Thermotherapy of prostate cancer using magnetic nanoparticles: Feasibility, imaging, and three-dimensional temperature distribution
Thermotherapy of prostate cancer using magnetic nanoparticles: Feasibility, imaging, and three-dimensional temperature distribution
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DOI：
10.1016/j.eururo.2006.11.023
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发表时间：
2007-12-01
期刊：
影响因子：
23.4
通讯作者：
Wust, Peter
中科院分区：
文献类型：
--
作者：
Johannsen, Manfred;Gneueckow, Uwe;Wust, Peter
目的：探讨热疗法的可行性，使用生物相容性超顺磁性纳米粒子在局部复发的前列腺癌患者，并评估一种基于成像的方法，用于非侵入性计算的三维temperature distribution.Methods：10例局部复发的前列腺癌后，主要治疗与治愈的意图进入一个前瞻性的1期试验。根据预先计划，将磁流体经会阴注射到前列腺中。患者接受了六个热治疗的60分钟的持续时间在每周的间隔使用交变磁场施加器。开发了一种基于前列腺计算机断层扫描（CT）的三维热分析方法，并与侵入性和腔内温度测量结果相关联。结果：CT对组织标本中氧化铁纳米颗粒的检出率中位数为89.5%（范围：70 - 98%）。前列腺的最高温度达到了55摄氏度。20%、50%和90%前列腺的中位温度分别为41.1 ℃（范围：40.0 - 47.4 ℃）、40.8 ℃（范围：39.5 - 45.4 ℃）和40.1 ℃（范围：38.843.4 ℃）。中位尿道和直肠温度分别为40.5 ℃（范围：38.4 - 43.6 ℃）和39.8 ℃（范围：38.2 - 43.4 ℃）。在43 ℃时，90%的前列腺的中位热剂量为7.8（范围：3.5 - 136.4）累积等效分钟。结论：磁性纳米粒子加热技术是可行的。在25%的可用磁场强度下，前列腺中达到了高热至热消融温度，表明更高温度的显著潜力。一种非侵入性的温度测量方法，这种方法可以开发，这可能是用于热剂量在未来的研究。(c)2006年欧洲泌尿外科协会。Elsevier B.V.出版，保留所有权利。
Objectives: To investigate the feasibility of thermotherapy using biocompatible superparamagnetic nanoparticles in patients with locally recurrent prostate cancer and to evaluate an imaging-based approach for noninvasive calculations of the three-dimensional temperature distribution.Methods: Ten patients with locally recurrent prostate cancer following primary therapy with curative intent were entered into a prospective phase 1 trial. The magnetic fluid was injected transperineally into the prostates according to a pre-plan. Patients received six thermal therapies of 60-min duration at weekly intervals using an alternating magnetic field applicator. A method of three-dimensional thermal analysis based on computed tomography (CT) of the prostates was developed and correlated with invasive and intraluminal temperature measurements. The sensitivity of nanoparticle detection by means of CT was investigated in phantoms.Results: The median detection rate of iron oxide nanoparticles in tissue specimens using CT was 89.5% (range: 70-98%). Maximum temperatures up to 55 degrees C were achieved in the prostates. Median temperatures in 20%, 50%, and 90% of the prostates were 41.1 degrees C (range: 40.0-47.4 degrees C) 40.8 degrees C (range: 39.5-45.4 degrees C), and 40.1 degrees C (range: 38.843.4 degrees C), respectively. Median urethral and rectal temperatures were 40.5 degrees C (range: 38.4-43.6 degrees C) and 39.8 degrees C (range: 38.2-43.4 degrees C). The median thermal dose was 7.8 (range: 3.5-136.4) cumulative equivalent minutes at 43 degrees C in 90% of the prostates. Conclusion: The heating technique using magnetic nanoparticles was feasible. Hyperthermic to thermoablative temperatures were achieved in the prostates at 25% of the available magnetic field strength, indicating a significant potential for higher temperatures. A noninvasive thermometry method specific for this approach could be developed, which may be used for thermal dosimetry in future studies. (c) 2006 European Association of Urology. Published by Elsevier B.V. All rights reserved.