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Worlikar T, Zhang M, Ganguly A, Hall TL, Shi J, Zhao L, Lee FT, Mendiratta-Lala M, Cho CS, Xu Z. Impact of Histotripsy on Development of Intrahepatic Metastases in a Rodent Liver Tumor Model. Cancers (Basel) 2022; 14:1612. [PMID: 35406383 PMCID: PMC8996987 DOI: 10.3390/cancers14071612] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/18/2022] [Indexed: 02/04/2023] Open
Abstract
Histotripsy has been used for tumor ablation, through controlled, non-invasive acoustic cavitation. This is the first study to evaluate the impact of partial histotripsy ablation on immune infiltration, survival outcomes, and metastasis development, in an in vivo orthotopic, immunocompetent rat HCC model (McA-RH7777). At 7−9 days post-tumor inoculation, the tumor grew to 5−10 mm, and ~50−75% tumor volume was treated by ultrasound-guided histotripsy, by delivering 1−2 cycle histotripsy pulses at 100 Hz PRF (focal peak negative pressure P− >30 MPa), using a custom 1 MHz transducer. Complete local tumor regression was observed on MRI in 9/11 histotripsy-treated rats, with no local recurrence or metastasis up to the 12-week study end point, and only a <1 mm residual scar tissue observed on histology. In comparison, 100% of untreated control animals demonstrated local tumor progression, developed intrahepatic metastases, and were euthanized at 1−3 weeks. Survival outcomes in histotripsy-treated animals were significantly improved compared to controls (p-value < 0.0001). There was evidence of potentially epithelial-to-mesenchymal transition (EMT) in control tumor and tissue healing in histotripsy-treated tumors. At 2- and 7-days post-histotripsy, increased immune infiltration of CD11b+, CD8+ and NK cells was observed, as compared to controls, which may have contributed to the eventual regression of the untargeted tumor region in histotripsy-treated tumors.
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Affiliation(s)
- Tejaswi Worlikar
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (T.W.); (T.L.H.)
| | - Man Zhang
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA; (M.Z.); (M.M.-L.)
| | - Anutosh Ganguly
- Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA; (A.G.); (C.S.C.)
| | - Timothy L. Hall
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (T.W.); (T.L.H.)
| | - Jiaqi Shi
- Department of Pathology & Clinical Labs, Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Lili Zhao
- Department of Biostatistics, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Fred T. Lee
- Department of Radiology, University of Wisconsin, Madison, WI 53705, USA;
| | - Mishal Mendiratta-Lala
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA; (M.Z.); (M.M.-L.)
| | - Clifford S. Cho
- Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA; (A.G.); (C.S.C.)
- Department of Surgery, Ann Arbor VA Healthcare, Ann Arbor, MI 48105, USA
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (T.W.); (T.L.H.)
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