Interventional real-time optical imaging guidance for complete tumor ablation

Kan, Xuefeng; Zhang, Feng; Zhou, Gengui; Ji, Hongxiu; Monsky, Wayne L.; Ingraham, Christopher R.; Zheng, Chuansheng; Yang, Xiaoming

doi:10.1073/pnas.2113028118

Cited by 10 publications

(4 citation statements)

References 31 publications

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“…Kan et al recently developed a “one-stop-shop” interventional oncologic technology “Intraprocedural real-time optical imaging guidance for complete tumor ablation”, they can identify residual tumors in real-time during operation, to conduct repeated ablation and completely kill tumor cells. 147 In addition, the European Association for the Study recognized the value of fusion imaging (FI) which tackled the limitations of each single imaging modality (computed tomography, ultrasound and magnetic resonance imaging). 1 The FI technique provides more accurate determination and tumor location improving the rate of complete ablation.…”

Section: Discussionmentioning

confidence: 99%

An Overview of Hepatocellular Carcinoma After Insufficient Radiofrequency Ablation

Guo¹,

Ren²,

Dong³

et al. 2022

JHC

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Radiofrequency ablation (RFA) is a commonly used treatment for hepatocellular carcinoma (HCC), however, various complex conditions in clinical practice may lead to insufficient radiofrequency ablation (IRFA), allowing residual HCC to survive. In clinical practice and laboratory models, IRFA plays an important role in rapid tumor progression. Therefore, targeting the residual HCC and avoiding IRFA were worthwhile methods. A deeper understanding of IRFA is required; IRFA contributes to the improvement of proliferative activity, migration rates, and invasive capacity, and this may be due to the involvement of multiple complex processes or proteins, including epithelial mesenchymal transitions (EMTs), cancer stem cells (CSCs), autophagy, heat shock proteins (HSPs), changes of non-tumor cells and extracellular matrix, altered immune microenvironment, hypoxia-inducible factors (HIFs), growth factors, epigenetic alterations, and metabolic reprogramming. We focus on the processes of the above mechanisms and possible therapeutic approach, with a review of the literature. Additionally, we recapitulated the construction methods of various experimental models of IRFA (in vivo and in vitro).

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Section: Discussionmentioning

confidence: 99%

An Overview of Hepatocellular Carcinoma After Insufficient Radiofrequency Ablation

Guo¹,

Ren²,

Dong³

et al. 2022

JHC

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“…In the present study, we also successfully validated the technical feasibility using our recently established ICG-based interventional optical imaging to assess the response of hepatic tumors to the RFH-enhanced intratumoral oncolytic immunotherapy. In plasma, ICG has an absorption peak around 807 nm and an emission peak around 822 nm, which well suited in the requirement of the new interventional OI system at its first near-infrared (NIR-I) window ( 32 , 33 ). To apply our new interventional OI technique in monitoring of RFH-enhanced oncolytic immunotherapy, we first optimized ICG dose and detection time-window for intracellular uptake by VX2 tumor cells, with conclusion of the optimized ICG concentration at 100 μg/mL and optimized time window for the best detection of ICG at 24 hours after the ICG treatment.…”

Section: Discussionmentioning

confidence: 99%

“…However, the OI for detection of deep-seated lesions is challenging, since the tissue penetration depth of current ICG-based fluorescence imaging is approximately 1 cm ( 30 , 31 ). To solve this problem of the limited penetration depth with current OI, we have recently established a new image-guided interventional OI approach, which are capable of precisely guiding the percutaneous position of micro-OI detectors into the targets, avoiding tissue scattering and reflection along the pathway of OI light ( 32 , 33 ).…”

Section: Introductionmentioning

confidence: 99%

Interventional Optical Imaging-Monitored Synergistic Effect of Radio-Frequency Hyperthermia and Oncolytic Immunotherapy

et al. 2022

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PurposeTo develop a new interventional oncology technique using indocyanine green (ICG)-based interventional optical imaging (OI) to monitor the synergistic effect of radiofrequency hyperthermia (RFH)-enhanced oncolytic immunotherapy.Materials and MethodsThis study included (1) optimization of ICG dose and detection time-window for intracellular uptake by VX2 tumor cells; (2) in-vitro confirmation of capability of using ICG-based OI to assess efficacy of RFH-enhanced oncolytic therapy (LTX-401) for VX2 cells; and (3) in-vivo validation of the interventional OI-monitored, intratumoral RFH-enhanced oncolytic immunotherapy using rabbit models with orthotopic liver VX2 tumors. Both in-vitro and in-vivo experiments were divided into four study groups (n=6/group) with different treatments: (1) combination therapy of RFH+LTX-401; (2) RFH alone at 42°C for 30 min; (3) oncolytic therapy with LTX-401; and (4) control with saline. For in-vivo validation, orthotopic hepatic VX2 tumors were treated using a new multi-functional perfusion-thermal radiofrequency ablation electrode, which enabled simultaneous delivery of both LTX-401 and RFH within the tumor and at the tumor margins.ResultsIn in-vitro experiments, taking up of ICG by VX2 cells was linearly increased from 0 μg/mL to 100 μg/mL, while ICG-signal intensity (SI) reached the peak at 24 hours. MTS assay and apoptosis analysis demonstrated the lowest cell viability and highest apoptosis in combination therapy, compared to three monotherapies (P<0.005). In in-vivo experiments, ultrasound imaging detected the smallest relative tumor volume for the combination therapy, compared to other monotherapies (P<0.005). In both in-vitro and in-vivo experiments, ICG-based interventional optical imaging detected a significantly decreased SI in combination therapy (P<0.005), which was confirmed by the “gold standard” optical/X-ray imaging (P<0.05). Pathologic/laboratory examinations further confirmed the significantly decreased cell proliferation with Ki-67 staining, significantly increased apoptotic index with TUNEL assay, and significantly increased quantities of CD8 and CD80 positive cells with immunostaining in the combination therapy group, compared to other three control groups (P<0.005).ConclusionsWe present a new interventional oncology technique, interventional optical imaging-monitored RFH-enhanced oncolytic immunotherapy, which may open new avenues to effectively manage those patients with larger, irregular and unresectable malignancies, not only in liver but also the possibility in other organs.

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“…Fluorescence can safely be used in several oncology contexts, such as (i) in advanced epithelial ovarian cancer to evaluate invisible microscopic peritoneal metastasis with a high negative predictive value [ 28 ]; (ii) for multiple indications in neuro-oncology for resection to the functional limit of the peritumoral region with a greater extent of resection and better outcomes [ 29 , 30 ]; (iii) to identify structures, including the prostate, neurovascular bundle and lymph nodes in robot-assisted radical prostatectomy [ 31 ]; (iv) to better define the borders of the surgical resection in head and neck cancer [ 13 , 32 ]; (v) for sentinel lymph node mapping in early-stage cervical and endometrial cancer [ 33 ]; (vi) to support hepatic resection in liver surgery [ 34 ]. This surgical approach improves the current ablation technology, showing promising potential for the complete treatment of more prominent or irregular malignant lesions in the liver and other solid organs.…”

Section: Intraoperative Imaging Modalities To Improve Surgical Precisionmentioning

confidence: 99%

Image-guided cancer surgery: a narrative review on imaging modalities and emerging nanotechnology strategies

et al. 2023

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Surgical resection is the cornerstone of solid tumour treatment. Current techniques for evaluating margin statuses, such as frozen section, imprint cytology, and intraoperative ultrasound, are helpful. However, an intraoperative assessment of tumour margins that is accurate and safe is clinically necessary. Positive surgical margins (PSM) have a well-documented negative effect on treatment outcomes and survival. As a result, surgical tumour imaging methods are now a practical method for reducing PSM rates and improving the efficiency of debulking surgery. Because of their unique characteristics, nanoparticles can function as contrast agents in image-guided surgery. While most image-guided surgical applications utilizing nanotechnology are now in the preclinical stage, some are beginning to reach the clinical phase. Here, we list the various imaging techniques used in image-guided surgery, such as optical imaging, ultrasound, computed tomography, magnetic resonance imaging, nuclear medicine imaging, and the most current developments in the potential of nanotechnology to detect surgical malignancies. In the coming years, we will see the evolution of nanoparticles tailored to specific tumour types and the introduction of surgical equipment to improve resection accuracy. Although the promise of nanotechnology for producing exogenous molecular contrast agents has been clearly demonstrated, much work remains to be done to put it into practice. Graphical Abstract

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Interventional real-time optical imaging guidance for complete tumor ablation

Cited by 10 publications

References 31 publications

An Overview of Hepatocellular Carcinoma After Insufficient Radiofrequency Ablation

An Overview of Hepatocellular Carcinoma After Insufficient Radiofrequency Ablation

Interventional Optical Imaging-Monitored Synergistic Effect of Radio-Frequency Hyperthermia and Oncolytic Immunotherapy

Image-guided cancer surgery: a narrative review on imaging modalities and emerging nanotechnology strategies

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