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Pan X, Huang W, Nie G, Wang C, Wang H. Ultrasound-Sensitive Intelligent Nanosystems: A Promising Strategy for the Treatment of Neurological Diseases. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2303180. [PMID: 37871967 DOI: 10.1002/adma.202303180] [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: 04/05/2023] [Revised: 09/26/2023] [Indexed: 10/25/2023]
Abstract
Neurological diseases are a major global health challenge, affecting hundreds of millions of people worldwide. Ultrasound therapy plays an irreplaceable role in the treatment of neurological diseases due to its noninvasive, highly focused, and strong tissue penetration capabilities. However, the complexity of brain and nervous system and the safety risks associated with prolonged exposure to ultrasound therapy severely limit the applicability of ultrasound therapy. Ultrasound-sensitive intelligent nanosystems (USINs) are a novel therapeutic strategy for neurological diseases that bring greater spatiotemporal controllability and improve safety to overcome these challenges. This review provides a detailed overview of therapeutic strategies and clinical advances of ultrasound in neurological diseases, focusing on the potential of USINs-based ultrasound in the treatment of neurological diseases. Based on the physical and chemical effects induced by ultrasound, rational design of USINs is a prerequisite for improving the efficacy of ultrasound therapy. Recent developments of ultrasound-sensitive nanocarriers and nanoagents are systemically reviewed. Finally, the challenges and developing prospects of USINs are discussed in depth, with a view to providing useful insights and guidance for efficient ultrasound treatment of neurological diseases.
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Affiliation(s)
- Xueting Pan
- CAS Key Laboratory for Biomedical Effects of Nanomaterials & Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing, 100190, China
| | - Wenping Huang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials & Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing, 100190, China
- School of Nanoscience and Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Guangjun Nie
- CAS Key Laboratory for Biomedical Effects of Nanomaterials & Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing, 100190, China
- School of Nanoscience and Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Changyong Wang
- Beijing Institute of Basic Medical Sciences, 27 Taiping Road, Beijing, 100850, China
| | - Hai Wang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials & Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing, 100190, China
- School of Nanoscience and Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
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Tran MD, Ngo H, Fawzy A. High-Intensity Focused Ultrasound in Dentistry: A Literature Review. Int Dent J 2024:S0020-6539(24)00060-1. [PMID: 38609759 DOI: 10.1016/j.identj.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 04/14/2024] Open
Abstract
Although high-intensity focused ultrasound (HIFU) has been applied widely in medicine, utilising its non-invasive dual ablation and thermal coagulation properties, its application in dentistry has primarily remained in the research phase, predominantly in in vitro studies. Nonetheless, there has been a consistent increase in the number of publications on this subject in recent decades, focusing on areas such as remineralisation of dentine surfaces, removal of smear layers, drug delivery, and microbial elimination. The number of advantages HIFU can offer, such as its non-surgical nature, absence of ionising radiation, lack of residue, and absence of aerosols, is driving this upward trend, indicating the potential for HIFU in clinical dentistry and ongoing efforts towards developing HIFU-based devices for routine dental use. This succinct review aims to outline the historical context, operational mechanisms of HIFU, summarise recent dental research, and provide a forward-looking perspective on the role of HIFU in modern clinical dentistry.
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Affiliation(s)
- Minh Dien Tran
- Restorative Dentistry/Dental Biomaterials Research Group, UWA Dental School/The University of Western Australia, Perth, Australia.
| | - Hien Ngo
- Restorative Dentistry/Dental Biomaterials Research Group, UWA Dental School/The University of Western Australia, Perth, Australia
| | - Amr Fawzy
- Restorative Dentistry/Dental Biomaterials Research Group, UWA Dental School/The University of Western Australia, Perth, Australia
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Lawson McLean A, Vetrano IG, Lawson McLean AC, Conti A, Mertens P, Müther M, Nemir J, Peschillo S, Santacroce A, Sarica C, Tuleasca C, Zoia C, Régis J. Revitalizing neurosurgical frontiers: The EANS frontiers in neurosurgery committee's strategic framework. BRAIN & SPINE 2024; 4:102794. [PMID: 38601776 PMCID: PMC11004717 DOI: 10.1016/j.bas.2024.102794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/12/2024]
Abstract
Introduction The field of neurosurgery faces challenges with the increasing involvement of other medical specialties in areas traditionally led by neurosurgeons. This paper examines the implications of this development for neurosurgical practice and patient care, with a focus on specialized areas like pain management, peripheral nerve surgery, and stereotactic radiosurgery. Research question To assess the implications of the expanded scope of other specialties for neurosurgical practice and to consider the response of the EANS Frontiers in Neurosurgery Committee to these challenges. Materials and methods Analysis of recent trends in neurosurgery, including the shift in various procedures to other specialties, demographic challenges, and the emergence of minimally invasive techniques. This analysis draws on relevant literature and the initiatives of the Frontiers in Neurosurgery Committee. Results We explore a possible decrease in neurosurgical involvement in certain areas, which may have implications for patient care and access to specialized neurosurgical interventions. The Frontiers in Neurosurgery Committee's role in addressing these concerns is highlighted, particularly in terms of training, education, research, and networking for neurosurgeons, especially those early in their careers. Discussion and conclusion The potential decrease in neurosurgical involvement in certain specialties warrants attention. This paper emphasizes the importance of carefully considered responses by neurosurgical societies, such as the EANS, to ensure neurosurgeons continue to play a vital role in managing neurological diseases. Emphasis on ongoing education, integration of minimally invasive techniques, and multidisciplinary collaboration is essential for maintaining the field's competence and quality in patient care.
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Affiliation(s)
- Aaron Lawson McLean
- Department of Neurosurgery, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena University Hospital, Jena, Germany
| | - Ignazio G. Vetrano
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anna C. Lawson McLean
- Department of Neurosurgery, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena University Hospital, Jena, Germany
| | - Alfredo Conti
- UOC Neurochirurgia, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Patrick Mertens
- Department of Neurosurgery, University Hospital of Neurology and Neurosurgery, Hospices Civils de Lyon, University Lyon 1, Lyon, France
| | - Michael Müther
- Department of Neurosurgery, University Hospital Münster, Münster, Germany
| | - Jakob Nemir
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, Zagreb, Croatia
| | - Simone Peschillo
- Endovascular Neurosurgery, Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Antonio Santacroce
- Department of Neurosurgery, St. Barbara-Klinik Hamm-Heessen, Hamm, Germany
- Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
- European Radiosurgery Center Munich, Munich, Germany
| | - Can Sarica
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontatio, Canada
| | - Constantin Tuleasca
- Lausanne University Hospital (CHUV), Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland
- University of Lausanne (UNIL), Faculty of Biology and Medicine (FBM), Lausanne, Switzerland
| | - Cesare Zoia
- UOC Neurochirurgia, Ospedale Moriggia Pelascini, Gravedona e Uniti, Italy
| | - Jean Régis
- Aix Marseille University, Department of Functional Neurosurgery, CHU Timone, Marseille, France
| | - EANS Frontiers in Neurosurgery Committee
- Department of Neurosurgery, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena University Hospital, Jena, Germany
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- UOC Neurochirurgia, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Alma Mater Studiorum Università di Bologna, Bologna, Italy
- Department of Neurosurgery, University Hospital of Neurology and Neurosurgery, Hospices Civils de Lyon, University Lyon 1, Lyon, France
- Department of Neurosurgery, University Hospital Münster, Münster, Germany
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, Zagreb, Croatia
- Endovascular Neurosurgery, Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
- Department of Neurosurgery, St. Barbara-Klinik Hamm-Heessen, Hamm, Germany
- Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
- European Radiosurgery Center Munich, Munich, Germany
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontatio, Canada
- Lausanne University Hospital (CHUV), Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland
- University of Lausanne (UNIL), Faculty of Biology and Medicine (FBM), Lausanne, Switzerland
- UOC Neurochirurgia, Ospedale Moriggia Pelascini, Gravedona e Uniti, Italy
- Aix Marseille University, Department of Functional Neurosurgery, CHU Timone, Marseille, France
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Ciatawi K, Dusak IWS, Wiratnaya IGE. High-intensity focused ultrasound-a needleless management for osteoid osteoma: a systematic review. Musculoskelet Surg 2024; 108:21-30. [PMID: 38150115 DOI: 10.1007/s12306-023-00801-1] [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: 07/29/2022] [Accepted: 10/24/2023] [Indexed: 12/28/2023]
Abstract
Osteoid osteoma is one of the most frequent benign musculoskeletal neoplasm. Radiofrequency ablation is the method of choice for non-conservative treatment of osteoid osteoma. Recently, high-intensity focused ultrasound (HIFU) has been proposed as a safer option. The objective of this study is to review the efficacy and side effects of HIFU in the management of osteoid osteoma. A comprehensive search was conducted in PubMed, Science Direct, and Clinical Key until June 30, 2022. Demographic data, baseline characteristics, success rates, pre- and post-procedure pain scores, recurrences, and complications were recorded. Eleven studies were included in this systematic review. Pooled analysis that involved 186 subjects resulted in an overall success rate of 91.94%. Recurrence was reported in two studies, in which it occurred in 4/177 (2.26%) subjects. Skin burn was found in 1 (0.54%) patients. No major or other complications were reported. Three studies compared the success rate of HIFU and RFA. Success rate was slightly higher in the RFA group with insignificant difference (p = 0.15). High-intensity focused ultrasound showed promising results. It offers a safer treatment approach for osteoid osteoma, especially in children, and can be considered for recalcitrant cases after RFA. Nonetheless, more studies are expected in the future.
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Affiliation(s)
- K Ciatawi
- Faculty of Medicine, University of North Sumatera, Medan, Indonesia.
| | - I W S Dusak
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | - I G E Wiratnaya
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Udayana University, Denpasar, Indonesia
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Khong SJML, ismail AH, Sujani S, Devindaran N, Abdul Rashid MF, Mohd Zaman UMS. Safety and Efficacy of High-Intensity Focused Ultrasound and Monopolar Radiofrequency Combination Therapy for Skin Tightening: A Retrospective Study in Malaysia. Malays J Med Sci 2024; 31:114-123. [PMID: 38456105 PMCID: PMC10917599 DOI: 10.21315/mjms2024.31.1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/21/2023] [Indexed: 03/09/2024] Open
Abstract
Background High-intensity focused ultrasound (HIFU) and monopolar radiofrequency (MRF) are common treatment modalities that have shown significant results in skin tightening. Nevertheless, the novel combination of these two treatments is new to the Malaysian landscape. Thus, this study aims to investigate the safety and efficacy of this novel combination treatment for the Malaysian population. Methods This retrospective study included data on HIFU and MRF combination therapy for skin tightening collected from an aesthetic clinic in Johor Bahru, Malaysia from June 2018 to May 2021. Efficacy was assessed using the Global Aesthetic Improvement Scale (GAIS) and Glogau classification, while the safety of the treatment was analysed using pain scores and adverse events (AEs). Results A total of 56 patients with a mean age of 47.7 years old (SD 10.00) were included in this study. The majority of the patients had Fitzpatrick skin types III and IV. Most of the patients were Chinese, followed by Malay, Indian and others. Most patients (96.4%) showed clinically significant improvement in skin tightening after treatment, with 15 patients scoring 1 (very much improved) and 39 scoring 2 (improved). All patients reported transient mild erythema, with no serious AEs, such as burn, swelling, numbness or muscle weakness. Among the patients, 80% reported a pain score of 5, while 10% reported pain scores of 4 and 6. Conclusion Combining HIFU with MRF therapy improved GAIS scores by 96.4%, indicating a secure and efficient skin-tightening method. Transient erythema was shown to be the most common side effect of this combination.
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Li S, Ma WW, Yang MJ, Deng YB, Hu L, Chen JY. Long-term re-intervention after USgHIFU and prediction of NPVR in different ages of patients with uterine fibroids. Int J Hyperthermia 2024; 41:2304264. [PMID: 38258583 DOI: 10.1080/02656736.2024.2304264] [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: 09/19/2023] [Accepted: 01/07/2024] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVE Long-term re-intervention after ultrasound-guided high intensity focused ultrasound (USgHIFU) ablation was reported, and the prediction of non-perfusion volume ratio (NPVR) in differently aged patients with uterine fibroids (UFs) was explored. MATERIALS AND METHODS Patients with UFs who underwent USgHIFU ablation from January 2012 to December 2019 were enrolled and divided into < 40-year-old and ≥ 40-year-old groups. Cox regression was used to analyze the influencing factors of re-intervention rate, and receiver operating characteristic (ROC) curve was used to analyze the correlation between NPVR and re-intervention rate. RESULTS A total of 2141 patients were enrolled, and 1558 patients were successfully followed up. The 10-year cumulative re-intervention rate was 21.9%, and the < 40-year-old group had a significantly higher rate than the ≥ 40-year-old group (30.8% vs. 19.1%, p < 0.001). NPVR was an independent risk factor in both two groups. When the NPVR reached 80.5% in the < 40-year-old group and 75.5% in the ≥ 40-year-old group, the risk of long-term re-intervention was satisfactory. CONCLUSION The long-term outcome of USgHIFU is promising. The re-intervention rate is related to NPVR in differently aged patients. Young patients need a high NPVR to reduce re-intervention risk.
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Affiliation(s)
- Shuang Li
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Wang-Wa Ma
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Mei-Jie Yang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Yong-Bin Deng
- Department of Gynecology, Chongqing Haifu Hospital, Chongqing, China
| | - Liang Hu
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Ultrasound Ablation Center, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jin-Yun Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Ultrasound Ablation Center, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Antoniou A, Damianou C. Feasibility of Ultrasonic Heating through Skull Phantom Using Single-element Transducer. J Med Ultrasound 2024; 32:32-40. [PMID: 38665339 PMCID: PMC11040484 DOI: 10.4103/jmu.jmu_3_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/14/2023] [Accepted: 03/31/2023] [Indexed: 04/28/2024] Open
Abstract
Background Noninvasive neurosurgery has become possible through the use of transcranial focused ultrasound (FUS). This study assessed the heating ability of single element spherically focused transducers operating at 0.4 and 1.1 MHz through three-dimensional (3D) printed thermoplastic skull phantoms. Methods Phantoms with precise skull bone geometry of a male patient were 3D printed using common thermoplastic materials following segmentation on a computed tomography head scan image. The brain tissue was mimicked by an agar-based gel phantom developed in-house. The selection of phantom materials was mainly based on transmission-through attenuation measurements. Phantom sonications were performed through water, and then, with the skull phantoms intervening the beam path. In each case, thermometry was performed at the focal spot using thermocouples. Results The focal temperature change in the presence of the skull phantoms was reduced to less than 20 % of that recorded in free field when using the 0.4 MHz transducer, whereas the 1.1 MHz trans-skull sonication produced minimal or no change in focal temperature. The 0.4 MHz transducer showed better performance in trans-skull transmission but still not efficient. Conclusion The inability of both tested single element transducers to steer the beam through the high attenuating skull phantoms and raise the temperature at the focus was confirmed, underlying the necessity to use a correction technique to compensate for energy losses, such those provided by phased arrays. The proposed phantom could be used as a cost-effective and ergonomic tool for trans-skull FUS preclinical studies.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering and Informatics, Cyprus University of Technology, Limassol, Cyprus
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Park JR, Kim G, Won J, Kim CW, Park D. Evaluation of Doxorubicin-loaded Echogenic Macroemulsion for Targeted Drug Delivery. Curr Drug Deliv 2024; 21:785-793. [PMID: 37016528 DOI: 10.2174/1567201820666230403111118] [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: 12/12/2022] [Revised: 01/26/2023] [Accepted: 02/06/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND The latest technology trend in targeted drug delivery highlights stimuliresponsive particles that can release an anticancer drug in a solid tumor by responding to external stimuli. OBJECTIVE This study aims to design, fabricate, and evaluate an ultrasound-responsive drug delivery vehicle for an ultrasound-mediated drug delivery system. METHODS The drug-containing echogenic macroemulsion (eME) was fabricated by an emulsification method using the three phases (aqueous lipid solution as a shell, doxorubicin (DOX) contained oil, and perfluorohexane (PFH) as an ultrasound-responsive agent). The morphological structure of eMEs was investigated using fluorescence microscopy, and the size distribution was analyzed by using DLS. The echogenicity of eME was measured using a contrast-enhanced ultrasound device. The cytotoxicity was evaluated using a breast cancer cell (MDA-MB-231) via an in vitro cell experiment. RESULTS The obtained eME showed an ideal morphological structure that contained both DOX and PFH in a single particle and indicated a suitable size for enhancing ultrasound response and avoiding complications in the blood vessel. The echogenicity of eME was demonstrated via an in vitro experiment, with results showcasing the potential for targeted drug delivery. Compared to free DOX, enhanced cytotoxicity and improved drug delivery efficiency in a cancer cell were proven by using DOX-loaded eMEs and ultrasound. CONCLUSION This study established a platform technology to fabricate the ultrasound-responsive vehicle. The designed drug-loaded eME could be a promising platform with ultrasound technology for targeted drug delivery.
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Affiliation(s)
- Jong-Ryul Park
- BioInfra Life Science Inc., 524, Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea
| | - Gayoung Kim
- BioInfra Life Science Inc., 524, Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea
| | - Jongho Won
- BioInfra Life Science Inc., 524, Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea
| | - Chul-Woo Kim
- BioInfra Life Science Inc., 524, Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea
| | - Donghee Park
- BioInfra Life Science Inc., 524, Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea
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Na H, Park J, Jeong KH. Plasmon-enhanced optoacoustic transducer with Ecoflex thin film for broadband ultrasound generation using overdriven pulsed laser diode. JOURNAL OF BIOMEDICAL OPTICS 2023; 28:125005. [PMID: 38144698 PMCID: PMC10739335 DOI: 10.1117/1.jbo.28.12.125005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 12/26/2023]
Abstract
Significance Ultrasonic transducers facilitate noninvasive biomedical imaging and therapeutic applications. Optoacoustic generation using nanoplasmonic structures provides a technical solution for highly efficient broadband ultrasonic transducer. However, bulky and high-cost nanosecond lasers as conventional excitation sources hinder a compact configuration of transducer. Aim Here, we report a plasmon-enhanced optoacoustic transducer (PEAT) for broadband ultrasound generation, featuring an overdriven pulsed laser diode (LD) and an Ecoflex thin film. The PEAT module consists of an LD, a collimating lens, a focusing lens, and an Ecoflex-coated 3D nanoplasmonic substrate (NPS). Approach The LD is overdriven above its nominal current and precisely modulated to achieve nanosecond pulsed beam with high optical peak power. The focused laser beam is injected on the NPS with high-density electromagnetic hotspots, which allows for the efficient plasmonic photothermal effect. The thermal expansion of Ecoflex finally generates broadband ultrasound. Results The overdriven pulsed LD achieves a maximum optical peak power of 40 W, exceeding the average optical power of 3 W. The 22 μ m thick Ecoflex-coated NPS exhibits an eightfold optoacoustic enhancement with a fractional - 6 dB bandwidth higher than 160% and a peak frequency of 2.5 MHz. In addition, the optoacoustic amplitude is precisely controlled by the optical peak power or the laser pulse width. The PEAT-integrated microfluidic chip clearly demonstrates acoustic atomization by generating aerosol droplets at the air-liquid interface. Conclusions Plasmon-enhanced optoacoustic generation using PEAT can provide an approach for compact and on-demand biomedical applications, such as ultrasound imaging and lab-on-a-chip technologies.
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Affiliation(s)
- Hamin Na
- Korea Advanced Institute of Science and Technology (KAIST), Department of Bio and Brain Engineering, Daejeon, Republic of Korea
- Korea Advanced Institute of Science and Technology (KAIST), KAIST Institute for Health Science and Technology (KIHST), Daejeon, Republic of Korea
| | - Jaehyeok Park
- Korea Advanced Institute of Science and Technology (KAIST), Department of Bio and Brain Engineering, Daejeon, Republic of Korea
- Korea Advanced Institute of Science and Technology (KAIST), KAIST Institute for Health Science and Technology (KIHST), Daejeon, Republic of Korea
| | - Ki-Hun Jeong
- Korea Advanced Institute of Science and Technology (KAIST), Department of Bio and Brain Engineering, Daejeon, Republic of Korea
- Korea Advanced Institute of Science and Technology (KAIST), KAIST Institute for Health Science and Technology (KIHST), Daejeon, Republic of Korea
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Liu P, Foiret J, Situ Y, Zhang N, Kare AJ, Wu B, Raie MN, Ferrara KW, Qi LS. Sonogenetic control of multiplexed genome regulation and base editing. Nat Commun 2023; 14:6575. [PMID: 37852951 PMCID: PMC10584809 DOI: 10.1038/s41467-023-42249-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023] Open
Abstract
Manipulating gene expression in the host genome with high precision is crucial for controlling cellular function and behavior. Here, we present a precise, non-invasive, and tunable strategy for controlling the expression of multiple endogenous genes both in vitro and in vivo, utilizing ultrasound as the stimulus. By engineering a hyper-efficient dCas12a and effector under a heat shock promoter, we demonstrate a system that can be inducibly activated through thermal energy produced by ultrasound absorption. This system allows versatile thermal induction of gene activation or base editing across cell types, including primary T cells, and enables multiplexed gene activation using a single guide RNA array. In mouse models, localized temperature elevation guided by high-intensity focused ultrasound effectively triggers reporter gene expression in implanted cells. Our work underscores the potential of ultrasound as a clinically viable approach to enhance cell and gene-based therapies via precision genome and epigenome engineering.
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Affiliation(s)
- Pei Liu
- Molecular Imaging Program at Stanford (MIPS), Department of Radiology, School of Medicine, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Josquin Foiret
- Molecular Imaging Program at Stanford (MIPS), Department of Radiology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Yinglin Situ
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Nisi Zhang
- Molecular Imaging Program at Stanford (MIPS), Department of Radiology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Aris J Kare
- Molecular Imaging Program at Stanford (MIPS), Department of Radiology, School of Medicine, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Bo Wu
- Molecular Imaging Program at Stanford (MIPS), Department of Radiology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Marina N Raie
- Molecular Imaging Program at Stanford (MIPS), Department of Radiology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Katherine W Ferrara
- Molecular Imaging Program at Stanford (MIPS), Department of Radiology, School of Medicine, Stanford University, Stanford, CA, USA.
| | - Lei S Qi
- Department of Bioengineering, Stanford University, Stanford, CA, USA.
- Sarafan ChEM-H, Stanford University, Stanford, CA, USA.
- Chan Zuckerberg Biohub - San Francisco, San Francisco, CA, USA.
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Antoniou A, Evripidou N, Georgiou L, Chrysanthou A, Ioannides C, Damianou C. Tumor phantom model for MRI-guided focused ultrasound ablation studies. Med Phys 2023; 50:5956-5968. [PMID: 37226334 DOI: 10.1002/mp.16480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/24/2023] [Accepted: 05/02/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND The persistent development of focused ultrasound (FUS) thermal therapy in the context of oncology creates the need for tissue-mimicking tumor phantom models for early-stage experimentation and evaluation of relevant systems and protocols. PURPOSE This study presents the development and evaluation of a tumor-bearing tissue phantom model for testing magnetic resonance imaging (MRI)-guided FUS (MRgFUS) ablation protocols and equipment based on MR thermometry. METHODS Normal tissue was mimicked by a pure agar gel, while the tumor simulator was differentiated from the surrounding material by including silicon dioxide. The phantom was characterized in terms of acoustic, thermal, and MRI properties. US, MRI, and computed tomography (CT) images of the phantom were acquired to assess the contrast between the two compartments. The phantom's response to thermal heating was investigated by performing high power sonications with a 2.4 MHz single element spherically focused ultrasonic transducer in a 3T MRI scanner. RESULTS The estimated phantom properties fall within the range of literature-reported values of soft tissues. The inclusion of silicon dioxide in the tumor material offered excellent tumor visualization in US, MRI, and CT. MR thermometry revealed temperature elevations in the phantom to ablation levels and clear evidence of larger heat accumulation within the tumor owing to the inclusion of silicon dioxide. CONCLUSION Overall, the study findings suggest that the proposed tumor phantom model constitutes a simple and inexpensive tool for preclinical MRgFUS ablation studies, and potentially other image-guided thermal ablation applications upon minimal modifications.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Nikolas Evripidou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Leonidas Georgiou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Antreas Chrysanthou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Cleanthis Ioannides
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
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12
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Imtiaz C, Farooqi MA, Bhatti T, Lee J, Moin R, Kang CU, Farooqi HMU. Focused Ultrasound, an Emerging Tool for Atherosclerosis Treatment: A Comprehensive Review. Life (Basel) 2023; 13:1783. [PMID: 37629640 PMCID: PMC10455721 DOI: 10.3390/life13081783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Focused ultrasound (FUS) has emerged as a promising noninvasive therapeutic modality for treating atherosclerotic arterial disease. High-intensity focused ultrasound (HIFU), a noninvasive and precise modality that generates high temperatures at specific target sites within tissues, has shown promising results in reducing plaque burden and improving vascular function. While low-intensity focused ultrasound (LIFU) operates at lower energy levels, promoting mild hyperthermia and stimulating tissue repair processes. This review article provides an overview of the current state of HIFU and LIFU in treating atherosclerosis. It focuses primarily on the therapeutic potential of HIFU due to its higher penetration and ability to achieve atheroma disruption. The review summarizes findings from animal models and human trials, covering the effects of FUS on arterial plaque and arterial wall thrombolysis in carotid, coronary and peripheral arteries. This review also highlights the potential benefits of focused ultrasound, including its noninvasiveness, precise targeting, and real-time monitoring capabilities, making it an attractive approach for the treatment of atherosclerosis and emphasizes the need for further investigations to optimize FUS parameters and advance its clinical application in managing atherosclerotic arterial disease.
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Affiliation(s)
- Cynthia Imtiaz
- Ocean and Biomedical Ultrasound Laboratory, Department of Ocean System Engineering, Jeju National University, Jeju-si 63243, Republic of Korea; (C.I.)
| | - Muhammad Awais Farooqi
- Department of Mechatronics Engineering, Jeju National University, Jeju-si 63243, Republic of Korea
| | - Theophilus Bhatti
- Interdisciplinary Department of Advanced Convergence Technology and Science, College of Pharmacy, Jeju National University, Jeju 63243, Republic of Korea
| | - Jooho Lee
- Ocean and Biomedical Ultrasound Laboratory, Department of Ocean System Engineering, Jeju National University, Jeju-si 63243, Republic of Korea; (C.I.)
| | - Ramsha Moin
- Department of Pediatrics, Elaj Hospital, Gujranwala 52250, Pakistan
| | - Chul Ung Kang
- Department of Mechatronics Engineering, Jeju National University, Jeju-si 63243, Republic of Korea
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Kuo YY, Chen WT, Lin GB, Lu CH, Chao CY. Study on the effect of a triple cancer treatment of propolis, thermal cycling-hyperthermia, and low-intensity ultrasound on PANC-1 cells. Aging (Albany NY) 2023; 15:7496-7512. [PMID: 37506229 PMCID: PMC10457055 DOI: 10.18632/aging.204916] [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: 02/10/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023]
Abstract
To reduce side effects and enhance treatment efficacy, study on combination therapy for pancreatic cancer, a deadly cancer, has gained much attraction in recent years. In this study, we propose a novel triple treatment combining propolis and two physical stimuli-thermal cycling-hyperthermia (TC-HT) and low-intensity ultrasound (US). The study found that, after the triple treatment, the cell viability of a human cancer cell line PANC-1 decreased to a level 80% less than the control, without affecting the normal pancreatic cells. Another result was excessive accumulation of reactive oxygen species (ROS) after the triple treatment, leading to the amplification of apoptotic pathway through the MAPK family and mitochondrial dysfunction. This study, to the best of our knowledge, is the first attempt to combine TC-HT, US, and a natural compound in cancer treatment. The combination of TC-HT and US also promotes the anticancer effect of the heat-sensitive chemotherapy drug cisplatin on PANC-1 cells. It is expected that optimized parameters for different agents and different types of cancer will expand the methodology on oncological therapy in a safe manner.
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Affiliation(s)
- Yu-Yi Kuo
- Department of Physics, Lab for Medical Physics and Biomedical Engineering, National Taiwan University, Taipei, Taiwan
- Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
| | - Wei-Ting Chen
- Department of Physics, Lab for Medical Physics and Biomedical Engineering, National Taiwan University, Taipei, Taiwan
- Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
| | - Guan-Bo Lin
- Department of Physics, Lab for Medical Physics and Biomedical Engineering, National Taiwan University, Taipei, Taiwan
- Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
| | - Chueh-Hsuan Lu
- Department of Physics, Lab for Medical Physics and Biomedical Engineering, National Taiwan University, Taipei, Taiwan
- Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
| | - Chih-Yu Chao
- Department of Physics, Lab for Medical Physics and Biomedical Engineering, National Taiwan University, Taipei, Taiwan
- Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Applied Physics, Biophysics Division, National Taiwan University, Taipei, Taiwan
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Gunderman A, Montayre R, Ranjan A, Chen Y. Review of Robot-Assisted HIFU Therapy. SENSORS (BASEL, SWITZERLAND) 2023; 23:3707. [PMID: 37050766 PMCID: PMC10098661 DOI: 10.3390/s23073707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
This paper provides an overview of current robot-assisted high-intensity focused ultrasound (HIFU) systems for image-guided therapies. HIFU is a minimally invasive technique that relies on the thermo-mechanical effects of focused ultrasound waves to perform clinical treatments, such as tumor ablation, mild hyperthermia adjuvant to radiation or chemotherapy, vein occlusion, and many others. HIFU is typically performed under ultrasound (USgHIFU) or magnetic resonance imaging guidance (MRgHIFU), which provide intra-operative monitoring of treatment outcomes. Robot-assisted HIFU probe manipulation provides precise HIFU focal control to avoid damage to surrounding sensitive anatomy, such as blood vessels, nerve bundles, or adjacent organs. These clinical and technical benefits have promoted the rapid adoption of robot-assisted HIFU in the past several decades. This paper aims to present the recent developments of robot-assisted HIFU by summarizing the key features and clinical applications of each system. The paper concludes with a comparison and discussion of future perspectives on robot-assisted HIFU.
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Affiliation(s)
- Anthony Gunderman
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Rudy Montayre
- Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74078, USA
| | - Ashish Ranjan
- Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74078, USA
| | - Yue Chen
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
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15
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Ashar H, Ranjan A. Immunomodulation and targeted drug delivery with high intensity focused ultrasound (HIFU): Principles and mechanisms. Pharmacol Ther 2023; 244:108393. [PMID: 36965581 DOI: 10.1016/j.pharmthera.2023.108393] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/04/2023] [Accepted: 03/20/2023] [Indexed: 03/27/2023]
Abstract
High intensity focused ultrasound (HIFU) is a non-invasive and non-ionizing sonic energy-based therapeutic technology for inducing thermal and non-thermal effects in tissues. Depending on the parameters, HIFU can ablate tissues by heating them to >55 °C to induce denaturation and coagulative necrosis, improve radio- and chemo-sensitizations and local drug delivery from nanoparticles at moderate hyperthermia (~41-43 °C), and mechanically fragment cells using acoustic cavitation (also known as histotripsy). HIFU has already emerged as an attractive modality for treating human prostate cancer, veterinary cancers, and neuromodulation. Herein, we comprehensively review the role of HIFU in enhancing drug delivery and immunotherapy in soft and calcified tissues. Specifically, the ability of HIFU to improve adjuvant treatments from various classes of drugs is described. These crucial insights highlight the opportunities and challenges of HIFU technology and its potential to support new clinical trials and translation to patients.
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Affiliation(s)
- Harshini Ashar
- Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74078, United States of America
| | - Ashish Ranjan
- Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74078, United States of America.
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16
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Zheng AQ, Chen JY, Xiao ZB, Zhang R, Bai J. Sacral injury and influencing factors after ultrasonic ablation of uterine fibroids ≤30 mm from the sacrum. Diagn Interv Radiol 2023; 29:195-201. [PMID: 36960616 PMCID: PMC10679587 DOI: 10.5152/dir.2022.21407] [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: 04/16/2021] [Accepted: 10/22/2021] [Indexed: 01/13/2023]
Abstract
PURPOSE To study sacral injuries and influencing factors after ultrasonic ablation of uterine fibroids no more than 30 mm from the sacrum. METHODS A total of 406 patients with uterine fibroids who underwent percutaneous ultrasound ablation were analyzed retrospectively. All patients underwent contrast-enhanced magnetic resonance imaging (MRI) scans before and after high-intensity focused ultrasound. The abnormal signal intensity (low signal intensity on T1WI and high signal intensity on T2WI) on the postoperative MRIs was indicative of a sacral injury. The patients were divided into a sacrum injury group and a sacrum non-injury group. The relationship between fibroid characteristics, ultrasound ablation parameters, and injury was analyzed using univariate and multivariate analyses. RESULTS There were 139 cases of sacral injury (34.24%). When the distance from the fibroid's dorsal side to the sacrum was 0-10 mm, the risk assessment showed that the danger of sacral injury increased by 1.85 times and 3.03 times compared with that at a distance of 11-20 or 21-30 mm. Furthermore, the risk of sacral injury increased by 1.89 times and 3.23 times when the therapeutic dose (TD) of a fibroid was >500 KJ compared with that of a fibroid with TD= 250-500 KJ and <250 KJ. CONCLUSION A distance of 10 mm or less and a TD of >500 KJ were significantly correlated with sacral injury. The distance from the fibroid's dorsal side to the sacrum and the TD were the main causes of injury to the sacrum. A distance of 10 mm or less and a TD of >500 KJ carried higher injury risks, while a distance of 21-30 mm and a TD of <250 KJ were the most appropriate circumstances to reduce the risk of sacral injury.
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Affiliation(s)
- An-Qi Zheng
- Ultrasound in Medicine and Engineering, State Key Laboratory, Chongqing, China
| | - Jin-Yun Chen
- Ultrasound in Medicine and Engineering, State Key Laboratory, Chongqing, China
- Therapeutic Center of Ultrasound, Ablation The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhi-Bo Xiao
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rong Zhang
- Ultrasound in Medicine and Engineering, State Key Laboratory, Chongqing, China
- Therapeutic Center of Ultrasound, Ablation The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jin Bai
- Ultrasound in Medicine and Engineering, State Key Laboratory, Chongqing, China
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17
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Liao L, Xu YH, Bai J, Zhan P, Zhou J, Li MX, Zhang Y. MRI parameters for predicting the effect of ultrasound-guided high-intensity focused ultrasound in the ablation of uterine fibroids. Clin Radiol 2023; 78:61-69. [PMID: 36241567 DOI: 10.1016/j.crad.2022.09.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 06/01/2022] [Accepted: 09/03/2022] [Indexed: 01/07/2023]
Abstract
AIM To study the value of magnetic resonance imaging (MRI) parameters in predicting the efficacy of ultrasonic ablation of fibroids. MATERIALS AND METHODS A total of 91 patients were divided into groups based on non-perfused volume (NPV) ratio and blood supply type. The preoperative MRI parameters were measured and analysed. A correlation analysis between the MRI parameters and the NPV ratio was performed. Receiver operating characteristic (ROC) curves were used to analyse and determine the cut-off value of MRI parameters to predict the ablation rate of fibroids. RESULTS The uterine fibroids group with an NPV ratio <80% and the group with an NPV ratio of ≥80% had significant differences in signal intensity (SI) at MRI T2-weighted imaging (WI), fibroid-to-rectus abdominis SI ratio (SIR) at T2WI, and blood supply type (p<0.05). There were no significant differences in fibroid volume, T2WI signal uniformity, and apparent diffusion coefficient (ADC) values. The ADC value and SI and SIR at MRI T2WI in the group with poor blood supply were lower than those in the group with a rich blood supply (p<0.05). SI at MRI T2WI correlated negatively with the NPV ratio. The cut-off values for SI and SIR at MRI T2WI of fibroids whose NPV ratio exceeds 80% were 220.58 and 1.315, respectively. CONCLUSION SI at MRI T2WI and blood supply type could be predictors of the efficacy of ablation. Ultrasonic ablation of fibroids with MRI T2WI hyperintensity and a rich blood supply had poor efficacy.
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Affiliation(s)
- L Liao
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.
| | - Y H Xu
- Department of Medical Imaging, Zhongshan Hospital, Fudan University (Xuhui Branch), Shanghai 200000, China
| | - J Bai
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - P Zhan
- Department of Gynaecology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - J Zhou
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - M X Li
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Y Zhang
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
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High Intensity Focused Ultrasound (HIFU) in Digestive Diseases: An Overview of Clinical Applications for Liver and Pancreatic Tumors. Ing Rech Biomed 2022. [DOI: 10.1016/j.irbm.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Bismuth M, Katz S, Mano T, Aronovich R, Hershkovitz D, Exner AA, Ilovitsh T. Low frequency nanobubble-enhanced ultrasound mechanotherapy for noninvasive cancer surgery. NANOSCALE 2022; 14:13614-13627. [PMID: 36070492 DOI: 10.1039/d2nr01367c] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Scaling down the size of microbubble contrast agents to the nanometer level holds the promise for noninvasive cancer therapy. However, the small size of nanobubbles limits the obtained bioeffects as a result of ultrasound cavitation, when operating near the nanobubble resonance frequency. Here we show that coupled with low energy insonation at a frequency of 80 kHz, well below the resonance frequency of these agents, nanobubbles serve as noninvasive therapeutic warheads that trigger potent mechanical effects in tumors following a systemic injection. We demonstrate these capabilities in tissue mimicking phantoms, where a comparison of the acoustic response of micro- and nano-bubbles after insonation at a frequency of 250 or 80 kHz revealed that higher pressures were needed to implode the nanobubbles compared to microbubbles. Complete nanobubble destruction was achieved at a mechanical index of 2.6 for the 250 kHz insonation vs. 1.2 for the 80 kHz frequency. Thus, the 80 kHz insonation complies with safety regulations that recommend operation below a mechanical index of 1.9. In vitro in breast cancer tumor cells, the cell viability was reduced to 17.3 ± 1.7% of live cells. In vivo, in a breast cancer tumor mouse model, nanobubble tumor distribution and accumulation were evaluated by high frequency ultrasound imaging. Finally, nanobubble-mediated low frequency insonation of breast cancer tumors resulted in effective mechanical tumor ablation and tumor tissue fractionation. This approach provides a unique theranostic platform for safe, noninvasive and low energy tumor mechanotherapy.
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Affiliation(s)
- Mike Bismuth
- Department of Biomedical Engineering, Tel Aviv University, Tel Aviv 6997801, Israel.
| | - Sharon Katz
- Department of Biomedical Engineering, Tel Aviv University, Tel Aviv 6997801, Israel.
- The Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Tamar Mano
- Department of Biomedical Engineering, Tel Aviv University, Tel Aviv 6997801, Israel.
| | - Ramona Aronovich
- Department of Biomedical Engineering, Tel Aviv University, Tel Aviv 6997801, Israel.
| | - Dov Hershkovitz
- Department of Pathology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997800, Israel
| | - Agata A Exner
- Departments of Radiology and Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Tali Ilovitsh
- Department of Biomedical Engineering, Tel Aviv University, Tel Aviv 6997801, Israel.
- The Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
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Brahmandam A, Chan SM, Dardik A, Nassiri N, Aboian E. A narrative review on the application of high-intensity focused ultrasound for the treatment of occlusive and thrombotic arterial disease. JVS Vasc Sci 2022; 3:292-305. [PMID: 36276806 PMCID: PMC9579503 DOI: 10.1016/j.jvssci.2022.08.001] [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: 04/06/2021] [Accepted: 08/17/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives High-intensity focused ultrasound (HIFU) is a noninvasive therapeutic modality with a variety of applications. It is approved for the treatment of essential tremors, ablation of prostate, hepatic, breast, and uterine tumors. Although not approved for use in the treatment of atherosclerotic arterial disease, there is a growing body of evidence investigating applications of HIFU. Currently, percutaneous endovascular techniques are predominant for the treatment of arterial pathology; however, there are no endovascular techniques of HIFU available. This study aims to review the state of current evidence for the application of HIFU in atherosclerotic arterial disease. Methods All English-language articles evaluating the effect of HIFU on arterial occlusive and thrombotic disease until 2021 were reviewed. Both preclinical and human clinical studies were included. Study parameters such as animal or clinical model and outcomes were reviewed. In addition, details pertaining to settings on the HIFU device used were also reviewed. Results In preclinical models, atherosclerotic plaque progression was inhibited by HIFU, through decreases in oxidized low-density lipoprotein cholesterol and increases in macrophage apoptosis. Additionally, HIFU promotes angiogenesis in hindlimb ischemic models by the upregulation of angiogenic and antiapoptotic factors, with increased angiogenesis at higher line densities of HIFU. HIFU also promotes thrombolysis and conversely induces platelet activation at low frequencies and higher intensities. Various clinical studies have attempted to translate some of these properties and demonstrated positive clinical outcomes for arterial recanalization after thrombotic stroke, decreased atherosclerotic plaque burden in carotid arteries, increase in tissue perfusion and a decrease in diameter stenosis in patients with atherosclerotic arterial disease. Conclusions In current preclinical and clinical data, the safety and efficacy of HIFU shows great promise in the treatment of atherosclerotic arterial disease. Future focused studies are warranted to guide the refinement of HIFU settings for more widespread adoption of this technology.
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Jiang F, Wang L, Tang Y, Wang Y, Li N, Wang D, Zhang Z, Lin L, Du Y, Ou X, Zou J. US/MR Bimodal Imaging-Guided Bio-Targeting Synergistic Agent for Tumor Therapy. Int J Nanomedicine 2022; 17:2943-2960. [PMID: 35814614 PMCID: PMC9270014 DOI: 10.2147/ijn.s363645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/26/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Breast cancer is detrimental to the health of women due to the difficulty of early diagnosis and unsatisfactory therapeutic efficacy of available breast cancer therapies. High intensity focused ultrasound (HIFU) ablation is a new method for the treatment of breast tumors, but there is a problem of low ablation efficiency. Therefore, the improvement of HIFU efficiency to combat breast cancer is immediately needed. This study aimed to describe a novel anaerobic bacteria-mediated nanoplatform, comprising synergistic HIFU therapy for breast cancer under guidance of ultrasound (US) and magnetic resonance (MR) bimodal imaging. Methods The PFH@CL/Fe3O4 nanoparticles (NPs) (Perfluorohexane (PFH) and superparamagnetic iron oxides (SPIO, Fe3O4) with cationic lipid (CL) NPs) were synthesized using the thin membrane hydration method. The novel nanoplatform Bifidobacterium bifidum-mediated PFH@CL/Fe3O4 NPs were constructed by electrostatic adsorption. Thereafter, US and MR bimodal imaging ability of B. bifidum-mediated PFH@CL/Fe3O4 NPs was evaluated in vitro and in vivo. Finally, the efficacy of HIFU ablation based on B. bifidum-PFH@CL/Fe3O4 NPs was studied. Results B. bifidum combined with PFH@CL/Fe3O4 NPs by electrostatic adsorption and enhanced the tumor targeting ability of PFH@CL/Fe3O4 NPs. US and MR bimodal imaging clearly displayed the distribution of the bio-targeting nanoplatform in vivo. It was conducive for accurate and effective guidance of HIFU synergistic treatment of tumors. Furthermore, PFH@CL/Fe3O4 NPs could form microbubbles by acoustic droplet evaporation and promote efficiency of HIFU ablation under guidance of bimodal imaging. Conclusion A bio-targeting nanoplatform with high stability and good physicochemical properties was constructed. The HIFU synergistic agent achieved early precision imaging of tumors and promoted therapeutic effect, monitored by US and MR bimodal imaging during the treatment process.
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Affiliation(s)
- Fujie Jiang
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, People’s Republic of China
| | - Lu Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yu Tang
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yaotai Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Ningshan Li
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
- Department of Ultrasound, Xinqiao Hospital of Army Medical University, Chongqing, People’s Republic of China
| | - Disen Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhong Zhang
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Li Lin
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yan Du
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xia Ou
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jianzhong Zou
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
- Correspondence: Jianzhong Zou, State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China, Tel +86-13708302390, Email
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Kang Z, Yang M, Feng X, Liao H, Zhang Z, Du Y. Multifunctional Theranostic Nanoparticles for Enhanced Tumor Targeted Imaging and Synergistic FUS/Chemotherapy on Murine 4T1 Breast Cancer Cell. Int J Nanomedicine 2022; 17:2165-2187. [PMID: 35592098 PMCID: PMC9113557 DOI: 10.2147/ijn.s360161] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/01/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose Triple negative breast cancer (TNBC) is challenging for effective remission due to its very aggressive, extremely metastatic and resistant to conventional chemotherapy. Herein, a multifunctional theranostic nanoparticle was fabricated to enhance tumor targeted imaging and promote focused ultrasound (FUS) ablation and chemotherapy and sonodynamic therapy (SDT). A multi-modal synergistic therapy can improve the therapeutic efficacy and prognosis of TNBC. Methods AS1411 aptamer modified PEG@PLGA nanoparticles encapsulated with perfluorohexane (PFH) and anti-cancer drug doxorubicin (DOX) were constructed (AS1411-DOX/PFH-PEG@PLGA) to enhance tumor targeted imaging to guide ablation and synergistic effect of FUS/chemotherapy. FUS was utilized to trigger the co-release of doxorubicin and simultaneously PFH phase transition and activate DOX for SDT effect. The physicochemical, phase-changeable imaging capability, biosafety of nanoparticles and multi-mode synergistic effects on growth of TNBC were thoroughly evaluated in vivo and in vitro. Results The synthesized AS1411-DOX/PFH-PEG@PLGA (A-DPPs) nanoparticles are uniformly round with an average diameter of 306.03 ± 5.35 nm and the zeta potential of −4.05 ± 0.13 mV, displaying high biosafety and FUS-responsive drug release in vitro and in vivo. AS1411 modified NPs specifically bind to 4T1 cells and elevate the ultrasound contrast agent (UCA) image contrast intensity via PFH phase-transition after FUS exposure. Moreover, the combined treatment of A-DPPs nanoparticles with FUS exhibited significantly higher apoptosis rate, stronger inhibitory effect on 4T1 cell invasion in vitro, induced more reactive oxygen species (ROS), and enhanced anti-tumor effect compared to a single therapy (p < 0.05). Additionally, the joint strategy resulted in more intense cavitation effect and larger ablated areas and reduced energy efficiency factor (EEF) both in vitro and in vivo. Conclusion The multifunctional AS1411-DOX/PFH-PEG@PLGA nanoparticles can perform as a marvelous synergistic agent for enhanced FUS/chemotherapy, promote real-time contrast enhanced US imaging and improve the therapeutic efficacy and prognosis of TNBC.
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Affiliation(s)
- Zhengyue Kang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Min Yang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Xiaoling Feng
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Hongjian Liao
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Zhifei Zhang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Yonghong Du
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Correspondence: Yonghong Du, State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People’s Republic of China, Tel/Fax +86-23-68485021, Email
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Antoniou A, Georgiou L, Christodoulou T, Panayiotou N, Ioannides C, Zamboglou N, Damianou C. MR relaxation times of agar-based tissue-mimicking phantoms. J Appl Clin Med Phys 2022; 23:e13533. [PMID: 35415875 PMCID: PMC9121050 DOI: 10.1002/acm2.13533] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/29/2021] [Indexed: 12/31/2022] Open
Abstract
Agar gels were previously proven capable of accurately replicating the acoustical and thermal properties of real tissue and widely used for the construction of tissue-mimicking phantoms (TMPs) for focused ultrasound (FUS) applications. Given the current popularity of magnetic resonance-guided FUS (MRgFUS), we have investigated the MR relaxation times T1 and T2 of different mixtures of agar-based phantoms. Nine TMPs were constructed containing agar as the gelling agent and various concentrations of silicon dioxide and evaporated milk. An agar-based phantom doped with wood powder was also evaluated. A series of MR images were acquired in a 1.5 T scanner for T1 and T2 mapping. T2 was predominantly affected by varying agar concentrations. A trend toward decreasing T1 with an increasing concentration of evaporated milk was observed. The addition of silicon dioxide decreased both relaxation times of pure agar gels. The proposed phantoms have great potential for use with the continuously emerging MRgFUS technology. The MR relaxation times of several body tissues can be mimicked by adjusting the concentration of ingredients, thus enabling more accurate and realistic MRgFUS studies.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Leonidas Georgiou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | | | - Natalie Panayiotou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Cleanthis Ioannides
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Nikolaos Zamboglou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
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Antoniou A, Giannakou M, Evripidou N, Stratis S, Pichardo S, Damianou C. Robotic system for top to bottom MRgFUS therapy of multiple cancer types. Int J Med Robot 2022; 18:e2364. [DOI: 10.1002/rcs.2364] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 12/18/2022]
Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics Cyprus University of Technology Limassol Cyprus
| | | | - Nikolas Evripidou
- Department of Electrical Engineering, Computer Engineering, and Informatics Cyprus University of Technology Limassol Cyprus
| | - Stylianos Stratis
- Department of Electrical Engineering, Computer Engineering, and Informatics Cyprus University of Technology Limassol Cyprus
| | - Samuel Pichardo
- Hotchkiss Brain Institute Cumming School of Medicine University of Calgary Calgary Alberta Canada
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics Cyprus University of Technology Limassol Cyprus
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Gong X, Zhang X, Liu D, Yang C, Zhang R, Xiao Z, Chen W, Chen J. Physician Experience in Technical Success of Achieving NPVR ≥ 80% of High-Intensity Focused Ultrasound Ablation for Uterine Fibroids: A Multicenter Study. FRONTIERS IN MEDICAL TECHNOLOGY 2022; 3:790956. [PMID: 35345412 PMCID: PMC8957097 DOI: 10.3389/fmedt.2021.790956] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To evaluate the experience of the physician of the technical success in high-intensity focused ultrasound (HIFU) ablation of uterine fibroids with a nonperfused volume ratio (NPVR) of at least 80%. Methods Patients from a 20-center prospective study were enrolled in this study. In this study, among the 20 clinical centers, five centers had physician with >3 years of HIFU experience, and the other 15 centers initiated HIFU therapy <3 years, were defined as the experienced group and the inexperienced group, respectively. Technical success was defined as achieving NPVR ≥ 80% of uterine fibroids with no major complications and it was defined as the successful group; otherwise, it was defined as the unsuccessful group. Results A total of 1,352 patients were included at the age of 41.32 ± 5.08 years. The mean NPVR (87.48 ± 14.91%) was obtained in the inexperienced group (86.50 ± 15.76%) and in the experienced group (89.21 ± 13.12%), respectively. The multivariate analysis showed that the volume of uterus, location of fibroids, and physician experience were significantly correlated with technical success (p < 0.05). In the experienced group, 82.20% of uterine fibroids obtained NPVR ≥ 80%, compared with 75.32% in the inexperienced group, and the difference was significant (p = 0.003). The technical success rate of the experienced group was 82.00% which was higher than 75.20% of the inexperienced group (p = 0.004). Conclusion In technical success of achieving NPVR ≥ 80%, experience of the physician was positively correlated with technical success; NPVR and major complications for the inexperienced group were comparable to those of the experienced group from a clinical perspective; inexperienced physicians could reach NPVR ≥ 80% of sufficient ablation and were trustworthy in efficacy. Smaller uterus and fibroids of anterior wall were correlated with better technical success; experienced physicians still have better technical success when choosing patients with larger uterus, contributing to clinical decision-making and patient referral.
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Affiliation(s)
- Xue Gong
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Xinyue Zhang
- Department of Ultrasound Medicine, Mianyang Central Hospital, Mianyang, China
| | - Dang Liu
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Chao Yang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Rong Zhang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Zhibo Xiao
- Department of Radiology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenzhi Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Jinyun Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- *Correspondence: Jinyun Chen
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Hu S, Liu Y, Chen R, Xiao Z. Exploring the Diagnostic Performance of Magnetic Resonance Imaging in Ultrasound-Guided High-Intensity Focused Ultrasound Ablation for Abdominal Wall Endometriosis. Front Physiol 2022; 13:819259. [PMID: 35242052 PMCID: PMC8886207 DOI: 10.3389/fphys.2022.819259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 01/12/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aimed to explore the clinical value of magnetic resonance imaging (MRI) combined with ultrasound-guided high-intensity focused ultrasound (USg-HIFU) for the diagnosis and treatment of abdominal wall endometriosis (AWE). METHODS Magnetic resonance imaging was performed before and after USg-HIFU. Information on clinical characteristics of patients, MRI characteristics of lesions, and treatment outcomes were collected. Thirty AWE lesions in 29 patients were examined before HIFU treatment, while 27 patients were examined after treatment. The results of MRI and color doppler ultrasound before surgery, as well as the volume and the apparent diffusion coefficient (ADC) values of the lesions before and after USg-HIFU treatment were compared. We also observed the clinical symptoms remission, recurrence, and ablation rates of the lesions in follow-up after HIFU treatment. RESULTS The locations of the 30 AWE lesions were identified by MRI before USg-HIFU treatment. Their sizes appeared larger on MRI than ultrasound (P < 0.05). A total of 27 lesions were evaluated by MRI after USg-HIFU treatment, of which 92.6% (25/27) lesions were of high or slightly high signal intensity on T1-weighted images, and 77.8% (21/27) lesions were of mixed signal intensity on T2-weighted images. The mean ADC values of AWE lesions were 1.47 (1.20-1.59) × 10-3mm2/s and 1.86 (1.61-2.12) × 10-3mm2/s for pre-and post-HIFU treatment (P < 0.05). Patients with higher ablation rates (>50%) had a higher complete/partial remission rate than those with lower ablation rates (<50%), and had a lower recurrence rate (P < 0.05). CONCLUSION MRI is a useful tool for identifying the location, size, and concurrent changes of AWE before and after USg-HIFU treatment, which is beneficial for follow-up monitoring and defining treatment efficacy.
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Affiliation(s)
- Shangying Hu
- Department of Gynecology and Obstetrics, The University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Yuhang Liu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rongsheng Chen
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhibo Xiao
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Dahis D, Farti N, Romano T, Artzi N, Azhari H. Ultrasonic Thermal Monitoring of the Brain Using Golay-Coded Excitations-Feasibility Study. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:672-680. [PMID: 34851824 DOI: 10.1109/tuffc.2021.3132094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Thermal monitoring during focused ultrasound (FUS) transcranial procedures is mandatory and commonly performed by MRI. Transcranial ultrasonic thermal monitoring is an attractive alternative. Furthermore, using the therapeutic FUS transducer itself for this task is highly desirable. Nonetheless, such application is challenged by massive skull-induced signal attenuation and aberrations. This study examined the feasibility of implementing the Golay-coded excitations (CoE) for temperature monitoring in bovine brain samples in the range of 35 °C-43 °C (hyperthermia). Feasibility was assessed using computer simulations, water-based phantoms, and ex vivo bovine brain white-matter samples. The samples were gradually heated to about 45 °C and sonicated during cool down with a 1-MHz therapeutic FUS implementing Golay CoE. Initially, a calibration curve correlating the normalized time-of-flight (TOF) changes and the temperature was generated. Next, a bovine bone was positioned between the FUS and the brain samples, and the scanning process was repeated for different fresh samples. The calibration curve was then used as a mean for estimating the temperature, which was compared to thermocouple measurements. The simulations demonstrated a substantial improvement in signal-to-noise ratio (SNR) and suggested that the implementation of 4-bit sequences is advantageous. The experimental measurements with bone demonstrated good temperature estimation with an average absolute error for the water phantoms and brains of 1.46 °C ± 1.22 °C and 1.23 °C ± 0.99 °C, respectively. In conclusion, a novel noninvasive method utilizing the Golay CoE for ultrasonic thermal monitoring using a therapeutic FUS transducer is introduced. This method can lead to the development of an acoustic tool for brain thermal monitoring.
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Antoniou A, Damianou C. MR relaxation properties of tissue-mimicking phantoms. ULTRASONICS 2022; 119:106600. [PMID: 34627028 DOI: 10.1016/j.ultras.2021.106600] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
High quality tissue-mimicking phantoms (TMPs) have a critical role in the preclinical testing of emerging modalities for diagnosis and therapy. TMPs capable of accurately mimicking real tissue in Magnetic Resonance guided Focused Ultrasound (MRgFUS) applications should be fabricated with precise T1 and T2 relaxation times. Given the current popularity of the MRgFUS technology, we herein performed a systematic review on the MR relaxation properties of different phantoms types. Polyacrylamide (PAA) and agar based phantoms were proven capable of accurately replicating critical thermal, acoustical, and MR relaxation properties of various body tissues. Although gelatin phantoms were also proven factional in this regard, they lack the capacity to withstand ablation temperatures, and thus, are only recommended for hyperthermia applications. Other gelling agents identified in the literature are Poly-vinyl alcohol (PVA), Polyvinyl Chloride (PVC), silicone, and TX-150/ TX-151; however, their efficacy in thermal studies is yet to be established. PAA gels are favorable in that they offer optical transparency enabling direct visualization of coagulative lesions. On the other hand, agar phantoms have lower preparation costs and were proven very promising for use with the MRgFUS technology, without the toxicity issues related to the preparation and storage of PAA materials. Remarkably, agar turned out to be the prominent modifier of the T2 relaxation time even for phantoms containing other types of gelling agents instead of agar. This review could be useful in manufacturing realistic MRgFUS phantoms while simultaneously indicating an opportunity for further research in the field with a particular focus on the MR behavior of agar-based TMPs.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus.
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Co M, Chen C, Lee C, Yu S, Kwong A. Prospective clinical trial on the learning curve of high-intensity-focused ultrasound for the treatment of breast fibroadenoma. Surg Today 2022; 52:1048-1053. [PMID: 35000002 DOI: 10.1007/s00595-021-02421-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/18/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION High-intensity-focused ultrasound (HIFU) is a safe and feasible treatment option for breast fibroadenoma. However, its learning curve has not been described in the medical literature. METHODS All patients with biopsy-proven fibroadenoma considered indicated for HIFU were screened for eligibility for HIFU treatment. A total of 60 patients were recruited according to the pre-defined sample size calculation. RESULTS Sixty consecutive patients were divided into three cohorts in chronological order. The mean tumor volume shrinkage rates in cohorts 1, 2, and 3 at 6 months post-HIFU ablation were 38%, 34%, and 59%, respectively. Significant tumor shrinkage was observed from case 41 onward (p < 0.0001). Similarly, the mean tumor volume shrinkage rates in cohorts 1, 2, and 3 at 12 months post-HIFU ablation were 45%, 51%, and 71%, respectively. Significant tumor shrinkage was observed from case 41 onwards (p < 0.0473). The mean procedure time for the first 20 patients was 48.5 (range 45-75) minutes, while that in the second 20 patients was 39.7 (range 20-60) minutes, and that in the last 20 patients was 28.9 (range 15-45) minutes. The treatment time was significantly shorter from case 41 onwards (p = 0.0481). CONCLUSION Treatment outcomes and treatment time improved significantly after performing approximately 40 HIFU procedures.
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Affiliation(s)
- Michael Co
- Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Clement Chen
- Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Cassandra Lee
- Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Stephanie Yu
- Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Ava Kwong
- Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
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Yang MJ, Yu RQ, Chen JY, Wang ZB. Comparison of Dose and Effectiveness of a Single-Session Ultrasound-Guided High-Intensity Focused Ultrasound Ablation of Uterine Fibroids With Different Sizes. Front Oncol 2022; 11:725193. [PMID: 34993130 PMCID: PMC8724518 DOI: 10.3389/fonc.2021.725193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 11/25/2021] [Indexed: 01/16/2023] Open
Abstract
PURPOSE This study aimed to compare the dose and effectiveness of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation of uterine fibroids with different sizes and explore the effect of uterine fibroid size on dose, which provided dose evaluation for clinicians in accordance with the size of uterine fibroids. MATERIALS AND METHODS A total of 1,000 patients with symptomatic uterine fibroids who received a single-session USgHIFU treatment were enrolled in this study. The size of fibroids was divided into seven groups: 3-4 cm, 4-5 cm, 5-6 cm, 6-7 cm, 7-8 cm, 8-9 cm, and 9-11 cm. The dose was expressed on the basis of the energy efficiency factor (EEF) as the energy required for ablation per unit volume of tissue, and the non-perfused volume ratio (NPVR) was used to assess the effect of HIFU ablation. RESULTS The median NPVR of 88.3% (IQR: 80.3%-94.8%) was obtained, and no significant difference was observed among the seven groups. The classification of T2-weighted image signal intensity fibroids in the 4-5 cm group was compared with that in the 6-7 cm and 8-9 cm groups, and the difference was significant (p < 0.05). However, the proportion of T2WI hyperintense signal fibroids had no significant difference among the seven groups (p > 0.05). The median EEF was 3.88 J/mm3, and a significant difference was observed among the seven groups of EEF (p < 0.05). The EEF of groups with a fibroid size less than 6 cm was more than double the EEF of groups with a fibroid size above 6 cm. In addition, the EEF of groups with a fibroid size of 4-5 cm and 3-4 cm was 3-4 times higher than those with a fibroid size above 7 cm (p < 0.05). CONCLUSIONS A single-session HIFU ablation for uterine fibroids of 3-11 cm can obtain an NPVR of more than 80%. The EEF decreased with the increase of the size of uterine fibroids. A fibroid size of 6.5 cm was considered as a clinical meaningful point affecting EEF.
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Affiliation(s)
- Mei-Jie Yang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Ren-Qiang Yu
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jin-Yun Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, China.,Department of Oncology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhi-Biao Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, China
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Recker F, Thudium M, Strunk H, Tonguc T, Dohmen S, Luechters G, Bette B, Welz S, Salam B, Wilhelm K, Egger EK, Wüllner U, Attenberger U, Mustea A, Conrad R, Marinova M. Multidisciplinary management to optimize outcome of ultrasound-guided high-intensity focused ultrasound (HIFU) in patients with uterine fibroids. Sci Rep 2021; 11:22768. [PMID: 34815488 PMCID: PMC8611035 DOI: 10.1038/s41598-021-02217-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 11/08/2021] [Indexed: 12/22/2022] Open
Abstract
Little is known about the specific anaesthesiological and multidisciplinary management of high-intensity focused ultrasound (HIFU) in uterine fibroids. This observational single-center study is the first reporting on an interdisciplinary approach to optimize outcome following ultrasound (US)-guided HIFU in German-speaking countries. A sample of forty patients with symptomatic uterine fibroids was treated by HIFU. Relevant treatment parameters such as total treatment time for intervention, anaesthesia, and sonication time as well as total energy, body temperature, peri-interventional medication and complications were analyzed. Interventional variables did not correlate significantly either with opioid dose or with body temperature. The average fibroid volume reduction rate was 37.8% ± 23.5%, 48.5% ± 22.0% and 70.2% ± 25.5% after 3, 6 and 12 months, respectively. No major anaesthesiological complications occurred apart from an epileptic seizure prior to HIFU treatment in one patient. Peri-procedural hyperthermia (> 37.5 °C) occurred in two patients. Post-procedural two patients experienced a sciatic nerve irritation up to one year; one patient with very large treated fibroid experienced strong short-lasting post-procedural pain. There were two complication-free pregnancies of HIFU-treated patients. Multidisciplinary management is crucial to optimize safety and outcome of US-guided HIFU for uterine fibroids. Peri-procedural pain and temperature management are critical points where an adequate collaboration between anesthesiologist and interventionalist is mandatory.
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Affiliation(s)
- Florian Recker
- Department of Gynaecology and Gynaecological Oncology, University Hospital Bonn, Bonn, Germany
| | - Marcus Thudium
- Department of Anaesthesiology, University Hospital Bonn, Bonn, Germany
| | - Holger Strunk
- Department of Radiology, Städtisches Klinikum Solingen, Solingen, Germany
| | - Tolga Tonguc
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Sara Dohmen
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Guido Luechters
- Center for Development Research (ZEF), University Bonn, Bonn, Germany
| | - Birgit Bette
- Department of Anaesthesiology, University Hospital Bonn, Bonn, Germany
| | - Simone Welz
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Babak Salam
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Kai Wilhelm
- Department of Radiology, Johanniter Krankenhaus Bonn, Bonn, Germany
| | - Eva K Egger
- Department of Gynaecology and Gynaecological Oncology, University Hospital Bonn, Bonn, Germany
| | - Ullrich Wüllner
- Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Ulrike Attenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Alexander Mustea
- Department of Gynaecology and Gynaecological Oncology, University Hospital Bonn, Bonn, Germany
| | - Rupert Conrad
- Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Milka Marinova
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany. .,Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
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Applications of Ultrasound-Mediated Drug Delivery and Gene Therapy. Int J Mol Sci 2021; 22:ijms222111491. [PMID: 34768922 PMCID: PMC8583720 DOI: 10.3390/ijms222111491] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/11/2021] [Accepted: 10/19/2021] [Indexed: 12/14/2022] Open
Abstract
Gene therapy has continuously evolved throughout the years since its first proposal to develop more specific and effective transfection, capable of treating a myriad of health conditions. Viral vectors are some of the most common and most efficient vehicles for gene transfer. However, the safe and effective delivery of gene therapy remains a major obstacle. Ultrasound contrast agents in the form of microbubbles have provided a unique solution to fulfill the need to shield the vectors from the host immune system and the need for site specific targeted therapy. Since the discovery of the biophysical and biological effects of microbubble sonification, multiple developments have been made to enhance its applicability in targeted drug delivery. The concurrent development of viral vectors and recent research on dual vector strategies have shown promising results. This review will explore the mechanisms and recent advancements in the knowledge of ultrasound-mediated microbubbles in targeting gene and drug therapy.
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Jiang F, Yang H, Wang L, Wang Y, Tang Y, Wang D, Wang Q, Zou J. [ Escherichia coli expressing gas vesicles is safe for enhancing the ablation effect of highintensity focused ultrasound in tumor-bearing mice]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:649-656. [PMID: 34134950 DOI: 10.12122/j.issn.1673-4254.2021.05.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the effect and safety of Escherichia coli (E.coli) expressing gas vesicle (GVs) for enhancing the efficacy of tumor ablation by high intensity focused ultrasound (HIFU) in tumor-bearing mice. OBJECTIVE Thirty-two female BALB/c mice were used to establish mouse models bearing 4T1 tumor, which were randomized into GVs group [E.coli BL21 (AI)-PET28a-Arg1] and control group (PBS), and the efficacy of HIFU ablation was evaluated by examining coagulative necrotic volume and pathology of the tumors. Another 104 BALB/c mice were also randomly divided into GVs group and control group, and body weight changes of the mice were recorded on days 1, 4 and 15 after intravenous injection of E.coli containing GVs or PBS. White blood cells, red blood cells, hemoglobin and platelet counts and liver and renal function parameters of the mice were detected, and serum levels of TNF-α and IL-1β were examined using ELISA. The pathological changes in the liver and spleen were evaluated using HE staining to assess the safety of the treatments. OBJECTIVE HIFU ablation resulted in a significantly greater volume of coagulative necrosis and severer tissue damage in GVs group than in the control group (P < 0.001). In the 104 BALB/c mice without tumor cell inoculation, intravenous injection of E.coli expressing GVs, as compared with PBS, did not significantly affect body weight or cause changes in white blood cell, red blood cell and platelet counts or hemoglobin level (P1=0.59, P2=0.27, P3=0.76, P4=0.81). The liver and kidney function parameters (P1=0.12, P2=0.46, P3=0.62, P4=0.86) and serum levels of TNF-α and IL-1β (P1=0.48, P2=0.56) were all comparable between GVs group and control group. No obvious pathological changes were detected in the liver and spleen tissues in either GVs group or the control group. OBJECTIVE E.coli expressing GVs is safe for enhancing the ablation effect of HIFU in tumor-bearing mice.
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Affiliation(s)
- F Jiang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China
| | - H Yang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China
| | - L Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China
| | - Y Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China
| | - Y Tang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China
| | - D Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China
| | - Q Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China
| | - J Zou
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China
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Yang MJ, Yu RQ, Chen WZ, Chen JY, Wang ZB. A Prediction of NPVR ≥ 80% of Ultrasound-Guided High-Intensity Focused Ultrasound Ablation for Uterine Fibroids. Front Surg 2021; 8:663128. [PMID: 34150838 PMCID: PMC8211994 DOI: 10.3389/fsurg.2021.663128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/26/2021] [Indexed: 01/15/2023] Open
Abstract
Objective: To evaluate factors in predicting the treatment outcome of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation for uterine fibroids with a non-perfused volume ratio (NPVR) of at least 80%. Methods: One thousand patients with uterine fibroids who received USgHIFU were enrolled. Thirty-two independent variables of four dimensions of data set, including general information of patients, clinical symptoms, laboratory tests, and fibroid imaging characteristics, were used to investigate the potential predictors of the NPVR of at least 80% by multivariate logistic regression. NPVR was the gold standard for evaluating the efficiency of HIFU ablation, and a NPVR of at least 80% was considered sufficient ablation, while partial ablation was defined as having an NPVR of <80%. Results: Out of 1,000 fibroids, 758 obtained sufficient ablation and 242 obtained partial ablation, and the median NPVR was 88.3% (interquartile range: 80.3–94.8%). The probability of NPVR reaching 80% fibroids with a signal intensity of T2WI of hypointense, isointense, and hyperintense was 86.4, 76.5, and 62.6%, respectively; fibroids with an enhancement type of T1WI of slight, irregular, and regular was 81.5, 73.6, and 63.7%, respectively; and fibroids with uterine anteroposterior of 30–130 mm was 57.7–78.3%, respectively. In patients with a platelet count of 50 × 109/L−550 × 109/L, the probability of NPVR reaching 80% is from 53.4 to 80.1%, respectively. Conclusions: In predicting NPVR ≥ 80%, the signal intensity on T2WI was the most important factor affecting ablative efficiency, followed by enhancement type on T1WI, uterine anteroposterior, and platelet count.
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Affiliation(s)
- Mei-Jie Yang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Ren-Qiang Yu
- Department of Radiology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wen-Zhi Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Ultrasound Ablation Center, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jin-Yun Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Ultrasound Ablation Center, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhi-Biao Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
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Danahey J, Seip R, Lee B, Nassiri N, Dardik A, Guzman R, Nassiri N. Imaging of vascular malformations with a high-intensity focused ultrasound probe for treatment planning. J Vasc Surg Venous Lymphat Disord 2021; 9:1467-1472.e2. [PMID: 33838310 DOI: 10.1016/j.jvsv.2021.03.011] [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: 12/29/2020] [Accepted: 03/19/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We aimed to investigate whether a current commercially available high-intensity focused ultrasound (HIFU) probe can adequately image targeted vascular malformations (VMs) in anticipation of HIFU treatment planning and delivery. METHODS We enrolled 10 consecutive patients who were scheduled to undergo treatment of symptomatic peripheral VMs confirmed by routine preoperative contrast-enhanced magnetic resonance imaging and soft tissue duplex ultrasound. The lesions were situated no more than 6 cm from the skin. After induction of general anesthesia and before surgical intervention, we prepared and positioned the Sonablate HIFU probe (SonaCare Medical, LLC, Charlotte, NC) to obtain multiple B-mode images of the targeted VM in the transverse and longitudinal dimensions. We then rated the quality of the images and the feasibility of the imaging process itself using a previously devised questionnaire aimed at evaluating the adequacy of the images for potential HIFU treatment planning and delivery. The patients subsequently underwent surgical intervention and clinical follow-up for their VM per the standard protocol. RESULTS The study included 10 participants aged 21 to 67 years (mean ± standard deviation, 36.5 ± 16.5 years). Six patients (60%) identified as female. The VMs imaged consisted of eight venous (80%), one lymphatic (10%), and one combined lymphovenous (10%) malformation. The lesions were in the extremities only (50%), trunk only (20%), trunk and extremities (20%), or neck and extremities (10%). Pain related to the VM was present in all 10 patients (100%). In all 10 patients, the boundary and location of the VM could be visualized via the HIFU probe despite the diminished B-mode imaging resolution. The absence of Doppler functionality in the HIFU probe did not prevent the identification of the VMs in any patient up to a depth of 6 cm. The results from the postimaging survey showed that difficulty in preparing the study device for imaging was 1.1 ± 0.3 and difficulty in use was 1.1 ± 0.1, with a score of 1 equal to easy and 5 to difficult. The stability of the acoustic coupling to the patient was 1.3 ± 0.2, with a score of 1 representing very stable. CONCLUSIONS We were able to ultrasonically identify and outline all targeted peripheral VMs using a commercially available HIFU probe in anticipation of treatment planning and delivery. Baseline magnetic resonance imaging and soft tissue duplex ultrasound remain essential tools for guiding probe placement and HIFU imaging.
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Affiliation(s)
- James Danahey
- Division of Vascular and Endovascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Ralf Seip
- SonaCare Medical, LLC, Charlotte, NC
| | - Brian Lee
- SonaCare Medical, LLC, Charlotte, NC
| | - Nima Nassiri
- Institute of Urology, University of Southern California, Los Angeles, Calif
| | - Alan Dardik
- Division of Vascular and Endovascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Raul Guzman
- Division of Vascular and Endovascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Naiem Nassiri
- Division of Vascular and Endovascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn; Vascular Malformations Program, Yale New Haven Hospital, New Haven, Conn.
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Antoniou A, Evripidou N, Giannakou M, Constantinides G, Damianou C. Acoustical properties of 3D printed thermoplastics. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 149:2854. [PMID: 33940906 DOI: 10.1121/10.0004772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/03/2021] [Indexed: 06/12/2023]
Abstract
With focused ultrasound (FUS) gaining popularity as a therapeutic modality for brain diseases, the need for skull phantoms that are suitable for evaluating FUS protocols is increasing. In the current study, the acoustical properties of several three-dimensional (3D) printed thermoplastic samples were evaluated to assess their suitability to mimic human skull and bone accurately. Samples were 3D printed using eight commercially available thermoplastic materials. The acoustic properties of the printed samples, including attenuation coefficient, speed of sound, and acoustic impedance, were investigated using transmission-through and pulse-echo techniques. The ultrasonic attenuation, estimated at a frequency of 1.1 MHz, varied from approximately 7 to 32 dB/cm. The frequency dependence of attenuation was described by a power law in the frequency range of 0.2-3.5 MHz, and the exponential index of frequency was found to vary from 1.30 to 2.24. The longitudinal velocity of 2.7 MHz sound waves was in the range of 1700-3050 m/s. The results demonstrate that thermoplastics could potentially be used for the 3D construction of high-quality skull phantoms.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering and Computer Engineering and Informatics, Cyprus University of Technology, 30 Archiepiskopou Kyprianou Street, Limassol, 3036, Cyprus
| | - Nikolas Evripidou
- Department of Electrical Engineering and Computer Engineering and Informatics, Cyprus University of Technology, 30 Archiepiskopou Kyprianou Street, Limassol, 3036, Cyprus
| | - Marinos Giannakou
- MEDSONIC LTD, 35 Christaki Kranou Street, Germasogia, Limassol, 4041, Cyprus
| | - Georgios Constantinides
- Department of Mechanical Engineering and Materials Science and Engineering, Cyprus University of Technology, 30 Archiepiskopou Kyprianou Street, Limassol, 3036, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering and Computer Engineering and Informatics, Cyprus University of Technology, 30 Archiepiskopou Kyprianou Street, Limassol, 3036, Cyprus
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Song F, Gao H, Li D, Petrov AV, Petrov VV, Wen D, Sukhorukov GB. Low intensity focused ultrasound responsive microcapsules for non-ablative ultrafast intracellular release of small molecules. J Mater Chem B 2021; 9:2384-2393. [PMID: 33554993 DOI: 10.1039/d0tb02788j] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Focused ultrasound (FU) is in demand for clinical cancer therapy, but the possible thermal injury to the normal peripheral tissues limits the usage of the ablative FU for tumors with a large size; therefore research efforts have been made to minimize the possible side effects induced by the FU treatment. Non-ablative focused ultrasound assisted chemotherapy could open a new avenue for the development of cancer therapy technology. Here, low intensity focused ultrasound (LIFU) for controlled quick intracellular release of small molecules (Mw ≤ 1000 Da) without acute cell damage is demonstrated. The release is achieved by a composite poly(allylamine hydrochloride) (PAH)/poly-(sodium 4-styrenesulfonate) (PSS)/SiO2 microcapsules which are highly sensitive to LIFU and can be effectively broken by weak cavitation effects. Most PAH/PSS/SiO2 capsules in B50 rat neuronal cells can be ruptured and release rhodamine B (Rh-B) into the cytosol within only 30 s of 0.75 W cm-2 LIFU treatment, as demonstrated by the CLSM results. While the same LIFU treatment shows no obvious damage to cells, as proved by the live/dead experiment, showing that 90% of cells remain alive.
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Affiliation(s)
- Fengyan Song
- School of Aeronautic Science and Engineering, Beihang University, Beijing, 100191, P. R. China.
| | - Hui Gao
- School of Aeronautic Science and Engineering, Beihang University, Beijing, 100191, P. R. China.
| | - Danyang Li
- School of Engineering and Materials Science, Queen Mary University of London, Mile End Road, London, E1 4NS, UK.
| | - Arseniy V Petrov
- Educational Research Institute of Nanostructures and Biosystems, Saratov State University, 83 Astrakhanskaya Street, Saratov, 410012, Russia
| | - Vladimir V Petrov
- Educational Research Institute of Nanostructures and Biosystems, Saratov State University, 83 Astrakhanskaya Street, Saratov, 410012, Russia
| | - Dongsheng Wen
- School of Aeronautic Science and Engineering, Beihang University, Beijing, 100191, P. R. China. and School of Chemical and Processing Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - Gleb B Sukhorukov
- School of Engineering and Materials Science, Queen Mary University of London, Mile End Road, London, E1 4NS, UK.
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Keserci B, Duc NM, Nadarajan C, Huy HQ, Saizan A, Wan Ahmed WA, Osman K, Abdullah MS. Volumetric MRI-guided, high-intensity focused ultrasound ablation of uterine leiomyomas: ASEAN preliminary experience. ACTA ACUST UNITED AC 2021; 26:207-215. [PMID: 32209511 DOI: 10.5152/dir.2019.19157] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE We sought to present our preliminary experience on the effectiveness and safety of magnetic resonance imaging (MRI)-guided, high-intensity focused ultrasound (HIFU) therapy using a volumetric ablation technique in the treatment of Association of Asian Nations (ASEAN) patients with symptomatic uterine leiomyomas. METHODS This study included 33 women who underwent HIFU treatment. Tissue characteristics of leiomyomas were assessed based on T2- and T1-weighted MRI. The immediate nonperfused volume (NPV) ratio and the treatment effectiveness of MRI-guided HIFU on the basis of the degrees of volume reduction and improvement in transformed symptom severity score (SSS) were assessed. RESULTS The median immediate NPV ratio was 89.8%. Additionally, the median acoustic sonication power and HIFU treatment durations were 150 W and 125 min, respectively. At six-month follow-up, the median leiomyoma volume had decreased from 139 mL at baseline to 84 mL and the median transformed SSS had decreased from 56.2 at baseline to 18.8. No major adverse events were observed. CONCLUSION The preliminary results demonstrated that volumetric MRI-guided HIFU therapy for the treatment of symptomatic leiomyomas in ASEAN patients appears to be clinically acceptable with regard to treatment effectiveness and safety.
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Affiliation(s)
- Bilgin Keserci
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia;Department of Radiology, Hospital Universiti Sains Malaysia, USM 16150 Kubang Kerian, Kelantan, Malaysia
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University School of Medicine, Ho Chi Minh City, Vietnam
| | - Chandran Nadarajan
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia;Department of Radiology, Hospital Universiti Sains Malaysia, USM 16150 Kubang Kerian, Kelantan, Malaysia
| | - Huynh Quang Huy
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Aishah Saizan
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia;Department of Radiology, Hospital Universiti Sains Malaysia, USM 16150 Kubang Kerian, Kelantan, Malaysia
| | - Wan Aireene Wan Ahmed
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia;Department of Radiology, Hospital Universiti Sains Malaysia, USM 16150 Kubang Kerian, Kelantan, Malaysia
| | - Khalid Osman
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia;Department of Radiology, Hospital Universiti Sains Malaysia, USM 16150 Kubang Kerian, Kelantan, Malaysia
| | - Mohd Shafie Abdullah
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia;Department of Radiology, Hospital Universiti Sains Malaysia, USM 16150 Kubang Kerian, Kelantan, Malaysia
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Yu K, Niu X, He B. Neuromodulation Management of Chronic Neuropathic Pain in The Central Nervous system. ADVANCED FUNCTIONAL MATERIALS 2020; 30:1908999. [PMID: 34335132 PMCID: PMC8323399 DOI: 10.1002/adfm.201908999] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Indexed: 05/05/2023]
Abstract
Neuromodulation is becoming one of the clinical tools for treating chronic neuropathic pain by transmitting controlled physical energy to the pre-identified neural targets in the central nervous system. Its nature of drug-free, non-addictive and improved targeting have attracted increasing attention among neuroscience research and clinical practices. This article provides a brief overview of the neuropathic pain and pharmacological routines for treatment, summarizes both the invasive and non-invasive neuromodulation modalities for pain management, and highlights an emerging brain stimulation technology, transcranial focused ultrasound (tFUS) with a focus on ultrasound transducer devices and the achieved neuromodulation effects and applications on pain management. Practical considerations of spatial guidance for tFUS are discussed for clinical applications. The safety of transcranial ultrasound neuromodulation and its future prospectives on pain management are also discussed.
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Affiliation(s)
| | | | - Bin He
- Department of Biomedical Engineering, Carnegie Mellon University
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Li H, Zeng Y, Zhang H, Gu Z, Gong Q, Luo K. Functional gadolinium-based nanoscale systems for cancer theranostics. J Control Release 2020; 329:482-512. [PMID: 32898594 DOI: 10.1016/j.jconrel.2020.08.064] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/25/2020] [Accepted: 08/30/2020] [Indexed: 02/07/2023]
Abstract
Cancer theranostics is a new strategy for combating cancer that integrates cancer imaging and treatment through theranostic agents to provide an efficient and safe way to improve cancer prognosis. Design and synthesis of these cancer theranostic agents are crucial since these agents are required to be biocompatible, tumor-specific, imaging distinguishable and therapeutically efficacious. In this regard, several types of gadolinium (Gd)-based nanomaterials have been introduced to combine different therapeutic agents with Gd to enhance the efficacy of therapeutic agents. At the same time, the entire treatment procedure could be monitored via imaging tools due to incorporation of Gd ions, Gd chelates and Gd/other imaging probes in the theranostic agents. This review aims to overview recent advances in the Gd-based nanomaterials for cancer theranostics and perspectives for Gd nanomaterial-based cancer theranostics are provided.
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Affiliation(s)
- Haonan Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yujun Zeng
- Huaxi MR Research Center (HMRRC), Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Hu Zhang
- Amgen Bioprocessing Centre, Keck Graduate Institute, Claremont, CA 91711, USA
| | - Zhongwei Gu
- Huaxi MR Research Center (HMRRC), Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Kui Luo
- Huaxi MR Research Center (HMRRC), Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China.
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Wang Y, Chen C, Luo Y, Xiong J, Tang Y, Yang H, Wang L, Jiang F, Gao X, Xu D, Li H, Wang Q, Zou J. Experimental Study of Tumor Therapy Mediated by Multimodal Imaging Based on a Biological Targeting Synergistic Agent. Int J Nanomedicine 2020; 15:1871-1888. [PMID: 32256065 PMCID: PMC7085950 DOI: 10.2147/ijn.s238398] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/24/2020] [Indexed: 12/13/2022] Open
Abstract
Purpose The high-intensity focused ultrasound (HIFU) ablation of tumors is inseparable from synergistic agents and image monitoring, but the existing synergistic agents have the defects of poor targeting and a single imaging mode, which limits the therapeutic effects of HIFU. The construction of a multifunctional biological targeting synergistic agent with high biosafety, multimodal imaging and targeting therapeutic performance has great significance for combating cancer. Methods Multifunctional biological targeting synergistic agent consisting of Bifidobacterium longum (B. longum), ICG and PFH coloaded cationic lipid nanoparticles (CL-ICG-PFH-NPs) were constructed for targeting multimode imaging, synergistic effects with HIFU and imaging-guided ablation of tumors, which was evaluated both in vitro and in vivo. Results Both in vitro and in vivo systematical studies validated that the biological targeting synergistic agent can simultaneously achieve tumor-biotargeted multimodal imaging, HIFU synergism and multimodal image monitoring in HIFU therapy. Importantly, the electrostatic adsorption method and the targeting of B. longum to tumor tissues allow the CL-ICG-PFH-NPs to be retained in the tumor tissue, achieve the targeting ability of synergistic agent. Multimodal imaging chose the best treatment time according to the distribution of nanoparticles in the body to guide the efficient and effective treatment of HIFU. CL-ICG-PFH-NPs could serve as a phase change agent and form microbubbles that can facilitate HIFU ablation by mechanical effects, acoustic streaming and shear stress. This lays a foundation for the imaging and treatment of tumors. Conclusion In this work, a biological targeting synergistic agent was successfully constructed with good stability and physicochemical properties. This biological targeting synergistic agent can not only provide information for early diagnosis of tumors but also realize multimodal imaging monitoring during HIFU ablation simultaneously with HIFU treatment, which improves the shortcomings of HIFU treatment and has broad application prospects.
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Affiliation(s)
- Yaotai Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Chun Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Yong Luo
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Jie Xiong
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Yu Tang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Haiyan Yang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Lu Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Fujie Jiang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Xuan Gao
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Die Xu
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Huanan Li
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Qi Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Jianzhong Zou
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, People's Republic of China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, People's Republic of China
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Zhang X, Duan H. One-time high-intensity focused ultrasound ablation of abdominal wall endometriosis with concurrent uterine fibroids or adenomyosis: two cases and literature review. Quant Imaging Med Surg 2020; 10:511-517. [PMID: 32190576 DOI: 10.21037/qims.2019.12.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Xiaoying Zhang
- Department of HIFU Treatment Center Gynecology Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100006, China
| | - Hua Duan
- Department of HIFU Treatment Center Gynecology Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100006, China
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Cheng CA, Chen W, Zhang L, Wu HH, Zink JI. A Responsive Mesoporous Silica Nanoparticle Platform for Magnetic Resonance Imaging-Guided High-Intensity Focused Ultrasound-Stimulated Cargo Delivery with Controllable Location, Time, and Dose. J Am Chem Soc 2019; 141:17670-17684. [PMID: 31604010 DOI: 10.1021/jacs.9b07591] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Magnetic resonance imaging (MRI) is an essential modality for clinical diagnosis, and MRI-guided high-intensity focused ultrasound (MRgHIFU) is a powerful technology for targeted therapy. Clinical applications of MRgHIFU primarily utilize hyperthermia and ablation to treat cancerous tissue, but for drug delivery applications thermal damage is undesirable. A biofriendly MRgHIFU-responsive mesoporous silica nanoparticle (MSN) platform that is stimulated within a physiological safe temperature range has been developed, reducing the possibility of thermal damage to the surrounding healthy tissues. Biocompatible polyethylene glycol (PEG) was employed to cap the pores of MSNs, and the release of cargo molecules by HIFU occurs without substantial temperature increase (∼4 °C). To visualize by MRI and measure the stimulated delivery in situ, a U.S. Food and Drug Administration (FDA)-approved gadolinium-based contrast agent, gadopentetate dimeglumine (Gd(DTPA)2-), was used as the imageable cargo. Taking advantage of the three-dimensional (3-D) imaging and targeting capabilities of MRgHIFU, the release of Gd(DTPA)2- stimulated by HIFU was pinpointed at the HIFU focal point in 3-D space in a tissue-mimicking gel phantom. The amount of Gd(DTPA)2- released was controlled by HIFU stimulation times and power levels. A positive correlation between the amount of Gd(DTPA)2- released and T1 was found. The MRgHIFU-stimulated cargo release was further imaged in a sample of ex vivo animal tissue. With this technology, the biodistribution of the nanocarriers can be tracked and the MRgHIFU-stimulated cargo release can be pinpointed, opening up an opportunity for future image-guided theranostic applications.
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Affiliation(s)
- Chi-An Cheng
- Department of Bioengineering , University of California Los Angeles , Los Angeles , California 90095 , United States.,California NanoSystems Institute , University of California Los Angeles , Los Angeles 90095 , California , United States
| | - Wei Chen
- Department of Chemistry & Biochemistry , University of California Los Angeles , Los Angeles , California 90095 , United States.,California NanoSystems Institute , University of California Los Angeles , Los Angeles 90095 , California , United States
| | - Le Zhang
- Department of Radiological Sciences, David Geffen School of Medicine , University of California Los Angeles , Los Angeles , California 90095 , United States
| | - Holden H Wu
- Department of Bioengineering , University of California Los Angeles , Los Angeles , California 90095 , United States.,Department of Radiological Sciences, David Geffen School of Medicine , University of California Los Angeles , Los Angeles , California 90095 , United States
| | - Jeffrey I Zink
- Department of Chemistry & Biochemistry , University of California Los Angeles , Los Angeles , California 90095 , United States.,California NanoSystems Institute , University of California Los Angeles , Los Angeles 90095 , California , United States
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