Sonobiopsy Promises Easier Way to Diagnose Brain T
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Current brain tumor diagnosis protocols usually involve magnetic resonance imaging (MRI) and computerized tomography (CT) scans followed by tissue biopsy or surgical resection. Although tissue biopsies are less invasive than surgical resection, both are relatively invasive procedures that involve invading the skull to access brain tumors in various ways.
Patients who would like a less invasive procedure also have the option of blood-based liquid biopsies. This inexpensive technique involves running biomarkers through the blood to obtain genetic and molecular tumor information to help inform treatment decisions.
However, blood-based liquid biopsies aren’t as effective at diagnosing brain tumors as biomarkers from brain tumors given that the blood-brain barrier prevents the movement of brain tumor-derived biomarkers from tumors into peripheral blood circulation.
Washington University researchers have now devised a means of addressing this issue involving using microbubbles and focused ultrasound (FUS) to temporarily disrupt the blood-brain barrier and release many tumor biomarkers into peripheral circulation for analysis. Called sonobiopsy, this new technique was found to be safe and feasible for use in brain tumor diagnosis in a first-in-human prospective trial.
Cosenior study author Eric Leuthardt said that sonobiopsy allows physicians to acquire blood samples with a more accurate reflection of the brain tumor’s gene expression as well as the modular features located at a brain lesion site. When intravenously injected microbubbles were used in conjunction with transcranial low-intensity FUS, the researchers found that the technique induced temporal and reversible opening of the blood-brain barrier.
The combination is also quite effective at targeting lesions in the brain, allowing physicians to target lesions with millimeter accuracy. Microbubbles aid in the treatment by cavitating once they are exposed to focused ultrasounds, which can augment their mechanical effects.
Leuthardt and cosenior author Hong Chen built a compact FUS device that can be attached directly to a clinical navigation probe, which allows for meticulous FUS transducer positioning. Furthermore, the research team’s design enables easy sonobiopsy integration into the clinical workforce without forcing neurosurgeons to take extra training. According to Leuthardt, the sonobiopsy is similar to a regular brain biopsy without the risks involved in brain surgery.
The research team tested the safety and feasibility of the new technique in a pilot single-arm clinical trial involving five patients diagnosed with high-grade glioma. After performing biopsies using CT images, MRI and sonobiopsy, the researchers found that the treatment increased tumor-related biomarker concentrations in the blood significantly. They also determined that the treatment was safe for cancer treatment and did not cause any damage to healthy brain tissue.
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