In Situ Therapeutic Solutions Inc, Seattle, USA.
Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, USA.
Eur Radiol Exp. 2023 Aug 3;7(1):38. doi: 10.1186/s41747-023-00355-8.
Heterotopic ossification (HO) is a frequent and debilitating complication of traumatic musculoskeletal injuries and orthopedic procedures. Prophylactic dosing of botulinum toxin type A (BTxA) holds potential as a novel treatment option if accurately distributed throughout soft-tissue volumes where protection is clinically desired. We developed a high-resolution, microcomputed tomography (microCT)-based imaging strategy to assess drug distribution and validated this platform by quantifying distribution achieved via a prototype delivery system versus a single-bolus injection.
We injected an iodine-containing contrast agent (iodixanol 320 mg I/mL) into dissected rabbit musculature followed by microCT imaging and analysis. To contrast the performance of distributed versus bolus injections, a three-dimensional (3D) 64-cm-printed soft-tissue holder was developed. A centered 2-cm volume of interest (VOI) was targeted with a single-bolus injection or an equal volume distributed injection delivered via a 3D-printed prototype. VOI drug coverage was quantified as a percentage of the VOI volume that was < 1.0 mm from the injected fluid.
The microCT-based approach enabled high-resolution quantification of injection distribution within soft tissue. The distributed dosing prototype provided significantly greater tissue coverage of the targeted VOI (72 ± 3%, mean ± standard deviation) when compared to an equal volume bolus dose (43 ± 5%, p = 0.031) while also enhancing the precision of injection targeting.
A microCT-based imaging technique precisely quantifies drug distribution within a soft-tissue VOI, providing a path to overcome a barrier for clinical translation of prophylactic inhibition of HO by BTxA.
This platform will facilitate rapid optimization of injection parameters for clinical devices used to effectively and safely inhibit the formation of heterotopic ossification.
• MicroCT provides high-resolution quantification of soft-tissue drug distribution. • Distributed dosing is required to maximize soft-tissue drug coverage. • Imaging platform will enable rapid screening of 3D-printed drug distribution prototypes.
异位骨化(HO)是创伤性肌肉骨骼损伤和矫形手术的常见且使人虚弱的并发症。如果肉毒毒素 A 型(BTxA)的预防性给药能够准确地分布在需要临床保护的软组织体积中,那么它将成为一种新的治疗选择。我们开发了一种基于高分辨率微计算机断层扫描(microCT)的成像策略来评估药物分布,并通过定量比较通过原型输送系统与单次推注注射实现的分布来验证该平台。
我们将含碘造影剂(碘海醇 320mg I/mL)注入解剖的兔肌肉中,然后进行 microCT 成像和分析。为了对比分布注射和推注注射的性能,开发了一个三维(3D)64 厘米打印软组织固定器。通过 3D 打印原型,以单一推注或等量分布注射的方式靶向一个中心 2 厘米的感兴趣体积(VOI)。VOI 药物覆盖率作为距离注射液小于 1.0mm 的 VOI 体积的百分比进行量化。
基于 microCT 的方法能够在软组织内进行高分辨率的注射分布定量。与等量的推注剂量(43±5%,p=0.031)相比,分布给药原型显著提高了靶向 VOI 的组织覆盖率(72±3%,平均值±标准差),同时还提高了注射靶向的精度。
基于 microCT 的成像技术精确地量化了软组织 VOI 内的药物分布,为克服 BTxA 预防性抑制异位骨化的临床转化障碍提供了一条途径。
该平台将促进用于有效和安全抑制异位骨化形成的临床设备的注射参数的快速优化。
• microCT 提供软组织药物分布的高分辨率定量。• 为了最大限度地提高软组织药物覆盖率,需要进行分布给药。• 成像平台将能够快速筛选 3D 打印药物分布原型。