Mapping drug distribution using CT imaging following direct tissue injection in ex vivo liver: informing clinical implementation.

CVIR oncology Pub Date : 2025-01-01 Epub Date: 2025-12-16 DOI:10.1007/s44343-025-00027-x
Robert Morhard, Michal Mauda-Havakuk, Jose F Delgado, Michael T Kassin, Azam Ghafoor, Ira Pastan, Raffit Hassan, John W Karanian, William F Pritchard, Bradford J Wood, Andrew S Mikhail
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Abstract

Purpose: Direct intratumoral injection of therapeutic drugs can minimize total dose and adverse effects compared to systemic administration. Leakage from the injection site may cause variable drug distribution and efficacy, and off-target toxicity. This study aimed to evaluate the co-injection of an iodinated contrast agent with an imageable surrogate drug (fluorescent albumin) to estimate spatial drug distribution.

Methods: Fluorescent albumin and iodixanol were injected (1, 2, or 4 mL at 1 mL/min) into ex vivo bovine liver. Distribution of iodine on CT was compared to fluorescent albumin on fluorescence microscopy, including comparison of distribution volume in liver as a function of injected volume. Physical properties (hydrodynamic diameter, zeta potential) of both iodixanol and fluorescent albumin were measured.

Results: In comparison to fluorescent albumin, iodixanol is smaller (2.7 ± 0.4 nm vs. 17.0 ± 1.7 nm) and more neutrally charged (2.3 ± 0.5 mV vs. - 17.7 ± 1.4 mV). The distribution volume of iodixanol in tissue is approximately 7 times greater than that of fluorescent albumin. However, the correlation of distribution volumes of both agents is R 2 = 0.89. The variance in distribution volume in tissue of iodixanol and fluorescent albumin increased with injection volume.

Conclusion: The distributions of contrast and surrogate drug were correlated; however, differing physicochemical properties caused differences in their distribution. Although drug and contrast may not colocalize, contrast may serve as an imageable surrogate to inform preclinical development and clinical applications. This study suggests that dividing an interstitial injection into multifocal small-volume injections results in better localization of the injected drug at the target.

Trial registration: NCT04840615.

Supplementary information: The online version contains supplementary material available at 10.1007/s44343-025-00027-x.

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在离体肝脏直接组织注射后使用CT成像绘制药物分布:告知临床实施。
目的:与全身给药相比,肿瘤内直接注射治疗药物可以减少总剂量和不良反应。从注射部位泄漏可能导致药物分布和疗效的变化,以及脱靶毒性。本研究旨在评估碘化造影剂与可成像替代药物(荧光白蛋白)共同注射以估计药物的空间分布。方法:分别以1 mL/min的速度将荧光白蛋白和碘二沙醇(1、2、4 mL)注射到离体牛肝脏中。比较CT上碘的分布与荧光显微镜下荧光白蛋白的分布,包括比较肝脏内碘的分布体积与注射体积的关系。测定了碘二醇和荧光白蛋白的物理性质(水动力直径、zeta电位)。结果:与荧光白蛋白相比,碘沙醇更小(2.7±0.4 nm比17.0±1.7 nm),更具中性电荷(2.3±0.5 mV比- 17.7±1.4 mV)。碘沙醇在组织中的分布体积约为荧光白蛋白的7倍。但两种药剂的分布体积相关系数r2 = 0.89。碘沙醇和荧光白蛋白在组织中的分布体积随注射量的增加而增加。结论:造影剂与替代药物的分布具有相关性;然而,不同的物理化学性质导致了它们在分布上的差异。虽然药物和造影剂可能不能共定位,但造影剂可以作为一种可想象的替代品,为临床前开发和临床应用提供信息。本研究表明,将间质注射分成多灶小体积注射可使注射药物更好地定位于靶点。试验注册:NCT04840615。补充信息:在线版本包含补充资料,提供地址:10.1007/s44343-025-00027-x。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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