Stacey Markovic

Nanoparticle-based brachytherapy spacers for delivery of localized combined chemoradiation therapy.

PURPOSE In radiation therapy (RT), brachytherapy-inert source spacers are commonly used in clinical practice to achieve high spatial accuracy. These implanted devices are critical technical components of precise radiation delivery but provide no direct therapeutic benefits. METHODS AND MATERIALS Here we have fabricated implantable nanoplatforms or chemoradiation therapy (INCeRT) spacers loaded with silica nanoparticles (SNPs) conjugated containing a drug, to act as a slow-release drug depot for simultaneous localized chemoradiation therapy. The spacers are made of poly(lactic-co-glycolic) acid (PLGA) as matrix and are physically identical in size to the commercially available brachytherapy spacers (5 mm × 0.8 mm). The silica nanoparticles, 250 nm in diameter, were conjugated with near infrared fluorophore Cy7.5 as a model drug, and the INCeRT spacers were characterized in terms of size, morphology, and composition using different instrumentation techniques. The spacers were further doped with an anticancer drug, docetaxel. We evaluated the in vivo stability, biocompatibility, and biodegradation of these spacers in live mouse tissues. RESULTS The electron microscopy studies showed that nanoparticles were distributed throughout the spacers. These INCeRT spacers remained stable and can be tracked by the use of optical fluorescence. In vivo optical imaging studies showed a slow diffusion of nanoparticles from the spacer to the adjacent tissue in contrast to the control Cy7.5-PLGA spacer, which showed rapid disintegration in a few days with a burst release of Cy7.5. The docetaxel spacers showed suppression of tumor growth in contrast to control mice over 16 days. CONCLUSIONS The imaging with the Cy7.5 spacer and therapeutic efficacy with docetaxel spacers supports the hypothesis that INCeRT spacers can be used for delivering the drugs in a slow, sustained manner in conjunction with brachytherapy, in contrast to the rapid clearance of the drugs when administered systemically. The results demonstrate that these spacers with tailored release profiles have potential in improving the combined therapeutic efficacy of chemoradiation therapy.

A Computer Vision Approach to Rare Cell In Vivo Fluorescence Flow Cytometry

Noninvasive enumeration of rare circulating cell populations in small animals is of great importance in many areas of biomedical research. In this work, we describe a macroscopic fluorescence imaging system and automated computer vision algorithm that allows in vivo detection, enumeration and tracking of circulating fluorescently‐labeled cells from multiple large blood vessels in the ear of a mouse. This imaging system uses a 660 nm laser and a high sensitivity electron‐multiplied charge coupled device camera (EMCCD) to acquire fluorescence image sequences from relatively large (∼5 × 5 mm2) imaging areas. The primary technical challenge was developing an automated method for identifying and tracking rare cell events in image sequences with substantial autofluorescence and noise content. To achieve this, we developed a two‐step image analysis algorithm that first identified cell candidates in individual frames, and then merged cell candidates into tracks by dynamic analysis of image sequences. The second step was critical since it allowed rejection of >97% of false positive cell counts. Overall, our computer vision IVFC (CV‐IVFC) approach allows single‐cell detection sensitivity at estimated concentrations of 20 cells/mL of peripheral blood. In addition to simple enumeration, the technique recovers the cells trajectory, which in the future could be used to automatically identify, for example, in vivo homing and docking events.

Abstract A82: Localized tumor delivery of radiosensitizers and chemotherapeutics using ‘INCeRT’ implants.

Systemic chemotherapy is often used with radiation therapy in the management of prostate cancer, but leads to severe systemic toxicities. We have introduced a new modality of loco-regional chemoradiation therapy termed in-situ image guided radiation therapy (BIS-IGRT) that offers the potential to deliver planned, localized and sustained delivery of chemotherapy agent, without systemic toxicities, as part of routine minimally invasive image guided radiation therapy procedures. Such image guided chemoradiation therapy replaces inert spacers with no therapeutic impact currently used in brachytherapy, with drug eluting spacers that provide the same spatial benefit with the added localized chemotherapeutic. This new therapeutic modality requires characterization of the drug distribution produced by implantable drug eluters. This work presents imaging based means to measure and compare temporal and spatial properties of diffusion distributions around spacers loaded with multi-sized dye-doped nanoparticles or with free dye. The spacer with optimal diffusive properties was then loaded with chemotherapeutics and inserted intratumorally for efficacy of the local chemotherapy versus the standard systemic dosing.

Near-infrared fluorescence imaging platform for quantifying in vivo nanoparticle diffusion from drug loaded implants

Drug loaded implants are a new, versatile technology platform to deliver a localized payload of drugs for various disease models. One example is the implantable nanoplatform for chemo-radiation therapy where inert brachytherapy spacers are replaced by spacers doped with nanoparticles (NPs) loaded with chemotherapeutics and placed directly at the disease site for long-term localized drug delivery. However, it is difficult to directly validate and optimize the diffusion of these doped NPs in in vivo systems. To better study this drug release and diffusion, we developed a custom macroscopic fluorescence imaging system to visualize and quantify fluorescent NP diffusion from spacers in vivo. To validate the platform, we studied the release of free fluorophores, and 30 nm and 200 nm NPs conjugated with the same fluorophores as a model drug, in agar gel phantoms in vitro and in mice in vivo. Our data verified that the diffusion volume was NP size-dependent in all cases. Our near-infrared imaging system provides a method by which NP diffusion from implantable nanoplatform for chemo-radiation therapy spacers can be systematically optimized (eg, particle size or charge) thereby improving treatment efficacy of the platform.

Performance of computer vision in vivo flow cytometry with low fluorescence contrast.

Abstract. Detection and enumeration of circulating cells in the bloodstream of small animals are important in many areas of preclinical biomedical research, including cancer metastasis, immunology, and reproductive medicine. Optical in vivo flow cytometry (IVFC) represents a class of technologies that allow noninvasive and continuous enumeration of circulating cells without drawing blood samples. We recently developed a technique termed computer vision in vivo flow cytometry (CV-IVFC) that uses a high-sensitivity fluorescence camera and an automated computer vision algorithm to interrogate relatively large circulating blood volumes in the ear of a mouse. We detected circulating cells at concentrations as low as 20  cells/mL. In the present work, we characterized the performance of CV-IVFC with low-contrast imaging conditions with (1) weak cell fluorescent labeling using cell-simulating fluorescent microspheres with varying brightness and (2) high background tissue autofluorescence by varying autofluorescence properties of optical phantoms. Our analysis indicates that CV-IVFC can robustly track and enumerate circulating cells with at least 50% sensitivity even in conditions with two orders of magnitude degraded contrast than our previous in vivo work. These results support the significant potential utility of CV-IVFC in a wide range of in vivo biological models.

Computer Vision ;In Vivo Flow Cytometry of Low-Abundance Circulating Cells

We have developed and validated a new instrument and computer vision algorithm for fluorescence sensing, enumeration and tracking of rare circulating cells in mice ;in vivo without the need for drawing blood samples.

Localized tumor delivery of radiosensitizers and chemotherapeutics using ‘INCeRT’ implants

Systemic chemotherapy is often used with radiation therapy in the management of prostate cancer, but leads to severe systemic toxicities. We have introduced a new modality of loco-regional chemoradiation therapy termed in-situ image guided radiation therapy (BIS-IGRT) that offers the potential to deliver planned, localized and sustained delivery of chemotherapy agent, without systemic toxicities, as part of routine minimally invasive image guided radiation therapy procedures. Such image guided chemoradiation therapy replaces inert spacers with no therapeutic impact currently used in brachytherapy, with drug eluting spacers that provide the same spatial benefit with the added localized chemotherapeutic. This new therapeutic modality requires characterization of the drug distribution produced by implantable drug eluters. This work presents imaging based means to measure and compare temporal and spatial properties of diffusion distributions around spacers loaded with multi-sized dye-doped nanoparticles or with free dye. The spacer with optimal diffusive properties was then loaded with chemotherapeutics and inserted intratumorally for efficacy of the local chemotherapy versus the standard systemic dosing.

Fluorescence quantification of nanoparticle diffusion from smart brachytherapy spacers in vivo

New implantable smart nanoparticle (NP) coated brachytherapy spacers have recently been developed which allows controlled, long-term release of chemotherapeutic drugs into tumors. However, kinetics of NP (drug) diffusion over time is still poorly understood, and new methods for controlling and optimizing this release are needed. In this work, we developed and validated a novel broad-field transmission fluorescence imaging system to observe NP diffusion in bulk biological tissue. This allowed us to systematically quantify diffusion both in phantoms in vitro and in mice in vivo. We performed in vitro studies with free dye and NPs of different sizes (30 nm and 200 nm) in agar gel phantoms and analyzed the diffusion over time. It was found that the free dye diffusion coefficient was orders of magnitude larger than both NP types verifying that diffusion could be controlled based on particle size. We also performed preliminary studies in mice, where functionalized brachytherapy spacers were implanted into the hind flanks of nude mice. Continuous diffusion of free dye and NPs was observed, with maximal diffusion areas observed on day 4 and day 6 for 30 nm and 200 nm NPs, respectively. Our fluorescence imaging system was capable of robustly quantifying this size-dependent diffusion. In the future, we will use it to optimize and control drug delivery from smart nanoparticles over time.

Toward lower contrast computer vision in vivo flow cytometry

There are many applications in biomedical research where detection and enumeration of circulating cells (CCs) is important. Existing techniques involve drawing and enriching blood samples and analyzing them ex vivo. More recently, small animal “in vivo flow cytometry” (IVFC) techniques have been developed, where fluorescently-labeled cells flowing through small arterioles (ear, retina) are detected and counted. We recently developed a new high-sensitivity IVFC technique termed “Computer Vision(CV)-IVFC”. Here, large circulating blood volumes were monitored in the ears of mice with a wide-field video-rate near-infrared (NIR) fluorescent camera. Cells were labeled with a membrane dye and were detected and tracked in noisy image sequences. This technique allowed enumeration of CCs in vivo with overall sensitivity better than 10 cells/mL. However, an ongoing area of interest in our lab is optimization of the system for lower-contrast imaging conditions, e.g. when CCs are weakly labeled, or in the case higher background autofluorescence with visible dyes. To this end, we developed a new optical flow phantom model to control autofluorescence intensity and physical structure to better mimic conditions observed in mice. We acquired image sequences from a series of phantoms with varying levels of contrast and analyzed the distribution of pixel intensities, and showed that we could generate similar conditions to those in vivo. We characterized the performance of our CV-IVFC algorithm in these phantoms with respect to sensitivity and false-alarm rates. Use of this phantom model in optimization of the instrument and algorithm under lower-contrast conditions is the subject of ongoing work in our lab.

Bone optical spectroscopy for the measurement of hemoglobin content

Osteoporosis is a common side effect of spinal cord injuries. Blood perfusion in the bone provides an indication of bone health and may help to evaluate therapies addressing bone loss. Current methods for measuring blood perfusion of bone use dyes and ionizing radiation, and yield qualitative results. We present a device capable of measuring blood oxygenation in the tibia. The device illuminates the skin directly over the tibia with a white light source and measures the diffusely reflected light in the near infrared spectrum. Multiple source-detector distances are utilized so that the blood perfusion in skin and bone may be differentiated.