.1007/s00261-018-1516-1] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Microbubble ultrasound contrast agents (UCAs) were recently approved by the Food and Drug administration for non-cardiac imaging. The physical principles of UCAs, methods of administration, dosage, adverse effects, and imaging techniques both current and future are described. UCAs consist of microbubbles in suspension which strongly interact with the ultrasound beam and are readily detectable by ultrasound imaging systems. They are confined to the blood pool when administered intravenously, unlike iodinated and gadolinium contrast agents. UCAs have a proven safety record based on over two decades of use, during which they have been used in echocardiography in the U.S. and for non-cardiac imaging in the rest of the world. Adverse effects are less common with UCAs than CT/MR contrast agents. Compared to CT and MR, contrast-enhanced ultrasound has the advantages of real-time imaging, portability, and reduced susceptibility to metal and motion artifact. UCAs are not nephrotoxic and can be used in renal failure. High acoustic amplitudes can cause microbubbles to fragment in a manner that can result in short-term increases in capillary permeability or capillary rupture. These bioeffects can be beneficial and have been used to enhance drug delivery under appropriate conditions. Imaging with a mechanical index of < 0.4 preserves the microbubbles and is not typically associated with substantial bioeffects. Molecularly targeted ultrasound contrast agents are created by conjugating the microbubble shell with a peptide, antibody, or other ligand designed to target an endothelial biomarker associated with tumor angiogenesis or inflammation. These microbubbles then accumulate in the microvasculature at target sites where they can be imaged. Ultrasound contrast agents are a valuable addition to the diagnostic imaging toolkit. They will facilitate cross-sectional abdominal imaging in situations where contrast-enhanced CT and MR are contraindicated or impractical.
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Affiliation(s)
- Wui K Chong
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Unit 1473 | FCT15.5092, 1400 Pressler Street, Houston, TX, 77030, USA.
| | - Virginie Papadopoulou
- UNC-NC State Joint Department of Biomedical Engineering, Chapel Hill, NC, 27599, USA
| | - Paul A Dayton
- UNC Biomedical Research Imaging Center, Chapel Hill, NC, 27599, USA
- UNC-NC State Joint Department of Biomedical Engineering, Chapel Hill, NC, 27599, USA
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Xin Y, Zhang A, Xu LX, Brian Fowlkes J. Numerical Study of Bubble Area Evolution During Acoustic Droplet Vaporization-Enhanced HIFU Treatment. J Biomech Eng 2018; 139:2635775. [PMID: 28654938 DOI: 10.1115/1.4037150] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Indexed: 01/05/2023]
Abstract
Acoustic droplet vaporization has the potential to shorten treatment time of high-intensity focused ultrasound (HIFU) while minimizing the possible effects of microbubbles along the propagation path. Distribution of the bubbles formed from the droplets during the treatment is the major factor shaping the therapeutic region. A numerical model was proposed to simulate the bubble area evolution during this treatment. Using a linear acoustic equation to describe the ultrasound field, a threshold range was defined that determines the amount of bubbles vaporized in the treated area. Acoustic parameters, such as sound speed, acoustic attenuation coefficient, and density, were treated as a function of the bubble size distribution and the gas void fraction, which were related to the vaporized bubbles in the medium. An effective pressure factor was proposed to account for the influence of the existing bubbles on the vaporization of the nearby droplets. The factor was obtained by fitting one experimental result and was then used to calculate bubble clouds in other experimental cases. Comparing the simulation results to these other experiments validated the model. The dynamic change of the pressure and the bubble distribution after exposure to over 20 pulses of HIFU are obtained. It is found that the bubble area grows from a grainlike shape to a "tadpole," with comparable dimensions and shape to those observed in experiments. The process was highly dynamic with the shape of the bubble area changing with successive HIFU pulses and the focal pressure. The model was further used to predict the shape of the bubble region triggered by HIFU when a bubble wall pre-exists. The results showed that the bubble wall helps prevent droplet vaporization on the distal side of the wall and forms a particularly shaped region with bubbles. This simulation model has predictive potential that could be beneficial in applications, such as cancer treatment, by parametrically studying conditions associated with these treatments and designing treatment protocols.
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Affiliation(s)
- Ying Xin
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; 400 Med-X Research Institute, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China e-mail:
| | - Aili Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; 400 Med-X Research Institute, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China e-mail:
| | - Lisa X Xu
- Fellow ASME School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; 400 Med-X Research Institute, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China e-mail:
| | - J Brian Fowlkes
- Department of Radiology, University of Michigan Health System, 3226C Medical Sciences Building I, 1301 Catherine Street, Ann Arbor, MI 48109-5667 e-mail:
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