PO.CL12.04 · 临床研究
磁动力栓塞用于增强靶向肝细胞癌的开发与临床前验证
Development and preclinical validation of magnetomotive embolization for enhanced targeting of hepatocellular carcinoma
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景:肝细胞癌(HCC)是最常见的原发性肝癌类型,仍是全球癌症死亡的主要原因之一。经导管动脉栓塞(联合或不联合化疗)是中期HCC的标准治疗,但其生存获益仍然有限,反映出诸如肿瘤栓塞不完全等局限性。为解决这些局限,我们旨在开发一种栓塞方法,通过生物相容性磁性栓塞微球和磁场引导,改善肿瘤内微球的定位和肿瘤栓塞。
方法:设计了一套双圆柱NdFeB磁体系统,能在距磁体表面7.5 cm处产生高达25 mT的聚焦磁场,形成稳定的磁陷阱。采用乳液聚合法合成了掺入约30 nm Fe3O4氧化铁纳米颗粒的聚己内酯基磁性栓塞微球(40-60 µm),并对其形态、均一性和磁化特性进行了表征。在3D打印的血管肿瘤体模中评估磁体引导的微球递送,并在兔VX2肝肿瘤模型中进行体内验证。荷瘤兔(n=12)接受经动脉栓塞,随机分为磁体引导组(5 Hz交替旋转,15分钟)或对照组(各n=6)。
结果:显微分析证实微球形态均匀呈球形,粒径分布狭窄,而SQUID磁强计测量显示Fe3O4纳米颗粒核心具有亚铁磁性(磁化强度63.6 emu/g,在800 kA/m下矫顽力20 Oe),证实了强磁响应性,并支持MR安全性。粉末X射线衍射证实为Fe3O4,无提示存在不良氧化铁物种的异常峰。在肿瘤体模中,该磁体系统在临床前相关距离下成功将磁性微球聚集于靶区,实现了可重复的空间控制,与对照组中异质性分散形成对比。在体内,经动脉递送在技术上可行,所有荷瘤兔均耐受良好,无急性并发症。组织病理学分析显示,磁体辅助动物的肿瘤血管中磁性微球聚集。未观察到与器械相关的毒性。
结论:本研究确立了磁动力栓塞作为一种新型且可行的HCC局部区域治疗的概念验证。研究结果证明了在体模和临床前动物模型中的技术可行性、操作安全性以及有效的肿瘤内微球定位。在这些结果的基础上,未来工作将着重于整合机器人磁场控制以实现动态靶向,并在大动物模型中开展定量疗效和安全性研究,以推动该技术走向临床转化。
查看英文原文 English abstract
Background: Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and remains a leading cause of cancer mortality worldwide. Catheter-directed transarterial embolization (with or without chemotherapy) is the standard treatment for intermediate-stage HCC, but its survival benefit remains modest, reflecting limitations such as incomplete tumor embolization. To address these limitations, we aimed to develop an embolization approach that improves intratumoral bead localization and tumor embolization through biocompatible magnetic embolization beads and magnetic field guidance.
Methods : A dual-cylinder NdFeB magnet system was engineered to generate focused magnetic fields up to 25 mT at 7.5 cm from the magnet surface, creating a stable magnetic trap. Polycaprolactone-based magnetic embolization beads (40-60 µm) incorporating ~30 nm Fe3O4 iron oxide nanoparticles were synthesized using emulsion polymerization and characterized for morphology, uniformity, and magnetization. Magnet-guided bead delivery was assessed in 3D-printed vascular tumor phantoms and validated in vivo using the rabbit VX2 liver tumor model. Tumor-bearing rabbits (n=12) underwent transarterial embolization and were randomized into magnet-guided (5 Hz alternating rotation, 15 minutes) or control groups (n=6 each).
Results : Microscopic analysis confirmed uniform spherical bead morphology with a narrow size distribution, while SQUID magnetometry demonstrated ferrimagnetic behavior of Fe3O4 nanoparticle cores (magnetization 63.6 emu/g, coercivity 20 Oe at 800 kA/m), confirming strong magnetic responsiveness, and supporting MR-safety. Powder X-ray diffractometry confirmed Fe3O4 with no anomalous peaks suggesting the presence of undesirable iron oxide species. In tumor phantoms, the magnet system successfully concentrated magnetic beads within targeted regions at preclinical relevant distances, achieving reproducible spatial control and contrasting with heterogeneous dispersion in controls. In vivo, transarterial delivery was technically feasible and well tolerated in all tumor-bearing rabbits with no acute complications. Histopathologic analysis demonstrated concentration of the magnetic beads in tumor vasculature in magnet-assisted animals. No device-related toxicity was observed.
Conclusion : This study establishes proof-of-concept for magnetomotive embolization as a novel and feasible locoregional therapy for HCC. The findings demonstrate technical feasibility, procedural safety, and effective intratumoral bead localization in both phantom and preclinical animal models. Building on these results, future work will focus on integrating robotic magnetic field control for dynamic targeting and performing quantitative efficacy and safety studies in large-animal models to advance this technology toward clinical translation.
利益披露 Disclosure
R. C. Gaba,
Sus Clinicals Stock, Stock Option, ), Other, Scientific Advisory Board.
Guerbet USA LLC ).
ClearDynamic Other, consulting fees.
Fluidx Medical Technology Other, Scientific Advisory Board.
Kaveri University Other, Scientific Advisory Board.
L. Elkhadragy, None.
M. E. Sabo,
UNandUP LLC Employment, Patent.
D. C. Greenspan,
UN&UP, LLC. Independent Contractor.
F. M. Creighton,
UNandUP, LLC Employment, g., Board of Directors, non-salaried role), Other Business Ownership, Patent.