Hepatocellular carcinoma is a growing worldwide problem with a high mortality rate. This malignancy does not respond well to chemotherapy, and most patients present late in their disease at which time surgery is no longer an option. Over the past three decades, minimally invasive methods have evolved to treat unresectable disease and prolong survival. Intra-arterial embolization techniques are used for large or multiple tumors but have distressingly high levels of local recurrence and can be costly to implement. A new method called thermoembolization was recently reported, which destroys target tissue by combining reactive exothermic chemistry with an extreme local change in pH and ischemia. Described herein are experiments performed using this technique in vivo in a swine model. A microcatheter was advanced under fluoroscopic guidance into a branch of the hepatic artery to deliver a targeted dose of dichloroacetyl chloride dissolved in ethiodized oil into the liver. The following day, the animals were imaged by computed tomography and euthanized. Assessing the reaction product distribution and establishing a correlation with the effects are important for understanding the effects. This presented a significant challenge, however, as the reagent used does not contain a chromophore and is not otherwise readily detectable. Mass spectrometry imaging was employed to determine spatial distribution in treated samples. Additional insights on the biology were obtained by correlating the results with histology, immunohistochemistry, and immunofluorescence. The results are encouraging and may lead to a therapy with less local recurrence and improved overall survival for patients with this disease.

中文翻译：

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使用质谱成像在猪模型中热栓塞的分子和形态学效应的相关性。

肝细胞癌是世界范围内日益严重的问题，死亡率很高。这种恶性肿瘤对化学疗法反应不佳，大多数患者病情较晚，因此不再选择手术。在过去的三十年中，微创方法已经发展为可以治疗无法切除的疾病并延长生存期的方法。动脉内栓塞技术用于大型或多种肿瘤，但局部复发率高得令人痛苦，并且实施起来可能成本高昂。最近报道了一种称为热栓塞的新方法，该方法通过将反应性放热化学与pH值和局部缺血的极端局部变化相结合来破坏目标组织。本文描述了在猪模型中使用该技术在体内进行的实验。在荧光镜引导下将微导管推进到肝动脉的分支中，以将目标剂量的溶解在硫醇化油中的二氯乙酰氯输送到肝脏中。第二天，通过计算机断层摄影术对动物成像并实施安乐死。评估反应产物的分布并建立与效应的相关性对于理解效应很重要。然而，由于使用的试剂不包含生色团并且否则不易检测，因此这提出了重大挑战。质谱成像用于确定处理样品中的空间分布。通过将结果与组织学，免疫组织化学和免疫荧光相关联，可获得有关生物学的更多见解。