Enhancing Thermal Effect of Focused Ultrasound Therapy Using Gold Nanoparticles

Development of a prediction model for hyperthermia-enhanced drug delivery using thermosensitive nanoparticles

Therapies targeting solid tumors are often hindered by drug resistance mechanisms, which presenting significant challenges. This study investigates the synergistic effect of hyperthermia and chemotherapy by utilizing thermosensitive nanoparticles (NPs) to enhance drug uptake by cancer cells. The thermoresponsive nature of NPs enables precise drug release under hyperthermic conditions, making them ideal for localized treatment. To achieve this, we developed a multi-component numerical model of focused ultrasound-enhanced doxorubicin delivery using tumor-targeting nanoparticles. The model incorporates critical factors such as blood coagulation and non-Fourier heat transfer, and it was validated against experimental results, thereby enhancing the reliability and accuracy of our findings. Ultimately, a prediction model was developed to estimate heat-driven irreversible cell damage in relation to heating power and NP size. The results demonstrated a remarkable 13-fold increase in drug penetration and a 4.6-fold enhancement in the fraction of killed cells with hyperthermia. These findings underscore the importance of accurately controlling the temperature field and heating power for optimal hyperthermia-assisted chemotherapy outcomes.

Active Surface-Enhanced Raman Spectroscopy (SERS): A Novel Concept for Enhancing Signal Contrast in Complex Matrices Using External Perturbation

Noninvasive detection of surface-enhanced Raman spectroscopy (SERS) signals from deep within tissue represents a common challenge in many biological and clinical applications including disease diagnosis and therapy monitoring. Such signals are typically weak and not readily discernible from often much larger Raman and fluorescence background signals (e.g., from surrounding tissue). Consequently, suboptimal sensitivity in the detection of SERS signals is often achieved in these situations. Similar issues can arise in SERS measurements in other diffusely scattering samples and complex matrices. Here, we propose a novel concept, active SERS, for the efficient retrieval of SERS signals from deep within complex matrices such as biological tissues that mitigates these issues. It relies on applying an external perturbation to the sample to alter the SERS signal from nanoparticles (NPs) deep inside the matrix. A measurement with and without, or before and after, such perturbation then can provide powerful contrasting data enabling an effective elimination of the matrix signals to reveal more clearly the desired SERS signal without the interfering background and associated artifacts. The concept is demonstrated using ultrasound (US) as an external source of perturbation and SERS NPs inserted deep within a heterogeneous tissue phantom mimicking a cluster of NPs accumulated within a small target lesion. The overall SERS signal intensity induced by the applied US perturbation decreased by ∼21% and the SERS signal contrast was considerably improved by eliminating subtraction artifacts present in a conventional measurement performed at a neighboring spatial location in a heterogeneous tissue sample. Although the technique was demonstrated with SERS gold NPs with a standard Raman label, it is envisaged that active SERS NPs (both the nanoscale metal geometry and Raman label) could be specifically designed to deliver an augmented response to the external stimulus to further enhance the achievable SERS signal contrast and yield even greater improvement in detection sensitivity. The method was demonstrated using transmission Raman spectroscopy; however, it is also applicable to other Raman implementations including spatially offset Raman spectroscopy and conventional Raman spectroscopy performed both at depth and at surfaces of complex matrices.

Harnessing Ultrasonic Technologies to Treat Staphylococcus Aureus Skin Infections

The rise of antibiotic-resistant Staphylococcus aureus strains, particularly MRSA, complicates the management of skin and soft tissue infections. This review highlights ultrasonic methodologies as adjunctive therapies to combat S. aureus-driven skin infections and prevent progression to biofilm formation and chronic wounds. Low- and high-frequency ultrasound (LFU and HFU) demonstrate potential in disrupting biofilms, enhancing drug delivery, and promoting tissue repair through cavitation and microbubble activity. These approaches integrate ultrasonic frequencies with microbubbles and therapeutics, such as antibiotics and affimers, to minimize resistance and improve healing. Tailoring the bioeffects of ultrasound on skin structures through localized delivery technologies, including microneedle patches and piezoelectric systems, presents promising solutions for early intervention in skin and soft structure infections (SSSIs).

Advances in Nanomaterials for Immunotherapeutic Improvement of Cancer Chemotherapy

Immuno-stimulative effect of chemotherapy (ISECT) is recognized as a potential alternative to conventional immunotherapies, however, the clinical application is constrained by its inefficiency. Metronomic chemotherapy, though designed to overcome these limitations, offers inconsistent results, with effectiveness varying based on cancer types, stages, and patient-specific factors. In parallel, a wealth of preclinical nanomaterials holds considerable promise for ISECT improvement by modulating the cancer-immunity cycle. In the area of biomedical nanomaterials, current literature reviews mainly concentrate on a specific category of nanomaterials and nanotechnological perspectives, while two essential issues are still lacking, i.e., a comprehensive analysis addressing the causes for ISECT inefficiency and a thorough summary elaborating the nanomaterials for ISECT improvement. This review thus aims to fill these gaps and catalyze further development in this field. For the first time, this review comprehensively discusses the causes of ISECT inefficiency. It then meticulously categorizes six types of nanomaterials for improving ISECT. Subsequently, practical strategies are further proposed for addressing inefficient ISECT, along with a detailed discussion on exemplary nanomedicines. Finally, this review provides insights into the challenges and perspectives for improving chemo-immunotherapy by innovations in nanomaterials.

Ultrasound combined with microbubble mediated immunotherapy for tumor microenvironment

The tumor microenvironment (TME) plays an important role in dynamically regulating the progress of cancer and influencing the therapeutic results. Targeting the tumor microenvironment is a promising cancer treatment method in recent years. The importance of tumor immune microenvironment regulation by ultrasound combined with microbubbles is now widely recognized. Ultrasound and microbubbles work together to induce antigen release of tumor cell through mechanical or thermal effects, promoting antigen presentation and T cells' recognition and killing of tumor cells, and improve tumor immunosuppression microenvironment, which will be a breakthrough in improving traditional treatment problems such as immune checkpoint blocking (ICB) and himeric antigen receptor (CAR)-T cell therapy. In order to improve the therapeutic effect and immune regulation of TME targeted tumor therapy, it is necessary to develop and optimize the application system of microbubble ultrasound for organs or diseases. Therefore, the combination of ultrasound and microbubbles in the field of TME will continue to focus on developing more effective strategies to regulate the immunosuppression mechanisms, so as to activate anti-tumor immunity and/or improve the efficacy of immune-targeted drugs, At present, the potential value of ultrasound combined with microbubbles in TME targeted therapy tumor microenvironment targeted therapy has great potential, which has been confirmed in the experimental research and application of breast cancer, colon cancer, pancreatic cancer and prostate cancer, which provides a new alternative idea for clinical tumor treatment. This article reviews the research progress of ultrasound combined with microbubbles in the treatment of tumors and their application in the tumor microenvironment.

Sono-activated materials for enhancing focused ultrasound ablation: Design and application in biomedicine

The ablation effect of focused ultrasound (FUS) has played an increasingly important role in the biomedical field over the past decades, and its non-invasive features have great advantages, especially for clinical diseases where surgical treatment is not available or appropriate. Recently, rapid advances in the adjustable morphology, enzyme-mimetic activity, and biostability of sono-activated materials have significantly promoted the medical application of FUS ablation. However, a systematic review of sono-activated materials based on FUS ablation is not yet available. This progress review focuses on the recent design, fundamental principles, and applications of sono-activated materials in the FUS ablation biomedical field. First, the different ablation mechanisms and the key factors affecting ablation are carefully determined. Then, the design of sono-activated materials with high FUS ablation efficiencies is comprehensively discussed. Subsequently, the representative biological applications are summarized in detail. Finally, the primary challenges and future perspectives are also outlined. We believe this timely review will provide key information and insights for further exploration of focused ultrasound ablation and new inspiration for designing future sono-activated materials. STATEMENT OF SIGNIFICANCE: The ablation effect of focused ultrasound (FUS) has played an increasingly important role in the biomedical field over the past decades. However, there are also some challenges of FUS ablation, such as skin burns, tumour recurrence after thermal ablation, and difficulty in controlling cavitation ablation. The rapid advance in adjustable morphology, enzyme-mimetic activity, and biostability of sono-activated materials has significantly promoted the medical application of FUS ablation. However, the systematic review of sono-activated materials based on FUS ablation is not yet available. This progress review focuses on the recent design, fundamental principles, and applications in the FUS ablation biomedical field of sono-activated materials. We believe this timely review will provide key information and insights for further exploration of FUS ablation.

Real-time monitoring of focused ultrasound therapy using intelligence-based thermography: A feasibility study

Focused ultrasound (FUS) therapy has been widely studied for breast cancer treatment due to its potential as a fully non-invasive method to improve cosmetic and oncologic results. However, real-time imaging and monitoring of the therapeutic ultrasound delivered to the target area remain challenges for precision breast cancer therapy. The main objective of this study is to propose and evaluate a novel intelligence-based thermography (IT) method that can monitor and control FUS treatment using thermal imaging with the fusion of artificial intelligence (AI) and advanced heat transfer modeling. In the proposed method, a thermal camera is integrated into FUS system for thermal imaging of the breast surface, and an AI model is employed for the inverse analysis of the surface thermal monitoring, thereby estimating the features of the focal region. This paper presents experimental and computational studies conducted to assess the feasibility and efficiency of IT-guided FUS (ITgFUS). Tissue phantoms, designed to mimic the properties of breast tissue, were used in the experiments to investigate detectability and the impact of temperature rise at the focal region on the tissue surface. Additionally, an AI computational analysis employing an artificial neural network (ANN) and FUS simulation was carried out to provide a quantitative estimation of the temperature rise at the focal region. This estimation was based on the observed temperature profile on the breast model's surface. The results proved that the effects of temperature rise at the focused area could be detected by the thermal images acquired with thermography. Moreover, it was demonstrated that the AI analysis of the surface temperature measurement could result in near real-time monitoring of FUS by quantitative estimation of the temporal and spatial temperature rise profiles at the focal region.

Functionalized Carbon Nanoparticles as Theranostic Agents and Their Future Clinical Utility in Oncology

Over the years, research of nanoparticle applications in pre-clinical and clinical applications has greatly advanced our therapeutic and imaging approaches to many diseases, most notably neoplastic disorders. In particular, the innate properties of inorganic nanomaterials, such as gold and iron oxide, as well as carbon-based nanoparticles, have provided the greatest opportunities in cancer theranostics. Carbon nanoparticles can be used as carriers of biological agents to enhance the therapeutic index at a tumor site. Alternatively, they can also be combined with external stimuli, such as light, to induce irreversible physical damaging effects on cells. In this review, the recent advances in carbon nanoparticles and their use in cancer theranostics will be discussed. In addition, the set of evaluations that will be required during their transition from laboratory investigations toward clinical trials will be addressed.

Recent Trend of Ultrasound-Mediated Nanoparticle Delivery for Brain Imaging and Treatment

In view of the fact that the blood-brain barrier (BBB) prevents the transport of imaging probes and therapeutic agents to the brain and thus hinders the diagnosis and treatment of brain-related disorders, methods of circumventing this problem (e.g., ultrasound-mediated nanoparticle delivery) have drawn much attention. Among the related techniques, focused ultrasound (FUS) is a favorite means of enhancing drug delivery via transient BBB opening. Photoacoustic brain imaging relies on the conversion of light into heat and the detection of ultrasound signals from contrast agents, offering the benefits of high resolution and large penetration depth. The extensive versatility and adjustable physicochemical properties of nanoparticles make them promising therapeutic agents and imaging probes, allowing for successful brain imaging and treatment through the combined action of ultrasound and nanoparticulate agents. FUS-induced BBB opening enables nanoparticle-based drug delivery systems to efficiently access the brain. Moreover, photoacoustic brain imaging using nanoparticle-based contrast agents effectively visualizes brain morphologies or diseases. Herein, we review the progress in the simultaneous use of nanoparticles and ultrasound in brain research, revealing the potential of ultrasound-mediated nanoparticle delivery for the effective diagnosis and treatment of brain disorders.

Magic bubbles: utilizing histotripsy to modulate the tumor microenvironment and improve systemic anti-tumor immune responses

Focused Ultrasound (FUS) is emerging as a promising primary and adjunct therapy for the treatment of cancer. This includes histotripsy, which is a noninvasive, non-ionizing, non-thermal ultrasound guided ablation modality. As histotripsy has progressed from bench-to-bedside, it has become evident that this therapy has benefits beyond local tumor ablation. Specifically, histotripsy has the potential to shift the local tumor microenvironment from immunologically 'cold' to 'hot'. This is associated with the production of damage associated molecular patterns, the release of a selection of proinflammatory mediators, and the induction of inflammatory forms of cell death in cells just outside of the treatment zone. In addition to the induction of this innate immune response, histotripsy can also improve engagement of the adaptive immune system and promote systemic anti-tumor immunity targeting distal tumors and metastatic lesions. These tantalizing observations suggest that, in settings of widely metastatic disease burden, selective histotripsy of a limited number of accessible tumors could be a means of maximizing responsiveness to systemic immunotherapy. More work is certainly needed to optimize treatment strategies that best synergize histotripsy parameters with innate and adaptive immune responses. Likewise, rigorous clinical studies are still necessary to verify the presence and repeatability of these phenomena in human patients. As this technology nears regulatory approval for clinical use, it is our expectation that the insights and immunomodulatory mechanisms summarized in this review will serve as directional guides for rational clinical studies to validate and optimize the potential immunotherapeutic role of histotripsy tumor ablation.

Synergetic Thermal Therapy for Cancer: State-of-the-Art and the Future

As a safe and minimal-invasive modality, thermal therapy has become an effective treatment in cancer treatment. Other than killing the tumor cells or destroying the tumor entirely, the thermal modality results in profound molecular, cellular and biological effects on both the targeted tissue, surrounding environments, and even the whole body, which has triggered the combination of the thermal therapy with other traditional therapies as chemotherapy and radiation therapy or new therapies like immunotherapy, gene therapy, etc. The combined treatments have shown encouraging therapeutic effects both in research and clinic. In this review, we have summarized the outcomes of the existing synergistic therapies, the underlying mechanisms that lead to these improvements, and the latest research in the past five years. Limitations and future directions of synergistic thermal therapy are also discussed.

Anti-Cancer Activity of the Combinational Treatment of Noozone Cold Plasma with p-FAK Antibody-Conjugated Gold Nanoparticles in OSCC Xenograft Mice

Oral squamous cell cancer (OSCC) is the most common type of oral cancer (about 80–90% of cases) and various research is being done to cure the disease. This paper aims to verify whether treatment with no-ozone cold plasma (NCP), which is designed for safe usage of the plasma on oral cavities, in combination with gold nanoparticles conjugated with p-FAK antibody (p-FAK/GNP) can trigger the selective and instant killing of SCC-25 cells both in vitro and in vivo. When SCC25 and HaCaT cells are exposed to p-FAK/GNP+NCP, the instant cell death was observed only in SCC25 cells. Such p-FAK/GNP+NCP-mediated cell death was observed only when NCP was directly treated on SCC25 harboring p-FAK/GNP. During NCP treatment, the removal of charged particles from NCP using grounded electric mesh radically decreased the p-FAK/GNP+NCP-mediated cell death. This p-FAK/GNP+NCP-mediated selective cell death of OSCC was also observed in mice xenograft models using SCC25 cells. The mere treatment of p-FAK/GNP and NCP on the xenograft tumor slowly decreased the size of the tumor, and only about 50% of the tumor remained at the end of the experiment. On the other hand, 1 week of p-FAK/GNP+NCP treatment was enough to reduce half of the tumor size, and most of tumor tissue had vanished at the end. An analysis of isolated tissues showed that in the case of individual treatment with p-FAK/GNP or NCP, the cancer cell population was reduced due to apoptotic cell death. However, in the case of p-FAK/GNP+NCP, apoptotic cell death was unobserved, and most tissues were composed of collagen. Thus, this paper suggests the possibility of p-FAK/GNP+NCP as a new method for treating OSCC.

Recent Advances in Transition-Metal Based Nanomaterials for Noninvasive Oncology Thermal Ablation and Imaging Diagnosis

With the developments of nanobiotechnology and nanomedicine, non-invasive thermal ablation with fewer side effects than traditional tumor treatment methods has received extensive attention in tumor treatment. Non-invasive thermal ablation has the advantages of non-invasiveness and fewer side effects compared with traditional treatment methods. However, the clinical efficiency and biological safety are low, which limits their clinical application. Transition-metal based nanomaterials as contrast agents have aroused increasing interest due to its unique optical properties, low toxicity, and high potentials in tumor diagnosis. Transition-metal based nanomaterials have high conversion efficiency of converting light energy into heat energy, good near-infrared absorption characteristics, which also can targetedly deliver those loaded drugs to tumor tissue, thereby improving the therapeutic effect and reducing the damage to the surrounding normal tissues and organs. This article mainly reviews the synthesis of transition-metal based nanomaterials in recent years, and discussed their applications in tumor thermal ablation and diagnosis, hopefully guiding the development of new transition metal-based nanomaterials in enhancing thermal ablation.

Carbon nanotube-mediated high intensity focused ultrasound

High intensity focused ultrasound (HIFU) is emerging as a novel therapeutic technique for cancer treatment through a hyperthermal mechanism using ultrasound. However, collateral thermal damages to healthy tissue and skin burns due to the use of high levels of ultrasonic energy during HIFU treatment remain major challenges to clinical application. The main objective of the current study is to evaluate the potential of carbon nanotubes (CNTs) as effective absorption-enhancing agents for HIFU to mediate the heating process at low ultrasonic power levels, and consequently upgrade hyperthermal therapeutic effects of HIFU. An experimental study using in vitro tissue phantoms was conducted to assess the effects of CNTs on HIFU’s heating mechanism. Detailed information was extracted from the experiments for thermal analysis, including rate of absorbed energy density and temperature rise profile at the focal region. Parametric studies were carried out, revealing the effects of ultrasound parameters (ultrasonic power and driving frequency) on the performance of CNTs in various concentrations. The results indicated that CNTs significantly enhanced the thermal effect of HIFU by elevating energy absorption rate and consequential temperature rise. Moreover, it was demonstrated that an increase in ultrasonic power and driving frequency could lead to a better performance of CNTs during HIFU ablation procedures; the effects of CNTs could be further enhanced by increasing their volume concentration inside the medium.

Multifunctional Nanoparticles Encapsulating Astragalus Polysaccharide and Gold Nanorods in Combination with Focused Ultrasound for the Treatment of Breast Cancer

Purpose

Focused ultrasound (FUS) is a noninvasive method to produce thermal and mechanical destruction along with an immune-stimulatory effect against cancer. However, FUS ablation alone appears insufficient to generate consistent antitumor immunity. In this study, a multifunctional nanoparticle was designed to boost FUS-induced immune effects and achieve systemic, long-lasting antitumor immunity, along with imaging and thermal enhancement.

Materials and Methods

PEGylated PLGA nanoparticles encapsulating astragalus polysaccharides (APS) and gold nanorods (AuNRs) were constructed by a simple double emulsion method, characterized, and tested for cytotoxicity. The abilities of PA imaging and thermal-synergetic ablation efficiency were analyzed in vitro and in vivo. The immune-synergistic effect on dendritic cell (DC) differentiation in vitro and the immune response in vivo were also evaluated.

Results

The obtained APS/AuNR/PLGA-PEG nanoparticles have an average diameter of 255.00±0.1717 nm and an APS-loading efficiency of 54.89±2.07%, demonstrating their PA imaging capability and high biocompatibility both in vitro and in vivo. In addition, the as-prepared nanoparticles achieved a higher necrosis cell rate and induced apoptosis rate in an in vitro cell suspension assay, greater necrosis area and decreased energy efficiency factor (EEF) in an in vivo rabbit liver assay, and remarkable thermal-synergic performance. In particular, the nanoparticles upregulated the expression of MHC-II, CD80 and CD86 on cocultured DCs in vitro, followed by declining phagocytic function and enhanced interleukin (IL)-12 and interferon (INF)-γ production. Furthermore, they boosted the production of tumor necrosis factor (TNF)-α, IFN-γ, IL-4, IL-10, and IgG1 (P< 0.001) but not IgG2a. Immune promotion peaked on day 3 after FUS in vivo.

Conclusion

The multifunctional APS/AuNR/PLGA-PEG nanoparticles can serve as an excellent synergistic agent for FUS therapy, facilitating real-time imaging, promoting thermal ablation effects, and boosting FUS-induced immune effects, which have the potential to be used for further clinical FUS treatment.

Magnetic nanoparticles-enhanced focused ultrasound heating: size effect, mechanism, and performance analysis

High intensity focused ultrasound (HIFU) has attracted great interest as a new energy-based technique to treat disordered tissues, such as tumors, through a hyperthermal mechanism using ultrasonic waves. However, long treatment times and collateral damage to healthy tissues due to high acoustic powers are still challenges for the clinical application of HIFU. One possible strategy to enhance the deposition efficiency of HIFU at the tumor site is to employ magnetic nanoparticles (MNPs) as ultrasound absorption agents for the thermal therapy. The objectives of the current study are threefold: (i) to examine the effects of MNP features, including the size and volume concentration, on the thermal mechanism of HIFU (ii) to investigate the performance of MNPs as they were exposed to ultrasound fields at different ranges of power and frequency (iii) and to study the interaction mechanism between MNPs and ultrasonic waves during the MNPs-enhanced HIFU process. To this end, we developed an ultrasound-guided HIFU system to conduct an in vitro experimental study on tissue phantoms containing MNPs of different sizes and volume concentrations. A set of HIFU parameters such as temperature rise and the rate of absorbed energy was monitored to examine the role of MNPs during the NPs-enhanced HIFU thermal procedure. Results showed that the MNPs significantly improved the thermal effect of HIFU by enhancing the rate of energy converted to heat and the temperature rise at the focal region. Moreover, it was demonstrated that the increase of MNP size and volume concentration greatly enhanced the HIFU parameters; the effects of MNPs were further improved by increasing the power and frequency of acoustic field.

Analytical and Numerical Model of High Intensity Focused Ultrasound Enhanced With Nanoparticles

OBJECTIVE

High intensity focused ultrasound (HIFU) is a new noninvasive therapeutics that allows local treatment of solid tumors through a hyperthermal mechanism using ultrasonic energy. One promising strategy to increase the thermal efficiency of HIFU is to employ nanoparticles (NPs) as ultrasound agents for the hyperthermia procedure. However, the interaction mechanism between NPs and ultrasonic waves has not been well understood.

METHODS

In an effort to investigate the heating process of NPs-enhanced HIFU, we derived a set of HIFU equations governing the temperature variation during the thermal ablation based on the principle of conservation of energy for heat transfer mechanism. A numerical model was developed to solve the HIFU equations to simulate the absorption mechanism of HIFU in the presence of NPs, the consequent heat transfer process, and the temperature rise profile during the sonication period. The accuracy of numerical model was verified by performing a series of experiments on tissue-mimicking phantoms embedded with magnetic NPs (MNPs).

RESULTS

The transport processes taking place at the boundaries between NPs and surrounding medium played the major role in the temperature rise during HIFU sonication. Besides, the effects of MNPs on rising temperature were improved by amplifying the ultrasonic power and frequency as well as by increasing the MNP concentration.

CONCLUSION

A quantitative comparison with experimental results demonstrated the potential of the numerical model to accurately predict the heating mechanism of HIFU mediated by NPs.

SIGNIFICANCE

The proposed method can help with simulation of HIFU when NPs are employed as ultrasound agents.