title: A novel approach to identify non-palpable breast lesions combining fluorescent liposomes and magnetic resonance-guided high intensity focused ultrasound-triggered release.
abstract: The combination of fluorescein-containing liposomes (FCL) and magnetic resonance-guided high intensity focused ultrasound (MR-HIFU)-triggered release is a promising approach for lesion demarcation and more efficient removal of non-palpable breast lesions. Exposure of FCL to ablation temperatures (60 °C) using MR-HIFU would result in palpable, stained tumors, which are more easy to identify during surgical resection. In this study, proof-of-concept concerning fluorescent FCL for MR-HIFU-triggered release and tumor demarcation of non-palpable breast lesions is presented. Ex vivo experiments in human blood and porcine muscle tissue showed increased label release from the liposomes, clear fluorescence enhancement and diffusion of the released compound after heating to 60 °C. Next, fluorescein release of FCL was observed after MR-HIFU-mediated mild hyperthermia (42 °C) and ablation temperature (60 °C) for a short period (30s), which is in line with the clinically relevant MR-HIFU treatment parameters. These results indicate the potential of the FCL as a tool to improve tumor demarcation in patients by MR-HIFU-triggered release. Therefore, this method may offer a new tool for efficient surgical resection of non-palpable breast tumor lesions by enabling proper discrimination between tumor tissue and adjacent healthy tissue.
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center, Utrecht, The Netherlands. C.Oerlemans@umcutrecht.nl
authors.forename: Chris
authors.initials: C
authors.lastname: Oerlemans
authors.forename: Frank
authors.initials: F
authors.lastname: Nijsen
authors.forename: Miranda
authors.initials: M
authors.lastname: van Amersfoort
authors.forename: Louis
authors.initials: L
authors.lastname: van Bloois
authors.forename: Edwin
authors.initials: E
authors.lastname: Heijman
authors.forename: Peter
authors.initials: P
authors.lastname: Luijten
authors.forename: Willem
authors.initials: W
authors.lastname: Mali
authors.forename: Gert
authors.initials: G
authors.lastname: Storm
mesh_terms: D000818:Animals; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D003287:Contrast Media / Q000737:chemistry / Q000493:pharmacokinetics; D004355:Drug Stability; D004356:Drug Storage; D005260:Female; D019793:Fluorescein / Q000737:chemistry / Q000493:pharmacokinetics; D057086:High-Intensity Focused Ultrasound Ablation; D006358:Hot Temperature; D006801:Humans; D008081:Liposomes; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D018482:Muscle, Skeletal / Q000378:metabolism; D013552:Swine; D019690:Technetium Tc 99m Exametazime / Q000493:pharmacokinetics; D014018:Tissue Distribution
chemical_list: D003287:Contrast Media; D008081:Liposomes; D019690:Technetium Tc 99m Exametazime; D019793:Fluorescein