Endoscopic ultrasound guided injection of iron oxide magnetic nanoparticles for liver and pancreas: a feasibility study in pigs.

Abstract

Aims: Pancreatic cancer and hepatocellular carcinoma are two of the most aggressive types of cancer with limited therapeutic options in stages of advanced disease. Our objective is to assess the safety and feasibility of injecting iron oxide nanoparticles (IONs) via endoscopic ultrasound (EUS)-guidance, both systemically and locally in the liver and pancreas in order to study new potential therapies for liver and pancreatic tumors. Material and methods: Six domestic pigs were used for our study design, and divided into three groups: two were injected in the portal vein, and other four were subjected to local exposure of IONs in the liver and pancreas, two each. The pigs were on a 7 days follow-up and necropsy was performed with their organs harvested. A 3T MRI scan was also performed. Results: All animals underwent an endoscopic ultrasound fine needle injection (EUS-FNI) procedure without any complications. EUS-FNI procedure had an average time of 5 minutes and 21 seconds and consisted of 2 ml of ION injection. No perforations and no risk of potential bleeding were recorded. Macroscopic changes were observed only after pancreatic EUS-FNI. A significant amount of IONs was observed in the liver after local injection and after vascular EUS-FNI. The imaging results were confirmed by pathological examination with most of the IONs accumulated in Ito-like cells, Kupfer cells, and sinusoids. Conclusions: IONs have been widely studied for both diagnostic and therapeutic purposes. Their injection through EUS-guidance may develop new diagnosis strategies as well as curative or palliative therapies in pancreatic and liver tumors.

High frequency ultrasonography of the hand versus anti-RA33 evaluation in early rheumatoid arthritis - a pilot study

“…New imaging techniques have emerged as sensitive and reproducible tools for diagnosis, monitoring and assessing the prognosis in different area of research, and their good performance has been proved by several studies [8][9][10][11]. Ultrasonography (US), an imaging method with several advantages that has made it lately indispensable in daily medical practice, has an unquestionable value in RA, and offered new opportunities by defining and outlining certain pathologic aspects regarding synovial inflammation, the characteristic hallmark of this disease [12][13][14].…”

Endoscopic applications of magnets for the treatment of gastrointestinal diseases

“…Currently, endoscopic application of nanotechnology and magnetic nanoparticles is in its infancy. Only a few in vitro and in vivo animal studies have primarily investigated their roles in the treatment of esophageal[92], liver[93], and pancreatic[93] tumors by local or systemic injection.…”

Introductory Chapter: Endoscopy-Novel Techniques and Recent Advancements

“…This setting might provide a larger volume of drugs to the tumor and enhance their effect, while avoiding systemic reactions. Pain therapy has also been a matter of discussion especially in pancreatic cancer with the EUS-guided celiac plexus neurolysis and celiac plexus block after alcohol injection [65][66][67].…”