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Chen L, Zhou J, Deng Q, Feng J, Qiu Q, Huang W, Chen Y, Li Y. Ultrasound-visualized, site-specific vascular embolization using magnetic protein microcapsules. J Mater Chem B 2021; 9:2407-2416. [PMID: 33623935 DOI: 10.1039/d0tb02715d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Imaging-guided vascular embolization is frequently performed on patients with advanced hepatocellular carcinoma (HCC) to alleviate symptoms and extend their survival time. Current operation procedures are not only painful for patients, but are also inaccurate in tumor targeting after the release of embolic agents from the catheter, leading to injury to healthy tissues simultaneously. In this study, we developed an ultrasound-visualized, site-specific vascular embolization strategy with magnetic protein microcapsules (MPMs). MPMs were fabricated using a rapid emulsification method, giving it a smooth surface and a core-shell structure. Their diameters could be controlled within 10 μm, allowing them to pass through capillaries. The core-shell structure and loading of magnetic Fe3O4 endowed MPMs with good contrast under ultrasound imaging and magnetically inducible targeting properties, as well as aggregation response even under flowing conditions. In vitro cytotoxicity and hemolysis evaluation demonstrated good biocompatibility of the MPMs. Furthermore, mock embolization showed that cell death could be induced by aggregation of the MPMs. Such a combination of real-time monitoring using ultrasound and control on targeted vascular embolization might be a breakthrough in the treatment of advanced HCC.
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Affiliation(s)
- Lanxi Chen
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou 510006, China.
| | - Jianhua Zhou
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou 510006, China.
| | - Qiurong Deng
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou 510006, China.
| | - Jialin Feng
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, UK
| | - Qiong Qiu
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510120, China
| | - Wenwei Huang
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou 510006, China.
| | - Yin Chen
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou 510006, China.
| | - Yan Li
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou 510006, China.
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Klaassen NJM, Arntz MJ, Gil Arranja A, Roosen J, Nijsen JFW. The various therapeutic applications of the medical isotope holmium-166: a narrative review. EJNMMI Radiopharm Chem 2019; 4:19. [PMID: 31659560 PMCID: PMC6682843 DOI: 10.1186/s41181-019-0066-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/05/2019] [Indexed: 12/17/2022] Open
Abstract
Over the years, a broad spectrum of applications of the radionuclide holmium-166 as a medical isotope has been established. The isotope holmium-166 is attractive as it emits high-energy beta radiation which can be used for a therapeutic effect and gamma radiation which can be used for nuclear imaging purposes. Furthermore, holmium-165 can be visualized by MRI because of its paramagnetic properties and by CT because of its high density. Since holmium-165 has a natural abundance of 100%, the only by-product is metastable holmium-166 and no costly chemical purification steps are necessary for production of nuclear reactor derived holmium-166. Several compounds labelled with holmium-166 are now used in patients, such Ho166-labelled microspheres for liver malignancies, Ho166-labelled chitosan for hepatocellular carcinoma (HCC) and [166Ho]Ho DOTMP for bone metastases. The outcomes in patients are very promising, making this isotope more and more interesting for applications in interventional oncology. Both drugs as well as medical devices labelled with radioactive holmium are used for internal radiotherapy. One of the treatment possibilities is direct intratumoural treatment, in which the radioactive compound is injected with a needle directly into the tumour. Numerous other applications have been developed, like patches for treatment of skin cancer and holmium labelled antibodies and peptides. The second major application that is currently clinically applied is selective internal radiation therapy (SIRT, also called radioembolization), a novel treatment option for liver malignancies. This review discusses medical drugs and medical devices based on the therapeutic radionuclide holmium-166.
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Affiliation(s)
- Nienke J M Klaassen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands
| | - Mark J Arntz
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands
| | - Alexandra Gil Arranja
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands.,Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences (UIPS), Science for Life, Faculty of Science, Utrecht University, 3508, TB, Utrecht, The Netherlands.,Department of Radiation Science and Technology, Delft University of Technology, Mekelweg 15, 2629, JB, Delft, The Netherlands
| | - Joey Roosen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands
| | - J Frank W Nijsen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands.
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Zou Q, Hou F, Wang H, Liao Y, Wang Q, Yang Y. Microfluidic one-step preparation of alginate microspheres encapsulated with in situ-formed bismuth sulfide nanoparticles and their photothermal effect. Eur Polym J 2019. [DOI: 10.1016/j.eurpolymj.2019.03.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lewis AL, Willis SL, Dreher MR, Tang Y, Ashrafi K, Wood BJ, Levy EB, Sharma KV, Negussie AH, Mikhail AS. Bench-to-clinic development of imageable drug-eluting embolization beads: finding the balance. Future Oncol 2018; 14:2741-2760. [PMID: 29944007 DOI: 10.2217/fon-2018-0196] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
This review describes the historical development of an imageable spherical embolic agent and focuses on work performed in collaboration between Biocompatibles UK Ltd (a BTG International group company) and the NIH to demonstrate radiopaque bead utility and bring a commercial offering to market that meets a clinical need. Various chemistries have been investigated and multiple prototypes evaluated in search of an optimized product with the right balance of handling and imaging properties. Herein, we describe the steps taken in the development of DC Bead LUMI™, the first commercially available radiopaque drug-eluting bead, ultimately leading to the first human experience of this novel embolic agent in the treatment of liver tumors.
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Affiliation(s)
- Andrew L Lewis
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Sean L Willis
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Matthew R Dreher
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Yiqing Tang
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Koorosh Ashrafi
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Bradford J Wood
- Center for Interventional Oncology, Radiology & Imaging Sciences, NIH Clinical Center, National Institute of Biomedical Imaging & Bioengineering, & National Cancer Institute Center for Cancer Research, NIH, 10 Center Drive, Bethesda, MD 20892, USA
| | - Elliot B Levy
- Center for Interventional Oncology, Radiology & Imaging Sciences, NIH Clinical Center, National Institute of Biomedical Imaging & Bioengineering, & National Cancer Institute Center for Cancer Research, NIH, 10 Center Drive, Bethesda, MD 20892, USA
| | - Karun V Sharma
- Department of Radiology & Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Washington, DC 20010, USA
| | - Ayele H Negussie
- Center for Interventional Oncology, Radiology & Imaging Sciences, NIH Clinical Center, National Institute of Biomedical Imaging & Bioengineering, & National Cancer Institute Center for Cancer Research, NIH, 10 Center Drive, Bethesda, MD 20892, USA
| | - Andrew S Mikhail
- Center for Interventional Oncology, Radiology & Imaging Sciences, NIH Clinical Center, National Institute of Biomedical Imaging & Bioengineering, & National Cancer Institute Center for Cancer Research, NIH, 10 Center Drive, Bethesda, MD 20892, USA
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Radioactive holmium phosphate microspheres for cancer treatment. Int J Pharm 2018; 548:73-81. [PMID: 29913219 DOI: 10.1016/j.ijpharm.2018.06.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/13/2018] [Accepted: 06/14/2018] [Indexed: 12/21/2022]
Abstract
The aim of this study was the development of radioactive holmium phosphate microspheres (HoPO4-MS) with a high holmium content and that are stable in human serum for selective internal radiation therapy (SIRT) of liver cancer. To this end, holmium acetylacetonate microspheres (HoAcAc-MS) were prepared (34.2 ± 1.0 µm in diameter, holmium content of 46.2 ± 0.8 and density of 1.7 g/cm3) via an emulsification and solvent evaporation method. The concentration of HoAcAc in the organic solvent, the temperature of emulsification and the stirring speed were varied for the preparation of the HoAcAc-MS to obtain microspheres with different diameters ranging from 11 to 35 µm. Subsequently, the AcAc ligands of the HoAcAc-MS were replaced by phosphate ions by simply incubating neutron irradiated HoAcAc-MS in a phosphate buffer solution (0.116 M, pH 4.2) to yield radioactive HoPO4-MS. The obtained microspheres were analyzed using different techniques such as SEM-EDS, ICP-OES and HPLC. The prepared HoPO4-MS (29.5 ± 1.2 µm in diameter and a density of 3.1 g/cm3) present an even higher holmium content (52 wt%) than the HoAcAc-MS precursor (46 wt%). Finally, the stability of the HoPO4-MS was tested by incubation in human serum at 37 °C which showed no visible changes of the microspheres morphology and only 0.1% of holmium release was observed during the 2 weeks period of incubation. In conclusion, this study shows that stable radioactive HoPO4-MS can be prepared with suitable properties to be used for cancer therapy.
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Liu Q, Qian Y, Li P, Zhang S, Liu J, Sun X, Fulham M, Feng D, Huang G, Lu W, Song S. 131I-Labeled Copper Sulfide-Loaded Microspheres to Treat Hepatic Tumors via Hepatic Artery Embolization. Theranostics 2018; 8:785-799. [PMID: 29344306 PMCID: PMC5771093 DOI: 10.7150/thno.21491] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 11/15/2017] [Indexed: 12/11/2022] Open
Abstract
Purpose: Transcatheter hepatic artery embolization therapy is a minimally invasive alternative for treating inoperable liver cancer but recurrence is frequent. Multifunctional agents, however, offer an opportunity for tumor eradication. In this study, we were aim to synthesized poly (lactic-co-glycolic acid) (PLGA) microspheres encapsulating hollow CuS nanoparticles (HCuSNPs) and paclitaxel (PTX) that were then labeled with radioiodine-131 (131I) to produce 131I-HCuSNPs-MS-PTX. This compound combines the multi-theranostic properties of chemotherapy, radiotherapy and photothermal therapy. In addition, it can also be imaged with single photon emission computed tomography (SPECT) imaging and photoacoustic imaging. Methods: We investigated the value of therapeutic and imaging of 131I-HCuSNPs-MS-PTX in rats bearing Walker-256 tumor transplanted in the liver. After the intra-arterial (IA) injection of 131I-HCuSNPs-MS-PTX, 18F-Fluorodeoxyglucose (18F-FDG) micro-positron emission tomography/computed tomography (micro-PET/CT) imaging was used to monitor the therapeutic effect. PET/CT findings were verified by immunohistochemical analysis. SPECT/CT and photoacoustic imaging were performed to demonstrate the distribution of 131I-HCuSNPs-MS-PTX in vivo. Results: We found that embolization therapy in combination with chemotherapy, radiotherapy and photothermal therapy offered by 131I-HCuSNPs-MS-PTX completely ablated the transplanted hepatic tumors at a relatively low dose. In comparison, embolization monotherapy or combination with one or two other therapies had less effective anti-tumor efficacy. The combination of SPECT/CT and photoacoustic imaging effectively confirmed microsphere delivery to the targeted tumors in vivo and guided the near-infrared laser irradiation. Conclusion: Our study suggests that there is a clinical theranostic potential for imaging-guided arterial embolization with 131I-HCuSNPs-MS-PTX for the treatment of liver tumors.
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Sommer C, Pallwein-Prettner L, Vollherbst D, Seidel R, Rieder C, Radeleff B, Kauczor H, Wacker F, Richter G, Bücker A, Rodt T, Massmann A, Pereira P. Transarterial embolization (TAE) as add-on to percutaneous radiofrequency ablation (RFA) for the treatment of renal tumors: Review of the literature, overview of state-of-the-art embolization materials and further perspective of advanced image-guided tumor ablation. Eur J Radiol 2017; 86:143-162. [DOI: 10.1016/j.ejrad.2016.10.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/17/2016] [Accepted: 10/21/2016] [Indexed: 02/08/2023]
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Preparation and evaluation of MRI detectable poly (acrylic acid) microspheres loaded with superparamagnetic iron oxide nanoparticles for transcatheter arterial embolization. Int J Pharm 2016; 511:831-9. [DOI: 10.1016/j.ijpharm.2016.07.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 07/06/2016] [Accepted: 07/14/2016] [Indexed: 01/10/2023]
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Duran R, Sharma K, Dreher MR, Ashrafi K, Mirpour S, Lin M, Schernthaner RE, Schlachter TR, Tacher V, Lewis AL, Willis S, Hartog MD, Radaelli A, Negussie AH, Wood BJ, Geschwind JFH. A Novel Inherently Radiopaque Bead for Transarterial Embolization to Treat Liver Cancer - A Pre-clinical Study. Am J Cancer Res 2016; 6:28-39. [PMID: 26722371 PMCID: PMC4679352 DOI: 10.7150/thno.13137] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 08/19/2015] [Indexed: 02/06/2023] Open
Abstract
Purpose: Embolotherapy using microshperes is currently performed with soluble contrast to aid in visualization. However, administered payload visibility dimishes soon after delivery due to soluble contrast washout, leaving the radiolucent bead's location unknown. The objective of our study was to characterize inherently radiopaque beads (RO Beads) in terms of physicomechanical properties, deliverability and imaging visibility in a rabbit VX2 liver tumor model. Materials and Methods: RO Beads, which are based on LC Bead® platform, were compared to LC Bead. Bead size (light microscopy), equilibrium water content (EWC), density, X-ray attenuation and iodine distribution (micro-CT), suspension (settling times), deliverability and in vitro penetration were investigated. Fifteen rabbits were embolized with either LC Bead or RO Beads + soluble contrast (iodixanol-320), or RO Beads+dextrose. Appearance was evaluated with fluoroscopy, X-ray single shot, cone-beam CT (CBCT). Results: Both bead types had a similar size distribution. RO Beads had lower EWC (60-72%) and higher density (1.21-1.36 g/cc) with a homogeneous iodine distribution within the bead's interior. RO Beads suspension time was shorter than LC Bead, with durable suspension (>5 min) in 100% iodixanol. RO Beads ≤300 µm were deliverable through a 2.3-Fr microcatheter. Both bead types showed similar penetration. Soluble contrast could identify target and non-target embolization on fluoroscopy during administration. However, the imaging appearance vanished quickly for LC Bead as contrast washed-out. RO Beads+contrast significantly increased visibility on X-ray single shot compared to LC Bead+contrast in target and non-target arteries (P=0.0043). Similarly, RO beads demonstrated better visibility on CBCT in target arteries (P=0.0238) with a trend in non-target arteries (P=0.0519). RO Beads+dextrose were not sufficiently visible to monitor embolization using fluoroscopy. Conclusion: RO Beads provide better conspicuity to determine target and non-target embolization compared to LC Bead which may improve intra-procedural monitoring and post-procedural evaluation of transarterial embolization.
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Alginate microgels loaded with temperature sensitive liposomes for magnetic resonance imageable drug release and microgel visualization. Eur Polym J 2015. [DOI: 10.1016/j.eurpolymj.2015.03.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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