PMID- 32090074 OWN - NLM STAT- MEDLINE DCOM- 20201123 LR - 20220413 IS - 2314-6141 (Electronic) IS - 2314-6133 (Print) VI - 2020 DP - 2020 TI - Enhancement Effect of Microbubble-Enhanced Ultrasound in Microwave Ablation in Rabbit VX2 Liver Tumors. PG - 3050148 LID - 10.1155/2020/3050148 [doi] LID - 3050148 AB - OBJECTIVES: One reason for the high recurrence and metastatic rates of tumors such as hepatocellular carcinoma (HCC) treated by microwave ablation (MWA) is the presence of residual foci in the tumor due to heat sink effect. Microbubble-enhanced ultrasound (MEUS) can noninvasively disrupt and block the tumor blood perfusion and has the potential to overcome the heat sink effect and enhance the therapeutic effect of MWA. The study aimed at evaluating the potential additional benefit of microbubble-enhanced ultrasound (MEUS) in hepatocellular carcinoma (HCC) treated by microwave ablation (MWA). METHODS: In this study, a new strategy of combining MWA with MEUS for treating HCC was proposed. Twenty-four rabbits with VX2 tumors in livers were randomly divided into MEUS + MWA, MEUS alone, MWA alone, and blank control groups, respectively (n = 6). In the MEUS group, the tumors were directly exposed to therapeutic ultrasound for 5 min with a concurrent intravenous injection of microbubbles (0.1 ml/kg diluted into 5 ml saline). In the MWA group, the tumors were treated by MWA for 1 min. In the MEUS + MWA group, tumors were ablated by MWA for 1 min after ultrasound cavitation enhanced by microbubbles as in the MEUS group. In the blank control group, the tumors received probe sham and intravenous saline. Contrast-enhanced ultrasound (CEUS) was performed before treatment and immediately after treatment to display the size, shape, and contour of the tumors. Throughout the treatment process, the local temperature of the treatment area was detected by a temperature needle punctured into the tumor. The blood samples of animals were obtained after treatment for evaluating the liver function. Tumor cell necrosis and apoptotic rates were observed after treatment by histological examination. RESULTS: CEUS showed that although perfusion defects appeared in all the treatment groups, especially in the MEUS + MWA group, there was no significant difference between the two groups on the volumes of perfusion defects, which were 1.78 +/- 0.31 (cm(3)) in the MWA group and 1.84 +/- 0.20 (cm(3)) in the combined group (P < 0.01). The time to reach the peak temperature of the treatment area was 21.7 +/- 5.0 (s) in the MWA group and 10.3 +/- 5.0 (s) in the MEUS + MWA group (P < 0.01). The time to reach the peak temperature of the treatment area was 21.7 +/- 5.0 (s) in the MWA group and 10.3 +/- 5.0 (s) in the MEUS + MWA group (P < 0.01). The time to reach the peak temperature of the treatment area was 21.7 +/- 5.0 (s) in the MWA group and 10.3 +/- 5.0 (s) in the MEUS + MWA group (. CONCLUSIONS: These results suggested MEUS treatment alone may significantly reduce tumor blood perfusion and led to a sharp rise in the local temperature of the treatment area to a higher PT using MEUS + MWA with higher rates of necrosis and apoptosis of cancer cells without severe liver function damage, which might be a safe strategy for treating HCC. CI - Copyright (c) 2020 Shuyi Xiao et al. FAU - Xiao, Shuyi AU - Xiao S AD - The First Affiliated Hospital, Jinan University, Guangzhou, China. AD - Department of Medical Ultrasound, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China. AD - The Second Affiliated Hospital of South China University of Technology, Guangzhou, China. FAU - Hu, Zhiwen AU - Hu Z AUID- ORCID: 0000-0002-3472-6083 AD - Department of Medical Ultrasound, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China. AD - The Second Affiliated Hospital of South China University of Technology, Guangzhou, China. FAU - He, Yan AU - He Y AD - Department of Medical Ultrasound, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China. AD - The Second Affiliated Hospital of South China University of Technology, Guangzhou, China. FAU - Jin, Hai AU - Jin H AD - Department of Medical Ultrasound, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China. AD - The Second Affiliated Hospital of South China University of Technology, Guangzhou, China. FAU - Yang, Yuwen AU - Yang Y AD - Department of Medical Ultrasound, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China. AD - The Second Affiliated Hospital of South China University of Technology, Guangzhou, China. FAU - Chen, Liping AU - Chen L AD - Department of Medical Ultrasound, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China. AD - The Second Affiliated Hospital of South China University of Technology, Guangzhou, China. FAU - Chen, Qiaoli AU - Chen Q AD - Department of Medical Ultrasound, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China. AD - The Second Affiliated Hospital of South China University of Technology, Guangzhou, China. FAU - Luo, Qiong AU - Luo Q AD - The Second Affiliated Hospital of South China University of Technology, Guangzhou, China. FAU - Liu, Jianhua AU - Liu J AUID- ORCID: 0000-0001-8628-0127 AD - Department of Medical Ultrasound, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China. AD - The Second Affiliated Hospital of South China University of Technology, Guangzhou, China. LA - eng PT - Journal Article DEP - 20200123 PL - United States TA - Biomed Res Int JT - BioMed research international JID - 101600173 RN - 0 (Contrast Media) SB - IM MH - Animals MH - Contrast Media MH - Liver/diagnostic imaging/pathology/physiopathology MH - Liver Function Tests MH - Liver Neoplasms/*diagnostic imaging/pathology/physiopathology MH - *Microbubbles MH - *Microwaves MH - Necrosis MH - Perfusion MH - Rabbits MH - Temperature MH - *Ultrasonography PMC - PMC6998748 COIS- The authors declare that they have no conflicts of interest. EDAT- 2020/02/25 06:00 MHDA- 2020/11/24 06:00 PMCR- 2020/01/23 CRDT- 2020/02/25 06:00 PHST- 2019/08/24 00:00 [received] PHST- 2019/12/30 00:00 [accepted] PHST- 2020/02/25 06:00 [entrez] PHST- 2020/02/25 06:00 [pubmed] PHST- 2020/11/24 06:00 [medline] PHST- 2020/01/23 00:00 [pmc-release] AID - 10.1155/2020/3050148 [doi] PST - epublish SO - Biomed Res Int. 2020 Jan 23;2020:3050148. doi: 10.1155/2020/3050148. eCollection 2020.