Thermal Ablation Of Tumors Research Articles

Thermoacoustic CBE imaging for monitoring microwave ablation of the liver: A feasibility study

Microwave ablation is the most commonly used minimally invasive technique for thermal ablation of liver tumors, and accurate monitoring of the ablation area is crucial for evaluating treatment efficacy. While traditional imaging techniques play an important role in clinical monitoring, they still face several insurmountable challenges. Microwave-induced thermoacoustic imaging (TAI) has emerged as a promising modality for ablation detection due to its high resolution and deep imaging capabilities. To further enhance the effectiveness of TAI in ablation monitoring, we propose a technique based on thermoacoustic changes in backscattered energy (CBE) imaging. This method accurately delineates the liver ablation area by monitoring temperature variations before and after ablation. Experimental results show that thermoacoustic CBE imaging offers significant advantages over traditional TAI, achieving accuracies of 97.12% in ex vivo and 93.46% in in vivo experiments. Its superior resolution makes it an ideal choice for monitoring tissue damage during microwave ablation.

Multi-objective optimization based robotic path planning for interpolation reconstruction model of CT data

Robotic path planning plays a pivotal role in computer-aided liver tumor thermal ablation surgery. However, traditional methods face challenges in terms of low reconstruction efficiency and planning safety. To address these issues, we propose a method for robotic path planning of liver tumor thermal ablation surgery. Firstly, an interlayer interpolation algorithm based on optical flow estimation is utilized to compensate for large interlayer spacing in computed tomography (CT) images by inserting predicted images between sequence images. Secondly, the voxel traversal strategy and patch intersection calculation strategy in the standard marching cube (MC) algorithm is optimized to improve the efficiency of abdominal tissues reconstruction. Finally, comprehensive clinical constraints are summarized to ensure the surgery safety and the strength pareto evolutionary algorithm II (SPEA-II) is leveraged to optimize surgery path, which can obtain even distribution of solutions in high-dimension optimization problems. Extensive experiments conducted on the 3Dircadb and SLIVER07 datasets revealed that our proposed method reduces reconstruction time by 21.5% compared to the standard MC algorithm, while achieving an average overlap rate of 88.25% and an average Hausdorff distance of 15.25 mm between Pareto front points and surgeon's recommended puncture points.

Polydopamine Nanoformulations Induced ICD and M1 Phenotype Macrophage Polarization for Enhanced TNBC Synergistic Photothermal Immunotherapy.

Photothermal therapy (PTT) is a promising technology that can achieve the thermal ablation of tumors and induce immunogenic cell death (ICD). However, relying solely on the antitumor immune responses caused by PTT-induced ICD is insufficient to suppress tumor metastasis and recurrence effectively. Fortunately, multifunctional nanoformulation-based synergistic photothermal immunotherapy can eliminate primary and metastatic tumors and inhibit tumor recurrence for a long time. Herein, we select polydopamine (PDA) nanoparticles to serve as the carrier for our nanomedicine as well as a potent photothermal agent and modulator of macrophage polarization. PDA nanoparticles are loaded with the insoluble immune adjuvant Imiquimod (R837) to construct PDA(R837) nanoformulations. These straightforward yet highly effective nanoformulations demonstrate excellent performance, allowing for successful triple-negative breast cancer (TNBC) treatment through synergistic photothermal immunotherapy. Moreover, experimental results showed that PDA(R837) implementation of PTT is effective in the thermal ablation of primary tumors while causing ICD and releasing R837, further promoting dendritic cell (DC) maturation and activating the systemic antitumor immune response. Furthermore, PDA(R837) nanoformulations inhibit tumor metastasis and recurrence and achieve M1 phenotype macrophage polarization, achieving long-term and excellent antitumor efficacy. Therefore, the structurally simple PDA(R837) nanoformulations provide cancer treatment and have excellent clinical translational application prospects.

Gold nanoparticles for photothermal therapy – Influence of experimental conditions on the properties of resulting AuNPs

Gold nanoparticles (AuNPs)-mediated Photothermal Therapy (PTT) is a minimally-invasive therapeutic approach that uses AuNPs to convert light into heat, leading to the thermal ablation of tumors. Thus, the efficacy of this strategy strongly relies on the photothermal conversion potential of AuNPs. The ability to convert light into heat can be enhanced by tuning the physicochemical and optical properties of AuNPs. This can be achieved by changing the conditions of AuNP's synthesis, such as the order of addition of reagents. The present work entails to explore how varying the order of reagents addition modulates the properties of AuNPs, particularly enhancing the photothermal conversion potential of the resulting AuNPs and consequently, improving PTT efficacy. For this, eleven different AuNPs' nanoformulations were synthetized following different sequences of addition of reagents. These nanoformulations were characterized regarding their physicochemical properties namely size, surface charge, gold concentration, surface morphology and maximum absorbance wavelength. In addition, their thermal activation profiles were determined in vitro. Furthermore, the biocompatibility of different nanoformulations was also assessed. Three nanoformulations, with the most favorable photothermal activation profiles (AuNPs 2, 3 and 7), were then selected for preliminary in vitro safety and efficacy assays using a panel of cell lines. These three nanoformulations were deemed safe in vitro at the tested concentrations. At 250 μM of gold content, and after an incubation period of 4 h, followed by 5 min irradiation with a laser emitting at 808 nm (7.96 W/cm2), AuNPs 7 significantly reduced the cell viability of all cancer cell lines tested (MCF-7, HCT-116 and A375) by ≥ 45 %. However, such cytotoxic effect was not observed for the human keratinocyte cell line (HaCat), thus demonstrating its specificity towards cancer cells. Overall, the results herein presented reinforce that the order of reagents addition is highly important for achieving adequate AuNPs for PTT.

The photothermal effect induces M1 macrophage-derived TNF-α-type exosomes to inhibit bladder tumor growth

Bladder cancer presents a significant challenge for patient treatment and prognostic health due to its high recurrence and metastasis. Nanoparticle-based photothermal therapy offers a potential solution, as it can achieve thermal ablation of tumors through photothermal conversion, modulate cytokine and exosome secretion from macrophages to assist in treatment. Herein, a system that integrates gold-manganese nanomaterials and engineered macrophage-derived exosomes for the synergistic treatment of bladder tumors was developed. We encapsulated MnO2 on the surface of sea-urchin-like Au nanoclusters (AuNCs) to form a nanocomposite with a shell-and-core structure (Au@MnO2), effectively enhancing its stability and photothermal conversion efficiency. In vitro experiments showed that Au@MnO2 induced polarization of macrophages to secrete cytokines (e.g., TNF-α, iNOS, etc.) and TNF-α-rich exosomes of the M1 phenotype when exposed to near-infrared light. This M1 phenotype, combined with the nano-photothermal effect, significantly inhibited the proliferation of bladder tumor cells, and promoted apoptosis and cycle blockade. RNA sequencing revealed significant regulation of inflammation-related genes and pathways, including TNF, NF-κB, and cytokine receptor pathways, both in M1 macrophages and their exosomes. In vivo experiments confirmed that engineered macrophages combined with nano-photothermal effect inhibited subcutaneous tumor growth in mice and reduced the macrophage CD206/CD86 ratio in tissues. This study highlights the promise of engineered macrophages combining cytokines, M1-Exo, and the photothermal effects of Au@MnO2 to achieve synergistic treatment for bladder cancer.

Effectiveness and safety of sequential transarterial chemoembolization and microwave ablation for subphrenic hepatocellular carcinoma: A comprehensive evaluation.

Subphrenic carcinoma has been identified as a significant risk factor for the thermal ablation of intrahepatic tumors, resulting in a high rate of residual tumor recurrence. Some studies have proposed that combination treatment with transarterial chemoembolization (TACE) followed by radiofrequency ablation is both feasible and safe for tumors in the subphrenic region. However, research specifically examining the therapeutic outcomes of combination therapy using TACE and microwave ablation (TACE-MWA) in subphrenic tumors is lacking. To evaluate the efficacy and safety of TACE-MWA in patients with subphrenic hepatocellular carcinoma (HCC). Between December 2017 and December 2021, 49 patients diagnosed with HCC ≤ 6 cm, who received TACE-MWA, were included in this retrospective cohort study. These patients were classified into subphrenic and non-subphrenic groups based on the distance between the diaphragm and the tumor margin. The rates of local tumor progression (LTP), progression-free survival (PFS), and overall survival (OS) were compared between the two groups. Complications were evaluated by using a grading system developed by the Society of Interventional Radiology. After a median follow-up time of 38 mo, there were no significant differences in LTP between the subphrenic and non-subphrenic groups (27.3% and 22.2% at 5 years, respectively; P = 0.66), PFS (55.5% at 5 years in both groups; P = 0.91), and OS (85.0% and 90.9% in the subphrenic and non-subphrenic groups at 5 years; P = 0.57). However, a significantly higher rate of LTP was observed in subphrenic HCC > 3 cm compared to those ≤ 3 cm (P = 0.085). The dosage of iodized oil [hazard ratio (HR): 1.52; 95% confidence interval (CI): 1.11-2.08; P = 0.009] and multiple tumors (HR: 13.22; 95%CI: 1.62-107.51; P = 0.016) were independent prognostic factors for LTP. There were no significant differences in complication rates between the two groups (P = 0.549). Combined TACE and MWA was practical and safe for managing subphrenic HCC. The efficacy and safety levels did not vary significantly when tumors outside the subphrenic region were treated.

Drug delivery particles for targeted imaging-guided photothermal/chemotherapy synergy cancer therapy

The early stage of pancreatic cancer is asymptomatic and the treatment effect is not ideal. The progression to the advanced stage leads to a close relationship between mortality and morbidity. Therefore, there is an urgent need to develop precise and efficient therapeutic strategies to combat pancreatic cancer. In this study, we introduce a near-infrared (NIR) targeted drug delivery nanoparticle for ultrasound (US) imaging to guide magnetothermal/chemotherapy synergistic treatment of pancreatic cancer. Carboxylated polylactic acid (PLGA-PEG-COOH) serves as the structure of the nanoparticles, specifically binding the RGD cyclic peptide for pancreatic cancer targeting activity and promoting tumor aggregation of the nanoparticles. NIR-induced superparamagnetic iron oxide (SPIO) nanoparticles convert near-infrared light into thermal energy, triggering vaporization of perfluoropentane (PFH) droplets to generate PFH bubbles that enhance US imaging and help load doxorubicin (DOX), which are released from nanoparticles. SPIO can also be used for thermal ablation of tumors to improve therapeutic effect in treating pancreatic cancer. The results show that the targeted particles mediated by NIR have the characteristics of targeted drug delivery imaging. The microspheres exhibit strong acoustic and near-infrared responsiveness. Cell proliferation experiments showed that IR-mediated PFH-DOX@PLGA/SPIO-RGD NPs (RNPs) had a higher inhibitory effect on cell proliferation. Animal experiments have shown that RNPS can accumulate highly in the tumor area and show good therapeutic effect. In conclusion, this nanotherapeutic particle is a very promising targeted image-guided photothermal/chemotherapeutic synergistic tumor therapy strategy.

2024 multidisciplinary consensus on image-guided lung tumor ablation from the Taiwan Academy of Tumor Ablation.

In this article, the multidisciplinary team of the Taiwan Academy of Tumor Ablation, who have expertise in treating lung cancer, present their perspectives on percutaneous image-guided thermal ablation (IGTA) of lung tumors. The modified Delphi technique was applied to reach a consensus on clinical practice guidelines concerning ablation procedures, including a comprehensive literature review, selection of panelists, creation of a rating form and survey, and arrangement of an in-person meeting where panelists agreed or disagreed on various points. The conclusion was a final rating and written summary of the agreement. The multidisciplinary expert team agreed on 10 recommendations for the use of IGTA in the lungs. These recommendations include terms and definitions, line of treatment planning, modality, facility rooms, patient anesthesia settings, indications, margin determination, post-ablation image surveillance, qualified centers, and complication ranges. In summary, IGTA is a safe and feasible approach for treating primary and metastatic lung tumors, with a relatively low complication rate. However, decisions regarding the ablation technique should consider each patient's specific tumor characteristics.

Design of Path-Planning System for Interventional Thermal Ablation of Liver Tumors Based on CT Images.

Aiming at the shortcomings of artificial surgical path planning for the thermal ablation of liver tumors, such as the time-consuming and labor-consuming process, and relying heavily on doctors' puncture experience, an automatic path-planning system for thermal ablation of liver tumors based on CT images is designed and implemented. The system mainly includes three modules: image segmentation and three-dimensional reconstruction, automatic surgical path planning, and image information management. Through organ segmentation and three- dimensional reconstruction based on CT images, the personalized abdominal spatial anatomical structure of patients is obtained, which is convenient for surgical path planning. The weighted summation method based on clinical constraints and the concept of Pareto optimality are used to solve the multi-objective optimization problem, screen the optimal needle entry path, and realize the automatic planning of the thermal ablation path. The image information database was established to store the information related to the surgical path. In the discussion with clinicians, more than 78% of the paths generated by the planning system were considered to be effective, and the efficiency of system path planning is higher than doctors' planning efficiency. After improvement, the system can be used for the planning of the thermal ablation path of a liver tumor and has certain clinical application value.

Magnetotactic Bacteria AMB-1 with Active Deep Tumor Penetrability for NIR-II Photothermal Tumor Therapy.

The complex tumor structure and microenvironment such as abnormal tumor vasculature, dense tumor matrix, and elevated interstitial fluid pressure greatly hinder the penetration and retention of therapeutic agents in solid tumors. The development of an advanced method for robust penetration and retention of therapeutic agents in tumors is of great significance for efficient tumor treatments. In this work, we demonstrated that magnetotactic bacteria AMB-1 with hypoxic metabolism characteristics can actively penetrate the tumor to selectively colonize deep hypoxic regions, which emerge as a promising intelligent drug carrier. Furthermore, AMB-1 presents intrinsic second near-infrared (NIR-II) photothermal performance that can efficiently convert a 1064 nm laser into heat for tumor thermal ablation. We believe that our investigations not only develop a novel bacteria-based photothermal agent but also provide useful insights for the development of advanced tumor microbial therapies.

Development and Validation of an Algorithm Model for Predicting Heat Sink Effects during Pulmonary Thermal Ablation

The aim of this study was to develop an algorithm model to predict the heat sink effect during thermal ablation of lung tumors and to assist doctors in the formulation and adjustment of surgical protocols. The heat sink effect is an important factor affecting the therapeutic effect of tumor thermal ablation. At present, there is no algorithm model to predict the intraoperative heat sink effect automatically, which needs to be measured manually, which lacks accuracy and consumes time. To construct a segmentation model based on a convolutional neural network that can automatically identify and segment pulmonary nodules and vascular structure and measure the distance between the nodule and vascular. First, the classical Faster RCNN model was used as the nodule detection network. After obtaining the bounding box of pulmonary nodules, the VSPP-NET model was used to segment nodules in the bounding box. The distance from the nodule to the vasculature was measured after the surrounding vasculature was segmented by the VSPP-NET model. The lung CT images of 392 patients with pulmonary nodules were used as the training data for the algorithm. 68 cases were used as algorithm validation data, 29 as nodule algorithm test data, and 80 as vascular algorithm test data. We compared the heat sink effect of 29 cases of data with the results of the algorithm model and expert segmentation and compared the difference between the two results. In pulmonary CT image vasculature segmentation, the recall and precision of the algorithm model reached >0.88 and >0.78, respectively. The average time for automatic segmentation of each image model is 29 seconds, and the average time for manual segmentation is 158 seconds. The output image of the model shows that the results of nodule segmentation and nodule distance measurement are satisfactory. In terms of heat sink effect prediction, the positive rate of the algorithm group was 28.3%, and that of the expert group was 32.1%, with no significant difference between the two groups (p=0.687). The algorithm model developed in this study shows good performance in predicting the heat sink effect during pulmonary thermal ablation. It can improve the speed and accuracy of nodule and vessel segmentation, save ablation planning time, reduce the interference of human factors, and provide more reference information for surgeons to make ablation plans to improve the ablation effect.

Treatment Planning and Aberration Correction Algorithm for HIFU Ablation of Renal Tumors.

High-intensity focused ultrasound (HIFU) applications for thermal or mechanical ablation of renal tumors often encounter challenges due to significant beam aberration and refraction caused by oblique beam incidence, inhomogeneous tissue layers, and presence of gas and bones within the beam. These losses can be significantly mitigated through sonication geometry planning, patient positioning, and aberration correction using multielement phased arrays. Here, a sonication planning algorithm is introduced, which uses the simulations to select the optimal transducer position and evaluate the effect of aberrations and acoustic field quality at the target region after aberration correction. Optimization of transducer positioning is implemented using a graphical user interface (GUI) to visualize a segmented 3-D computed tomography (CT)-based acoustic model of the body and to select sonication geometry through a combination of manual and automated approaches. An HIFU array (1.5 MHz, 256 elements) and three renal cell carcinoma (RCC) cases with different tumor locations and patient body habitus were considered. After array positioning, the correction of aberrations was performed using a combination of backpropagation from the focus with an ordinary least squares (OLS) optimization of phases at the array elements. The forward propagation was simulated using a combination of the Rayleigh integral and k-space pseudospectral method (k-Wave toolbox). After correction, simulated HIFU fields showed tight focusing and up to threefold higher maximum pressure within the target region. The addition of OLS optimization to the aberration correction method yielded up to 30% higher maximum pressure compared to the conventional backpropagation and up to 250% higher maximum pressure compared to the ray-tracing method, particularly in strongly distorted cases.

Robotic-assisted CT-guided percutaneous thermal ablation of abdominal tumors: An analysis of 41 patients

PurposeRobotic assistance is rapidly evolving and may help physicians optimize needle guidance during percutaneous interventions. The purpose of the study was to report feasibility, safety, accuracy, immediate clinical success and short-term local tumor control after robotic-assisted computed tomography (CT)-guided thermal ablation of abdominal tumors. Materials and methodsForty-one patients who underwent percutaneous thermal ablation of abdominal tumors using robotic-assisted CT-guided were included. All ablations were performed with robotic assistance, using an optically-monitored robotic system with a needle guide sent to preplanned trajectories defined on three-dimensional-volumetric CT acquisitions with respiration monitoring. Endpoints were technical success, safety, distance from needle tip to planned trajectory and number of needle adjustments, and complete ablation rate. ResultsForty-one patients (31 men; mean age, 66.7 ± 9.9 [standard deviation (SD)] years [age range: 41–84 years]) were treated for 48 abdominal tumors, with 79 planned needles. Lesions treated were located in the liver (23/41; 56%), kidney (14/41;34%), adrenal gland (3/41; 7%) or retroperitoneum (1/41; 2%). Technical success was achieved in 39/41 (95%) patients, and 76/79 (96%) needle insertions. The mean lateral distance between the needle tip and planned trajectory was 3.2 ± 4.5 (SD) mm (range: 0–20 mm) before adjustments, and the mean three-dimensional distance was 1.6 ± 2.6 (SD) mm (range: 0–13 mm) after 29 manual depth adjustments (29/78; 37%) and 33 lateral adjustments (33/78; 42%). Two (2/79; 3%) needles required complete manual reinsertion. One grade 3 complication was reported in one patient (1/41; 2%). The overall clinical success rate was 100%. The 3-month local tumor control rate (progression free survival) was 95% (38/41). ConclusionThese results provide further evidence on the use of robotic-assisted needle insertion regarding feasibility, safety, and accuracy, resulting in effective percutaneous thermal ablation of abdominal tumors.

Improved Modeling of Temperature Evolution during Lung Cancer Tumor Thermal Ablation

Microwave ablation (MWA) represents one of the most powerful tools in cancer treatment. This therapeutic modality process is governed by the temperature and absorbed dose of radiation of the cell tissue. This study was performed to control the temperature effect using simulation during the MWA thermal damage of lung tumor. For this reason, a two-dimensional (2D) computational modeling generated for adaptive lung tissue was designed and analyzed using the finite element method (FEM). Different approaches, such as first-order Arrhenius rate equations, Maxwell equations, and the bioheat equation, have been used to simulate necrosis in cells. To control the heat, a proportional–integral–derivative (PID) controller was used to moderate the input microwave power source and to maintain the temperature of the target tip at a lower level of the initial temperature data. Furthermore, full cancer tissue necrosis was also evaluated by processing time and thermal damage fraction. The obtained data proved that the target tip temperature was affected by the temperature distribution and specific absorption rate (SAR). However, a specific treatment period of tumor ablation is required to control and decrease the damage of surrounding healthy tissue to ensure a safe operation without any risk.

Chitosan-initiated gold nanoparticles with enhanced fluorescence for unique Fe3+/PPi sensing and photothermal therapy

The design of surface ligands is crucial for ligand-protected gold nanoparticles (AuNPs). Herein, following the principle of green synthesis, environmentally friendly gold nanoparticles (AuNPs@His@CC, AuHC) were fabricated based on dual ligands of histidine and carboxylated chitosan. AuHC showed the advantages of low toxicity, good photoluminescent stability and ideal biocompatibility. Compared with single histidine-coated gold nanoclusters (AuNCs@His, AuH), AuHC presented enhanced fluorescence attributed to the addition of chitosan. The blue-emitting AuHC has a unique response to Fe3+ with detection limits as low as 9.51 nM. Interestingly, the quenched fluorescence of AuHC–Fe3+ system could be restored through the introduction of PPi with a detection limit of 10.6 μM. So an “on-off-on” fluorescence sensing platform was achieved. Apart from good optical properties and sensing, the designed AuHC demonstrated outstanding photothermal conversion efficiency (27.8 %), which made it ideal material for thermal ablation of tumor. To be specific, after laser irradiation (660 nm, 0.78 W cm−2, 10 min) of AuHC, the survival rate of HeLa cells as a tumor cell model decreased to 12.7 %, indicating that AuHC has a significant tumor inhibition effect in vitro. Besides, AuHC also could be a befitting candidate for overcoming drug-resistant tumor cells such as MCF-7/ADR cells. Notably, AuHC can markedly ablate solid tumors in 4T1 tumor-bearing mice after laser irradiation (660 nm, 0.78 W cm−2, 10 min). Hence this work provides insight into the design of multifunctional AuNPs platform for simultaneously integrating the ion sensing and photothermal therapy of cancer.

An Automatic Needle Puncture Path-Planning Method for Thermal Ablation of Lung Tumors.

Computed tomography (CT)-guided thermal ablation is an emerging treatment method for lung tumors. Ablation needle path planning in preoperative diagnosis is of critical importance. In this work, we proposed an automatic needle path-planning method for thermal lung tumor ablation. First, based on the improved cube mapping algorithm, binary classification was performed on the surface of the bounding box of the patient's CT image to obtain a feasible puncture area that satisfied all hard constraints. Then, for different clinical soft constraint conditions, corresponding grayscale constraint maps were generated, respectively, and the multi-objective optimization problem was solved by combining Pareto optimization and weighted product algorithms. Finally, several optimal puncture paths were planned within the feasible puncture area obtained for the clinicians to choose. The proposed method was evaluated with 18 tumors of varying sizes (482.79 mm3 to 9313.81 mm3) and the automatically planned paths were compared and evaluated with manually planned puncture paths by two clinicians. The results showed that over 82% of the paths (74 of 90) were considered reasonable, with clinician A finding the automated planning path superior in 7 of 18 cases, and clinician B in 9 cases. Additionally, the time efficiency of the algorithm (35 s) was much higher than that of manual planning. The proposed method is expected to aid clinicians in preoperative path planning for thermal ablation of lung tumors. By providing a valuable reference for the puncture path during preoperative diagnosis, it may reduce the clinicians' workload and enhance the objectivity and rationality of the planning process, which in turn improves the effectiveness of treatment.

Fiber-optic Temperature Field Monitoring Based on Deep Learning Network for Tumor Thermal Ablation

Fiber-optic Temperature Field Monitoring Based on Deep Learning Network for Tumor Thermal Ablation

Ultrasound-guided percutaneous thermal ablation of parotid tumors: experience from two-centers

Objective: To evaluate the efficacy and feasibility of ultrasound-guided percutaneous thermal ablation (TA) for treating benign parotid tumors. Methods: Patients with benign parotid tumors who underwent ultrasound-guided microwave ablation (MWA) or radiofrequency ablation (RFA) between January 2020 and March 2023 were included in this retrospective study. Change in tumor size (maximum diameter, tumor volume(V), volume reduction rate (VRR)) and cosmetic score (CS) were evaluated during a one-year follow-up period. We also recorded the incidence of any complications associated with TA. Results: A total of 23 patients (13 males and 10 females; median age 65 years, range 5–91 years) were included. The mean VRR at 1, 3, 6, and 12 months after TA was 37.03%±10.23%, 56.52%±8.76%, 82.28%±7.89%, and 89.39%±6.45%, respectively. Mean CS also changed from 3.39 ± 0.66 to 1.75 ± 0.93 (p < 0.001) by the end of follow-up time. Subgroup analysis showed that tumors with smaller initial maximum diameter had a faster CS reduction rate than those with larger initial diameter. The incidence of facial nerve dysfunction was 8.70%. Conclusion: Ultrasound-guided percutaneous TA is an effective and safe treatment option for patients with benign parotid tumors.

Distinct immunoreactions after a primary tumor microwave ablation using different heating parameters in a VX2 tumor model.

Thermal ablation of solid tumors in situ can activate the immune system and produce a specific immune response against the tumor. Microwave ablation (MWA) with different parameters can ablate tumors with similar sizes and cause different local inflammatory effects. Our aim was to determine the immunological effects induced by different energy modes of MWA for a primary tumor. Seventy rabbits with VX2 tumors that were implanted subcutaneously underneath the right second nipple were treated with high-power MWA (40 W for 1 min), low-power MWA (20 W for 2 min), or surgical resection or were left without treatment (control). Survival time was evaluated by log-rank test. On day 14 after ablation, immunohistochemistry and flow cytometry were used to evaluate the T-cell immune responses. In addition, the cytokine patterns were identified by enzyme-linked immunosorbent assay. Tumor eradication was achieved completely in the MWA groups, as proven by nicotinamide adenine dinucleotide diaphorase staining. Compared with the three treatment groups, the control group had a significantly higher number of pulmonary metastases and worse survival; however, no significant difference was observed among the three treatment groups. More intra-tumoral and systemic CD4+ and CD8+ T-cells were induced in the MWA groups than in the control group. Compared with operation, MWA induced more systemic CD4+ T-cells. More intra-tumoral CD4+ and CD8+ T-cells and systemic CD4+ T-cells were induced by high-power MWA than by low-power MWA. Moreover, MWA increased the interleukin 2 (IL2) and IL12 levels and decreased the IL4, IL6, and IL10 levels. Importantly, the serum IL12 level was significantly higher after high-power MWA than after low-power MWA. High-power MWA enhanced the type 1 T helper immune response and may be selected for the treatment of solid tumors. Future studies are needed to confirm our results.

"Ice and Fire" Supramolecular Cell-Conjugation Drug Delivery Platform for Deep Tumor Ablation and Boosted Antitumor Immunity.

Cancer recurrence and metastasis are two major challenges in the current clinical therapy. In this work, a novel diketopyrrolopyrrole-based photothermal reagent (DCN) with unique J-aggregation-induced redshift is synthesized to achieve efficient tumor thermal ablation under safe power (0.33Wcm-2 ). Meanwhile, S-nitroso-N-acetylpenicillamine (SNAP) is co-loaded with near-infrared-absorbing DCN in amphiphilic polymers to realize heat-induced massive release of nitric oxide (NO), which can form oxidant peroxynitrite (ONOO- ) to active matrix metalloproteinases (MMPs), thereby degrading the compact tumor extracellular matrix to improve the ablation depth and infiltration of immune cells. Through a facile supramolecular assembly method, the DCN/SNAP nanoparticles are anchored to liquid-nitrogen-frozen cancer cells, achieving enhanced antitumor immune responses and effective inhibition of distant tumors and pulmonary metastases after only one treatment. The safety and effectiveness of this supramolecular cell-conjugation platform are verified by 2D/3D cellular experiments and bilateral tumor model, confirming the thermal-ablation-gas-permeation-antigen-presentation therapeutic mode has promising anticancer prospects.