VTechWorks Repository :: Browsing by Author "Rossmeisl, John H. Jr."

Browsing by Author "Rossmeisl, John H. Jr."

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7.0-T Magnetic Resonance Imaging Characterization of Acute Blood-Brain-Barrier Disruption Achieved with Intracranial Irreversible Electroporation
Garcia, Paulo A.; Rossmeisl, John H. Jr.; Robertson, John L.; Olson, JohnD.; Johnson, Annette J.; Ellis, Thomas L.; Davalos, Rafael V. (PLOS, 2012-11-30)
The blood-brain-barrier (BBB) presents a significant obstacle to the delivery of systemically administered chemotherapeutics for the treatment of brain cancer. Irreversible electroporation (IRE) is an emerging technology that uses pulsed electric fields for the non-thermal ablation of tumors. We hypothesized that there is a minimal electric field at which BBB disruption occurs surrounding an IRE-induced zone of ablation and that this transient response can be measured using gadolinium (Gd) uptake as a surrogate marker for BBB disruption. The study was performed in a Good Laboratory Practices (GLP) compliant facility and had Institutional Animal Care and Use Committee (IACUC) approval. IRE ablations were performed in vivo in normal rat brain (n = 21) with 1-mm electrodes (0.45 mm diameter) separated by an edge-to-edge distance of 4 mm. We used an ECM830 pulse generator to deliver ninety 50-ms pulse treatments (0, 200, 400, 600, 800, and 1000 V/cm) at 1 Hz. The effects of applied electric fields and timing of Gd administration (25, +5, +15, and +30 min) was assessed by systematically characterizing IRE-induced regions of cell death and BBB disruption with 7.0-T magnetic resonance imaging (MRI) and histopathologic evaluations. Statistical analysis on the effect of applied electric field and Gd timing was conducted via Fit of Least Squares with a = 0.05 and linear regression analysis. The focal nature of IRE treatment was confirmed with 3D MRI reconstructions with linear correlations between volume of ablation and electric field. Our results also demonstrated that IRE is an ablation technique that kills brain tissue in a focal manner depicted by MRI (n = 16) and transiently disrupts the BBB adjacent to the ablated area in a voltage-dependent manner as seen with Evan’s Blue (n = 5) and Gd administration.
Advancements in Irreversible Electroporation for the Treatment of Cancer
Arena, Christopher Brian (Virginia Tech, 2013-05-03)
Irreversible electroporation has recently emerged as an effective focal ablation technique. When performed clinically, the procedure involves placing electrodes into, or around, a target tissue and applying a series of short, but intense, pulsed electric fields. Oftentimes, patient specific treatment plans are employed to guide procedures by merging medical imaging with algorithms for determining the electric field distribution in the tissue. The electric field dictates treatment outcomes by increasing a cell's transmembrane potential to levels where it becomes energetically favorable for the membrane to shift to a state of enhanced permeability. If the membrane remains permeabilized long enough to disrupt homeostasis, cells eventually die. By utilizing this phenomenon, irreversible electroporation has had success in killing cancer cells and treating localized tumors. Additionally, if the pulse parameters are chosen to limit Joule heating, irreversible electroporation can be performed safely on surgically inoperable tumors located next to major blood vessels and nerves. As with all technologies, there is room for improvement. One drawback associated with therapeutic irreversible electroporation is that patients must be temporarily paralyzed and maintained under general anesthesia to prevent intense muscle contractions occurring in response to pulsing. The muscle contractions may be painful and can dislodge the electrodes. To overcome this limitation, we have developed a system capable of achieving non-thermal irreversible electroporation without causing muscle contractions. This progress is the main focus of this dissertation. We describe the theoretical basis for how this new system utilizes alterations in pulse polarity and duration to induce electroporation with little associated excitation of muscle and nerves. Additionally, the system is shown to have the theoretical potential to improve lesion predictability, especially in regions containing multiple tissue types. We perform experiments on three-dimensional in vitro tumor constructs and in vivo on healthy rat brain tissue and implanted tumors in mice. The tumor constructs offer a new way to rapidly characterize the cellular response and optimize pulse parameters, and the tests conducted on live tissue confirm the ability of this new ablation system to be used without general anesthesia and a neuromuscular blockade. Situations can arise in which it is challenging to design an electroporation protocol that simultaneously covers the targeted tissue with a sufficient electric field and avoids unwanted thermal effects. For instance, thermal damage can occur unintentionally if the applied voltage or number of pulses are raised to ablate a large volume in a single treatment. Additionally, the new system for inducing ablation without muscle contractions actually requires an elevated electric field. To ensure that these procedures can continue to be performed safely next to major blood vessels and nerves, we have developed new electrode devices that absorb heat out of the tissue during treatment. These devices incorporate phase change materials that, in the past, have been reserved for industrial applications. We describe an experimentally validated numerical model of tissue electroporation with phase change electrodes that illustrates their ability to reduce the probability for thermal damage. Additionally, a parametric study is conducted on various electrode properties to narrow in on the ideal design.
Advancements in the Treatment of Malignant Gliomas and Other Intracranial Disorders With Electroporation-Based Therapies
Lorenzo, Melvin Florencio (Virginia Tech, 2021-04-19)
The most common and aggressive malignant brain tumor, glioblastoma (GBM), demonstrates on average a 5-year survival rate of only 6.8%. Difficulties arising in the treatment of GBM include the inability of large molecular agents to permeate through the blood-brain barrier (BBB); migration of highly invasive GBM cells beyond the solid tumor margin; and gross, macroscopic intratumor heterogeneity. These characteristics complicate treatment of GBM with standard of care, resulting in abysmal prognosis. Electroporation-based therapies have emerged as attractive alternates to standard of care, demonstrating favorable outcomes in a variety of tumors. Notably, irreversible electroporation (IRE) has been used for BBB disruption and nonthermal ablation of intracranial tumor tissues. Despite promising results, IRE can cause unintended muscle contractions and is susceptible to electrical heterogeneities. Second generation High-frequency IRE (H-FIRE) utilizes bursts of bipolar pulsed electric fields on the order of the cell charging time constant (~1 μs) to ablate tissue while reducing nerve excitation, muscle contraction, and is far less prone to differences in electrical heterogeneities. Throughout my dissertation, I discuss investigations of H-FIRE for the treatment of malignant gliomas and other intracranial disorders. To advance the versatility, usability, and understanding of H-FIRE for intracranial applications, my PhD thesis focuses on: (1) characterizing H-FIRE-mediated BBB disruption effects in an in vivo healthy rodent model; (2) the creation of a novel, real-time impedance spectroscopy technique (Fourier Analysis SpecTroscopy, FAST) using waveforms compatible with existing H-FIRE pulse generators; (3) development of FAST as an in situ technique to monitor ablation growth and to determine patient-specific ablation endpoints; (4) conducting a preliminary efficacy study of H-FIRE ablation in an orthotopic F98 rodent glioma model; and (5) establishing the feasibility of MRI-guided H-FIRE for the ablation malignant gliomas in a spontaneous canine glioma model. The culmination of this thesis advances our understanding of H-FIRE in intracranial tissues, as well as develops a novel, intraoperative impedance spectroscopy technique towards determining patient-specific ablation endpoints for intracranial H-FIRE procedures.
Advancing Transcranial Focused Ultrasound for Noninvasive Neuromodulation of Human Cortex
Mueller, Jerel Keith (Virginia Tech, 2015-09-09)
Ultrasound waves are mechanical undulations above the threshold for human hearing, and have been used widely in both the human body and brain for diagnostic and therapeutic purposes. Ultrasound can be controlled using specially designed transducers into a focus of a few millimeters in diameter. Low intensity ultrasound, such as used in imaging applications, appears to be safe in adults. It is also known that ultrasound waves can penetrate through the skull and be focused within the brain for ablation purposes, employing the heat generation properties of high intensity focused ultrasound. High intensity focused ultrasound is thus used to irreversibly ablate brain tissue in localized areas without observable damage to intermediate tissue and vasculature. Ablation with high intensity focused ultrasound guided by magnetic resonance imaging is used for abolishing brain tumors, and experimentally for pain. Low intensity ultrasound can be utilized beyond imaging in neuroscience and neurology by focusing the ultrasound beam to investigate the structure and function of discrete brain circuits. In contrast to high intensity focused ultrasound, the effects of low intensity focused ultrasound on neurons are reversible. Considering the volume of work on high intensity focused ultrasound, low intensity focused ultrasound remains decidedly underdeveloped. Given the great potential for impact of low intensity focused ultrasound in both clinical and scientific neuromodulation applications, we sought to advance the use of low intensity focused ultrasound for noninvasive, transcranial neuromodulation of human cortex. This dissertation contains novel research on the use of low intensity transcranial focused ultrasound for noninvasive neuromodulation of human cortex. The importance of mechanical forces in the nervous system is highlighted throughout to expand beyond the stigma that nervous function is governed chiefly by electrical and chemical means. Methods of transcranial focused ultrasound are applied to significantly modulate human cortical function, shown using electroencephalographic recordings and behavioral investigations of sensory discrimination performance. This dissertation also describes computational models used to investigate the insertion behavior of ultrasound across various tissues in the context of transcranial neuromodulation, as ultrasound's application for neuromodulation is relatively new and crudely understood. These investigations are critical for the refinement of device design and the overall advancement of ultrasound methods for noninvasive neuromodulation.
Biocompatibility of the fiberoptic microneedle device chronically implanted in the rat brain
Kani, Yukitaka; Hinckley, Jonathan; Robertson, John L.; Mehta, Jason M.; Rylander, Christopher G.; Rossmeisl, John H. Jr. (Elsevier, 2022-03)
The fiberoptic microneedle device (FMD) is a fused-silica microcatheter capable of co-delivery of fluids and light that has been developed for convection-enhanced delivery and photothermal treatments of glioblastoma. Here we investigate the biocompatibility of FMD fragments chronically implanted in the rat brain in the context of evaluating potential mechanical device failure. Fischer rats underwent craniectomy procedures for sham control (n & nbsp;= 16) or FMD implantation (n = 16) within the brain. Rats were examined daily after implantation, and at 14, 30, 90, and 180 days after implantation were evaluated via computed tomography of the head, hematologic and blood biochemical profiling, and necropsy examinations. Clinical signs of illness and distant implant migration were not observed, and blood analyses were not different between control and FMD implanted groups at any time. Mild inflammatory and astrogliotic reactions localized to the treatment sites within the brain were observed in all groups, more robust in FMD implanted groups compared to controls at days 30 and 90, and decreased in severity over days 90-180 of the study. One rat developed a chronic, superficial surgical site pyogranuloma attributed to the FMD silica implant. Chronically implanted FMD fragments were well tolerated clinically and resulted in anticipated mild, localized brain tissue responses that were comparable with other implanted biomaterials in the brain.
Biomechanical evaluation of two methods of surgical stabilization of the atlantoaxial joint
Kopf, Kelli Michaela (Virginia Tech, 2013-08-20)
Several methods of surgical stabilization of the atlantoaxial joint are described in the veterinary literature. Threaded acrylic pins placed ventrally together with polymethylmethacrylate (PMMA) is a well-established technique that has been widely used in clinical cases. However, Kishigami tension bands are a less technically demanding procedure with potentially fewer complications. The purpose of this study was to biomechanically compare these two techniques in ventral-to-dorsal bending in both mature and immature dogs. Seventeen normal canine cadavers <15kg were collected and radiographed to determine skeletal maturity. The cervical spines were dissected leaving bony and ligamentous structures intact. Eight mature spines and 9 immature spines were randomly divided into two groups. In one group a Kishigami tension band was applied over the dorsal arch of the atlas and attached to the spinous process of the axis using orthopedic wire. In the second group, six acrylic pins were placed ventrally in the atlas, axis, and transarticularly. The pins were then cut and covered with PMMA. The specimens were potted in custom steel pots and biomechanically analyzed in ventral-to-dorsal four-point bending. Load-displacement curves representing the degree of stiffness were compared between the groups. Stabilization using ventral pins and PMMA had a significantly greater stiffness than a Kishigami tension band when bending in ventral to dorsal bending. Within the stabilized vertebral segment, there was no significant difference between the stiffness of immature vs. mature bone. Further analysis in torsion and analysis in abnormal dogs will be helpful in establishing the clinical significance of these findings.
Burst sine wave electroporation (B-SWE) for expansive blood–brain barrier disruption and controlled non-thermal tissue ablation for neurological disease
Campelo, Sabrina N.; Salameh, Zaid S.; Arroyo, Julio P.; May, James L.; Altreuter, Sara O.; Hinckley, Jonathan; Davalos, Rafael V.; Rossmeisl, John H. Jr. (AIP Publishing, 2024-05-30)
The blood–brain barrier (BBB) limits the efficacy of treatments for malignant brain tumors, necessitating innovative approaches to breach the barrier. This study introduces burst sine wave electroporation (B-SWE) as a strategic modality for controlled BBB disruption without extensive tissue ablation and compares it against conventional pulsed square wave electroporation-based technologies such as high-frequency irreversible electroporation (H-FIRE). Using an in vivo rodent model, B-SWE and H-FIRE effects on BBB disruption, tissue ablation, and neuromuscular contractions are compared. Equivalent waveforms were designed for direct comparison between the two pulsing schemes, revealing that B-SWE induces larger BBB disruption volumes while minimizing tissue ablation. While B-SWE exhibited heightened neuromuscular contractions when compared to equivalent H-FIRE waveforms, an additional low-dose B-SWE group demonstrated that a reduced potential can achieve similar levels of BBB disruption while minimizing neuromuscular contractions. Repair kinetics indicated faster closure post B-SWE-induced BBB disruption when compared to equivalent H-FIRE protocols, emphasizing B-SWE’s transient and controllable nature. Additionally, finite element modeling illustrated the potential for extensive BBB disruption while reducing ablation using B-SWE. B-SWE presents a promising avenue for tailored BBB disruption with minimal tissue ablation, offering a nuanced approach for glioblastoma treatment and beyond.
Canine Butterfly Glioblastomas: a Neuroradiological Review
Rossmeisl, John H. Jr.; Clapp, Kemba; Pancotto, Theresa E.; Emch, Samantha; Robertson, John L.; Debinski, Waldemar (Frontiers, 2016-05-19)
In humans, high-grade gliomas may infiltrate across the corpus callosum resulting in bihemispheric lesions that may have symmetrical, winged-like appearances. This particular tumor manifestation has been coined a “butterfly” glioma (BG). While canine and human gliomas share many neuroradiological and pathological features, the BG morphology has not been previously reported in dogs. Here, we describe the magnetic resonance imaging (MRI) characteristics of BG in three dogs and review the potential differential diagnoses based on neuroimaging findings. All dogs presented for generalized seizures and interictal neurological deficits referable to multifocal or diffuse forebrain disease. MRI examinations revealed asymmetrical (2/3) or symmetrical (1/3), bihemispheric intra-axial mass lesions that predominantly affected the frontoparietal lobes that were associated with extensive perilesional edema, and involvement of the corpus callosum. The masses displayed heterogeneous T1, T2, and fluid-attenuated inversion recovery signal intensities, variable contrast enhancement (2/3), and mass effect. All tumors demonstrated classical histopathological features of glioblastoma multiforme (GBM), including glial cell pseudopalisading, serpentine necrosis, microvascular proliferation as well as invasion of the corpus callosum by neoplastic astrocytes. Although rare, GBM should be considered a differential diagnosis in dogs with an MRI evidence of asymmetric or symmetric bilateral, intra-axial cerebral mass lesions with signal characteristics compatible with glioma.
Canine Snake-Eye Myelopathy: Clinical, Magnetic Resonance Imaging, and Pathologic Findings in Four Cases
Rossmeisl, John H. Jr.; Cecere, Thomas E.; Kortz, Gregg D.; Geiger, David A.; Shinn, Richard L.; Hinckley, Jonathan; Caudell, David L.; Stahle, Jessica A. (Frontiers, 2019-07-05)
Intramedullary signal change (ISC) is a non-specific finding that is frequently observed on magnetic resonance imaging (MRI) examinations of the canine spinal cord. ISC can represent a variety of primary pathological processes such as neoplasms or myelitides or secondary changes such as edema, cysts, gliosis, or myelomalacia. An unusual phenotype of ISC is the "snake-eye" myelopathy (SEM), which refers to bilaterally symmetric T2 hyperintensities preferentially affecting the ventral horn gray matter on transverse MR images, which resemble a pair of snake's eyes. The pathophysiology of SEM is poorly understood in humans, and this imaging finding may be associated with cervical spondylotic myelopathy, spinal cord ischemia, ossification of the posterior longitudinal ligament, amyotrophic lateral sclerosis, and Hirayama disease. Here we describe four dogs with cervical MRI examinations consistent with an SEM-like phenotype. All dogs initially presented with a central cord syndrome or tetraparesis referable to a C6-T2 neuroanatomic localization, which was attributed to disc-associated spinal cord compression in three cases, while one dog had the SEM-like phenotype with no identifiable etiology. Once the SEM-like phenotype was present on MRI examinations, dogs demonstrated insidious clinical deterioration despite therapeutic interventions. Deterioration was characterized by lower motor neuron weakness and neurogenic muscle atrophy progressing to paralysis in the thoracic limbs, while neurological functions caudal to the level of the SEM-like lesion remained largely preserved for months to years thereafter. Neuropathological features of the SEM-like phenotype include multisegmental cavitations and poliomyelomalacia of laminae VI-IX of the caudal cervical spinal cord, although the lesion evolved into pan-necrosis of gray matter with extension into the adjacent white matter in one case with an 8 years history of progressive disease. Although the pathophysiology of SEM remains unknown, the topographical distribution and appearance of lesions is suggestive of a vascular disorder. As the SEM-like phenotype was uniformly characterized by longitudinally and circumferentially extensive neuronal necrosis, results of this small case series indicate that dogs with clinical signs of central cord syndrome and the SEM-like phenotype involving the cervicothoracic intumescence on MR examinations have a poor prognosis for the preservation or recovery of thoracic limb motor function.
A case of stiff dog syndrome associated with anti-glutamic acid decarboxylase antibodies
Pancotto, Theresa E.; Rossmeisl, John H. Jr. (2017-05-10)
Background The stiff person syndrome (SPS) is a rare and debilitating autoimmune disorder with an unknown pathogenesis and variable clinical presentation that can present a diagnostic challenge. Although entities that clinically mimic stiff-person spectrum disorders (SPSD) have manifested in horses, they have not been reported in dogs. Case presentation We describe a 2-year-old beagle dog presented for progressive attacks of muscular rigidity and lordosis with superimposed spasms of the appendicular muscles triggered by tactile stimulation which resulted in marked gait impairment. Resting electromyography revealed continuous motor unit activity in the axial musculature. Compared to age-matched healthy beagle dogs, this patient had elevated glutamic acid decarboxylase antibody concentrations in serum and cerebrospinal fluid. Conclusions This dog presented with phenotypic, electrodiagnostic, and immunologic criterion consistent with an SPSD, including elevated anti-GAD antibody titers, which we have termed the “stiff dog syndrome (SDS)”. Durable clinical improvement was achieved with symptomatic and immunosuppressive treatments including baclofen, gabapentin, prednisone, and intravenous immunoglobulin.
Clinical, Diagnostic, and Imaging Findings in Three Juvenile Dogs With Paraspinal Hyperesthesia or Myelopathy as a Consequence of Hemophilia A: A Case Report
Fowler, Kayla M.; Bolton, Timothy A.; Rossmeisl, John H. Jr.; Arendse, Avril U.; Vernau, Karen M.; Li, Ronald H.; Parker, Rell L. (Frontiers, 2022-04-15)
Three juvenile dogs presented with an acute onset of paraspinal hyperesthesia and/or neurologic deficits. These dogs underwent anesthesia forMRI and additional diagnostics. The thoracolumbar MRI in Dog 1 revealed an accumulation of T2-weighted (T2W) hyperintense, T1-weighted (T1W) iso- to hyperintense, contrast enhancing extradural material. The differential diagnoses were meningitis with secondary hemorrhage or empyema or late subacute hemorrhage. The initial cervical MRI in Dog 2 revealed T1W meningeal contrast enhancement suspected to be secondary to meningitis. A repeat MRI following neurologic decline after CSF sampling revealed a large area of T2W and T1W hyperintensity between fascial planes of the cervical musculature as well as T2W iso- to hyperintense and T1W iso- to hypointense extradural material at the level of C1 consistent with hemorrhage. The cervical MRI in Dog 3 revealed T2W hyperintense and T1W iso- to hypointense extradural compressive material consistent with hemorrhage. Dogs 1 and 2 underwent CSF sampling and developed complications, including subcutaneous hematoma and vertebral canal hemorrhage. Dog 3 underwent surgical decompression, which revealed a compressive extradural hematoma. In each case, a hemophilia panel including factor VIII concentration confirmed the diagnosis of hemophilia A. Dog 1 had a resolution of clinical signs for ~5 months before being euthanized from gastrointestinal hemorrhage. Dog 2 was euthanized due to neurologic decompensation following CSF sampling. Dog 3 did well for 2 weeks after surgery but was then lost to follow-up. This case series provides information on clinical signs, MRI findings, and outcome in 3 juvenile dogs with hemophilia A that developed neurologic deficits or paraspinal hyperesthesia secondary to spontaneous or iatrogenic vertebral canal hemorrhage. Hemophilia A should be considered as a differential in any young dog presenting with an acute onset of hyperesthesia with or without neurologic deficits. This diagnosis should be prioritized in young male dogs that have other evidence of hemorrhage on physical exam.
Combinatorial Treatments and Technologies for Safe and Effective Targeting of Malignant Gliomas Using High-Frequency Irreversible Electroporation.
Campelo, Sabrina Nicole (Virginia Tech, 2023-12-21)
Glioblastoma Multiforme (GBM) is a highly aggressive and prevalent brain tumor with an average 5-year survival rate of approximately 6.9%. Its complex pathophysiology, characterized by the capacity to invade surrounding tissues beyond the visible tumor margin, intratumor heterogeneity, hypoxic core, and the presence of the blood-brain barrier (BBB) that restricts the penetration of large therapeutic agents, all pose formidable challenges for effective therapeutic intervention. The standard of care for GBM has thus far exhibited limited success, and patients often face a poor prognosis. Electroporation-based therapies, such as irreversible electroporation (IRE), have emerged as promising alternatives to conventional treatments. By utilizing high amplitude pulsed electric fields, IRE is able to permeabilize cells, disrupt the BBB, and induce non thermal ablation of soft tissues. However, IRE is oftentimes accompanied by undesirable secondary effects such as muscle contractions, complex anesthetic protocols, and susceptibility to electrical heterogeneities, which have impeded its clinical translation. To address these limitations, high-frequency IRE (H-FIRE) was developed. H-FIRE employs short bursts of bipolar pulses, similar in duration to the cell charging time constant, enabling the desired tissue ablation while minimizing nerve excitation and muscle contractions. Additionally, H-FIRE reduces susceptibility to electrical heterogeneities, allowing for more predictable treatment volumes, thus enhancing the feasibility of clinical translation. This dissertation investigates H-FIRE for targeting malignant gliomas while looking into improved efficacy when administering the therapy in conjunction with other treatment forms and technologies. Specifically, the presented work focuses on several key areas: (1) determining the effect of pulsing protocol and geometric configuration selection on the biological outcomes from electroporation; (2) using a tumor bearing rodent glioma model to evaluate the effects of H-FIRE as a standalone therapy and as a combinatorial therapy with liposomal doxorubicin; (3) investigating the effects of waveform shape on biological outcomes; (4) utilizing real-time Fourier Analysis SpecTroscopy (FAST) to accurately model rises in temperature during treatment; and (5) modifying real-time FAST methods to determine treatment endpoints for safe and effective ablation volumes.
Comparison of direct measurement of intracranial pressures and presumptive clinical and magnetic resonance imaging indicators of intracranial hypertension in dogs with brain tumors
Giannasi, Savannah; Kani, Yukitaka; Hsu, Fang-Chi; Rossmeisl, John H. Jr. (2020-05-16)
Background Intracranial hypertension (ICH) is often presumptively diagnosed based on clinical or imaging findings. Clinical or imaging surrogates of ICH are not usually validated with reference standard direct intracranial pressure (dICP) recordings. Hypotheses Dogs with brain magnetic resonance imaging (MRI) or clinical features of presumed ICH would have higher dICP than dogs lacking those features. Animals Twenty dogs with gliomas and 3 normal controls. Methods Prospective, convenience study. Dogs were presumptively categorized with normal ICP or ICH from scores generated from described clinical and brain MRI indicators of ICH. dICP was recorded in anesthetized dogs using an intraparenchymal microsensor and compared between groups. Results dICP was not different between control (10.4 +/- 2.1 mm Hg) and dogs with glioma (15.6 +/- 8.3 mm Hg), or between dogs in clinically predicted ICP groups. Compared with dogs with MRI-predicted normal ICP, MRI-predicted ICH dogs had higher dICP (10.3 +/- 4.1 versus 19.2 +/- 7.9 mm Hg, P = .004), larger tumors (1.45 +/- 1.2 versus 5.71 +/- 3.03 cm(3), P = .0004), larger optic nerve sheath diameters, and 14/14 (100%) displayed structural anatomical shifts on MRI. At a dICP threshold of 15 mm Hg, the sensitivity of MRI for predicting ICH was 90% and the specificity 69%. Conclusions and Clinical Relevance dICP measurements are feasible in dogs with brain tumors. MRI features including brain herniations, mass effect, and optic nerve size aid in the identification of dogs with ICH. Clinical estimation of ICP did not discriminate between dogs with and without ICH.
Comparison of linear and volumetric criteria for the determination of therapeutic response in dogs with intracranial gliomas
Garcia Mora, Josefa Karina; Robertson, John L.; Hsu, Fang-Chi; Shinn, Richard Levon; Larson, Martha M.; Rylander, Christopher G.; Whitlow, Christopher T.; Debinski, Waldemar; Davalos, Rafael V.; Daniel, Gregory B.; Rossmeisl, John H. Jr. (Wiley, 2022-05)
Background: Brain tumor therapeutic responses can be quantified from magnetic resonance images (MRI) using 1- (1D) and 2-dimensional (2D) linear and volumetric methods, but few studies in dogs compare these techniques. Hypotheses: Linear methods will be obtained faster, but have less agreement than volumetric measurements. Therapeutic response agreement will be highest with the total T2W tumor volumetric (TTV) method. Therapeutic response at 6-weeks will correlate with overall survival (OS). Animals: Forty-six dogs with intracranial gliomas. Methods: Prospective study. Three raters measured tumors using 1D and 2D linear, TTV, and contrast-enhancing volumetric (CEV) techniques on 143 brain MRI to determine agreement between methods, define therapeutic responses, and assess relations with OS. Results: Raters performed 1D the fastest (2.9 ± 0.57 minutes) and CEV slowest (17.8 ± 6.2 minutes). Inter- and intraobserver agreements were excellent (intraclass correlations ≥.91) across methods. Correlations between linear (1D vs 2D; ρ >.91) and volumetric (TTV vs CEV; ρ >.73) methods were stronger than linear to volumetric comparisons (ρ range,.26-.59). Incorporating clinical and imaging data resulted in fewer discordant therapeutic responses across methods. Dogs having partial tumor responses at 6 weeks had a lower death hazard than dogs with stable or progressive disease when assessed using 2D, CEV, and TTV (hazard ration 2.1; 95% confidence interval, 1.22-3.63; P =.008). Conclusions and Clinical Importance: One-dimensional, 2D, CEV, and TTV are comparable for determining therapeutic response. Given the simplicity, universal applicability, and superior performance of the TTV, we recommend its use to standardize glioma therapeutic response criteria.
Computed Tomography and Magnetic Resonance Imaging Are Equivalent in Mensuration and Similarly Inaccurate in Grade and Type Predictability of Canine Intracranial Gliomas
Stadler, Krystina L.; Ruth, Jeffrey D.; Pancotto, Theresa E.; Werre, Stephen R.; Rossmeisl, John H. Jr. (Frontiers, 2017-09-25)
While magnetic resonance imaging (MRI) is the gold-standard imaging modality for diagnosis of intracranial neoplasia, computed tomography (CT) remains commonly used for diagnosis and therapeutic planning in veterinary medicine. Despite the routine use of both imaging modalities, comparison of CT and MRI has not been described in the canine patient. A retrospective study was performed to evaluate CT and MRI studies of 15 dogs with histologically confirmed glioma. Multiple lesion measurements were obtained, including two-dimensional and volumetric dimensions in pre-contrast and post-contrast images. Similar measurement techniques were compared between CT and MRI. The glioma type (astrocytoma or oligodendroglioma) and grade (high or low) were predicted on CT and MRI independently. With the exception of the comparison between CT pre-contrast volume to T2-weighted MRI volume, no other statistical differences between CT and MRI measurements were identified. Overall accuracy for tumor grade (high or low) was 46.7 and 53.3% for CT and MRI, respectively. For predicted tumor type, accuracy of CT was 53.3% and MRI and MRI 60%. Based on the results of this study, both CT and MRI contrast measurement techniques are considered equivalent options for lesion mensuration. Given the low-to-moderate predictability of CT and MRI in glioma diagnosis, histopathology remains necessary for accurate diagnosis of canine brain tumors.
Creation and Characterization of Several Polymer/Conductive Element Composite Scaffolds for Skeletal Muscle Tissue Engineering
Fischer, Kristin Mckeon (Virginia Tech, 2012-02-17)
After skeletal muscle damage, satellite cells move towards the injured area to assist in regeneration. However, these cells are rare as their numbers depend on the age and composition of the injured muscle. This regeneration method often results in scar tissue formation along with loss of function. Although several treatment methods have been investigated, no muscle replacement treatment currently exists. Tissue engineering attempts to create, repair, and/or replace damaged tissue by combining cells, biomaterials, and tissue-inducing substances such as growth factors. Electrospinning produces a non-woven scaffold out of biomaterials with fiber diameters ranging from nanometers to microns to create an extracellular-like matrix on which cells attach and proliferate. Our focus is on synthetic polymers, specifically poly(D,L-lactide) (PDLA), poly(L-lactide) (PLLA), and poly(ε-caprolactone) (PCL). Skeletal muscle cells grown on electrospun scaffolds tend to elongate and fuse together thus, mimicking natural tissue. Electrical stimulation has been shown to increase the number of cells fused in culture and decreased the time needed in culture for cells to contract. Therefore, a conductive element was added to each scaffold, specifically polyaniline (PANi), gold nanoparticles (Au Nps), and multi-walled carbon nanotubes (MWCNT). Our project goal is to create a polymeric, conductive, and biocompatible scaffold for skeletal muscle regeneration. PANi and PDLA were mixed to form the following solutions 24% (83% PDLA/17% PANi), 24% (80% PDLA/20% PANi), 22% (75%PDLA/25% PANi), 29% (83% PDLA/17% PANi), and 29% (80% PDLA/20% PANi). Only the 75/25 electrospun scaffold was conductive and had a calculated conductivity of 0.0437 S/cm. Scaffolds with larger amounts of PANi were unable to be electrospun. PDLA/PANi scaffolds were biocompatible as primary rat skeletal muscle cells cultured in vitro did attach. However, the scaffolds shrunk, degraded easily, and became brittle. Although PDLA/PANi scaffolds were easily manufactured, our results indicate that this polymer mixture is not appropriate for skeletal muscle scaffolds. PLLA and Au Nps were electrospun together to form three composite scaffolds: 7% Au-PLLA, 13% Au-PLLA, and 21% Au-PLLA. These were compared to PLLA electrospun scaffolds. Measured scaffold conductivities were 0.008 ± 0.015 S/cm for PLLA, 0.053 ± 0.015 S/cm for 7% Au-PLLA, 0.076 ± 0.004 S/cm for 13% Au-PLLA, and 0.094 ± 0.037 S/cm for 21% Au-PLLA. It was determined via SEM with a Bruker energy dispersive x-ray spectrometer (EDS) that the Au Nps were not evenly distributed within the scaffolds as they had agglomerated. Rat primary muscle cells cultured on the three Au-PLLA scaffolds displayed low cellular activity. A second cell study was conducted to determine Au NPs toxicity. The results show that the Au Nps were not toxic to the cells and the low cellular activity may be a marker for myotube fusion. Elastic modulus and yield stress values for the three Au-PLLA scaffolds measured on days 0, 7, 14, 21, and 28 were much larger than skeletal muscle tissue. Due to the larger mechanical properties and Au Nps agglomeration, a third polymer and conductive element scaffold was investigated. PCL was chosen as the new synthetic polymer as it had a lower elastic modulus and high elongation. MWCNT were chosen as the conductive element as they disperse well within PCL when acid functionalized. A third component was added to the scaffold to help it move similar to skeletal muscle. Ionic polymer gels (IPG) are hydrogels that respond to an external stimulus such as temperature, pH, light, and electric field. A poly(acrylic acid)/poly(vinyl alcohol) (PAA/PVA) mixture is one type of IGP that responds to an electric field. The scaffolds were coaxially electrospun so that each fiber had a PCL-MWCNT interior with a PAA/PVA sheath. These scaffolds were compared to electrospun PCL and PCL-MWCNT ones. The addition of MWCNT to the PCL did increase scaffold conductivity. Actuation of the PCL-MWCNT-PAA/PVA scaffold occurred when 15V and 20V were applied. All three scaffolds had rat primary skeletal muscle cells attached but, more multinucleated cells with actin interaction were seen on PCL-MWCNT-PAA/PVA scaffolds. Once again the mechanical properties were greater than muscle, but because of its ability to actuate we believe the PCL-MWCNT-PAA/PVA scaffold has potential as a bioartificial muscle. Further characterization of the PCL-MWCNT-PAA/PVA included varying the ratios of PAA/PVA, smaller crosslinking times, and lower amounts of MWCNT. Four ratios, 83/17, 60/40, 50/50, and 40/60, were successfully coaxially electrospun with PCL and MWCNT. Overall, very few differences were seen between the four ratios in conductivity, cellular biocompatibility, actuation angular speed, and mechanical properties. The 83/17 and 40/60 ratios were chosen for additional investigation into mechanical properties and actuation. As the mechanical properties of the two types of scaffolds did not change significantly through degradation, lower PVA crosslinking times were tested. No significant effects were found and it was hypothesized that the evaporation of the solution played a role in the crosslinking process. The smaller MWCNT amount scaffolds also did not significantly affect the mechanical properties or the actuation angular speeds. More work into lowering the scaffold mechanical properties while increasing the actuation angular speed is necessary. Though the mechanical properties for the 83/17 and 40/60 scaffolds remained high compared to skeletal muscle, we also looked for differences in in vivo biocompatibility. Both scaffolds were implanted into the right vastus lateralis muscle of Sprague-Dawley rats. The left vastus lateralis muscle served as either the PBS injected sham surgery or an unoperated control. Biocompatibility was evaluated using enzymes, creatine kinase (CK) and lactate dehydrogenase (LDH), levels, fibrosis formation, inflammation, scaffold cellular infiltration, and neovascularization on days 7, 14, 21, and 28 post-implantation. Fibrotic tissue formation, inflammation, and elevated CK and LDH levels were observed initially but responses decreased during the four week study. Cells infiltrated the scaffolds and histological staining showed more fibroblasts than myogenic cells initially but over time, the fibroblasts decreased and myogenic cells increased. Neovascularization of both scaffolds was also recorded. PCL-MWCNT-PAA/PVA scaffolds were determined to be biocompatible, but some differences between the two types were noted. The 83/17 scaffolds caused less of a response from the body compared to the 40/60 scaffolds and had more myogenic cells attached. However, the 40/60 scaffolds had a larger number of blood vessels running through the scaffold. In conclusion, we have successfully fabricated a polymeric, conductive, and biocompatible scaffold that can actuate for skeletal muscle tissue engineering. Although our results are promising, more work is necessary to continue developing and refining the scaffold.
Cross-species transcriptional analysis reveals conserved and host-specific neoplastic processes in mammalian glioma
Connolly, Nina P.; Shetty, Amol C.; Stokum, Jesse A.; Hoeschele, Ina; Siegel, Marni B.; Miller, C. Ryan; Kim, Anthony J.; Ho, Cheng-Ying; Davila, Eduardo; Simard, J. Marc; Devine, Scott E.; Rossmeisl, John H. Jr.; Holland, Eric C.; Winkles, Jeffrey A.; Woodworth, Graeme F. (Springer Nature, 2018-01-19)
Glioma is a unique neoplastic disease that develops exclusively in the central nervous system (CNS) and rarely metastasizes to other tissues. This feature strongly implicates the tumor-host CNS microenvironment in gliomagenesis and tumor progression. We investigated the differences and similarities in glioma biology as conveyed by transcriptomic patterns across four mammalian hosts: rats, mice, dogs, and humans. Given the inherent intra-tumoral molecular heterogeneity of human glioma, we focused this study on tumors with upregulation of the platelet-derived growth factor signaling axis, a common and early alteration in human gliomagenesis. The results reveal core neoplastic alterations in mammalian glioma, as well as unique contributions of the tumor host to neoplastic processes. Notable differences were observed in gene expression patterns as well as related biological pathways and cell populations known to mediate key elements of glioma biology, including angiogenesis, immune evasion, and brain invasion. These data provide new insights regarding mammalian models of human glioma, and how these insights and models relate to our current understanding of the human disease.
Design and Validation of Medical Devices for Photothermally Augmented Treatments
Andriani, Rudy Thomas (Virginia Tech, 2014-09-15)
*1-Dimensional Advective-Diffusion Model in Porous Media Infusion of therapeutic agents into tissue is makes use of two mass transport modes: advective transport, and molecular diffusion. Bulk infusion into a 0.6% wt agarose phantom was modeled as an infinite, homogenous, and isotropic porous medium saturated with the same solvent used in the infused dye tracer. The source is assumed to be spherical and isotropic with constant flow rate and concentration. The Peclet numberdecreases with power function Pe = 15762t0.337 due to the decrease in mean dye-front pore velocity as V goes to Vfinal. Diffusive mass transport does not become significant during any relevent time period. *Arborizing Fiberoptic Microneedle Catheter We have developed an arborizing catheter that allows multiple slender fused-silica CED cannulae to be deployed within a target volume of the brain via a single needle tract, and tested it in a widely accepted tissue phantom. The arborizing catheter was constructed by bonding and encapsulating seven slender PEEK tubes in a radially symmetric bundle with a progressive helical angle along the length, then grinding a conicle tip where the helical angle is greatest. The catheter was tested by casting 0.6% wt agarose around the device with all needles deployed to a tip-to-tip distance of 4 mm. Phantom temperature was maintained at 26 ± 2°C. 5% wt Indigo Carmine dye was infused at a rate of 0.3 uL/min/needle for 4 hours. N=4 infusions showed a Vd/Vi of 139.774, with a standard deviation of 45.01. This is an order of magnitude greater than single-needle infusions under similar conditions [45]. The arborizer showed the additional benefit of arresting reflux propagating up the lengths of individual needles, which has historically been a weakness of single-needle CED catheter designs. *In Vivo Co-Delivery of Single Walled Carbon Nano-horns and Laser Light to Treat Human Transitional Cell Carcinoma of the Urinary Bladder in a Rodent Model Using a rodent model we explored a treatment method for Transitional Cell Carcinoma (TCC) in the urinary bladder in which Single Walled Carbon Nanohorn (SWNH) solution and 1064 nm laser light are delivered into tumorous tissue via a co-delivery Fiberoptic Microneedle Device (FMD). Preliminary treatment parameters were determined by injecting SWNH solutions with concentrations of 0 mg/mL, 0.17 mg/mL, or 0.255 mg/mL into ex vivo porcine skin and irradiating each for three minutes at laser powers of 500 mW, or 1000 mW. The combination with the greatest temperature increase without burning the tissue, 0.17 mg/mL at 1000 mW, was selected for the in vivo treatment. TCC tumors were induced in a rodent model by injecting a solution of 106 AY27 urothelial carcinoma cells into the lateral aspect of the left hind leg of young, female F344 rats. When tumors reached 5-10 mm3, rats were anesthitized and treated. SWNH solution was injected directly into the tumor and irradiated until the target temperature of 60degC was achieved. The rats were then recovered from anestesia and monitored for 7-14 days, at which point they were humanely sacrificed, and the tumors prepared for histological examination. Histological assessment of areas of FMD treatment correlated well with gross morphological appearance. Foci of tumor necrosis showed sharp (1-2 mm) delineation from areas of viable tumor (not treated) and normal tissue. We believe we have demonstrated the feasibility of using the FMD for treatment of urothelial carcinoma using an animal model of this disease, and are encouraged to continue development of this treatment and testing in larger animal models.
Development and Evaluation of a Caregiver Reported Quality of Life Assessment Instrument in Dogs With Intracranial Disease
Weiske, Rebecca; Sroufe, Maureen; Quigley, Mindy; Pancotto, Theresa E.; Werre, Stephen R.; Rossmeisl, John H. Jr. (2020-08-18)
In veterinary medicine, quality of life (QOL) assessment instruments, which are important components of the holistic evaluation of treatment success, have largely not included organ-specific concerns that may be broadly relevant to caregivers of dogs with intracranial disease. The objective of this study was to identify core questionnaire items and domains that contribute to health-related QOL (HRQOL) in dogs with intracranial disease. A questionnaire was developed that contained 39 QOL-related items encompassing physical, social/companionship, and brain-specific domains associated with the treatment of dogs with intracranial disease, and administered to caregivers of 56 dogs diagnosed with genetic, inflammatory, neoplastic, traumatic, and vascular brain diseases, 52 healthy dogs, and 20 dogs with non-neurological illnesses. Clinician derived functional measures of each dog's health status including chronic pain, Karnofsky performance, and modified Glasgow coma scale scores were also recorded. Principal component analysis refined the final questionnaire, termed the CanBrainQOL-24, to 24-items within the three domains with a minimum Cronbach's alpha of 0.7, indicative of good internal consistency. The CanBrainQOL-24 discriminated between healthy and diseased dogs. Physical and brain-specific domains were significantly different between dogs with intracranial and non-neurological diseases. Significant correlations were observed between owner reported visual analog scores and CanBrainQOL-24 scores, as well between clinician derived functional status measures and owner reported QOL. The CanBrainQOL-24 contains core questions relevant to caregiver assessment of HRQOL in dogs with a variety of intracranial diseases, and provides information that is complementary to clinician derived functional outcome measures.
Development of a Fiberoptic Microneedle Device for Simultaneous Co-Delivery of Fluid Agents and Laser Light with Specific Applications in the Treatment of Brain and Bladder Cancers
Hood, Robert L. (Virginia Tech, 2013-10-16)
This dissertation describes the development of the fiberoptic microneedle device (FMD), a microneedle technology platform for fluid and light delivery, from general engineering characterization to specific applications in treating bladder and brain cancers. The central concept of the FMD is physical modification of silica fiberoptics and capillary tubes into sharp microneedles capable of penetrating a tissue's surface, enabling light and fluid delivery into the interstitial spaces. Initial studies sought to characterize the mechanical penetration and optical delivery of multimode fiberoptics and capillary tubes modified through a custom, CO2 laser melt-drawing technique. Additional work with multimode fibers investigated using an elastomeric lateral support medium to ensure robust penetration of small diameter fibers. These early experiments laid an engineering foundation for understanding the FMD technology. Subsequent studies focused on developing the FMD to treat specific diseases. The first such investigation sought to leverage the high aspect ratio nature of FMDs made from long capillary tubes as a therapy delivery device deployable through the instrument channel of a urological cystoscope. The therapeutic strategy was to infuse single-walled carbon nanohorns (SWNHs), a carbon-based nanoparticle allowing surface modification and drug encapsulation, into the infiltrating front of later stage bladder tumors. The SWNHs primarily serve as exogenous chromophores, enabling a fluid-based control of photothermal heat generation created when the SWNHs interacted with laser energy from an interstitial FMD or a light-emitting fiber in the bladder's interior. The study described here primarily sought to characterize the dispersal of the infused SWNHs and the photothermal response of the particles when heated with a 1064 nm laser. The FMD was also developed as a platform capable of conducting convection-enhanced delivery (CED), a therapeutic approach to treat invasive tumors of the central nervous system such as malignant glioma (MG). Intracranial CED involves the placement of small catheters local to the tumor site and slow infusion of a chemotherapeutic over long timeframes (12-72 hours). A primary challenge of this treatment approach is infused chemotherapeutics not dispersing sufficiently to reach the infiltrating cells in the tumor's margins. The hypothetical improvement provided by the FMD technology is using sub-lethal photothermal heating to sufficiently increase the diffusive and convective transport of an infusate to reach infiltrative cells in the tumor's periphery. Initial experiments sought to demonstrate and characterize a heat-mediated increase of volumetric dispersal in Agarose tissue phantoms and ex vivo tissue. Subsequent studies with in vivo rodent models determined the best laser parameters to achieve the desired levels of diffuse, sub-lethal heat generation and then demonstrated the hypothesis of increasing the rate of volumetric dispersal though concurrent local hyperthermia. This research was the first demonstration of photothermal augmentation of an interstitially infused fluid's dispersal rate, which may have uses outside of the CED approach to brain cancer exhibited here. Taken in sum, this manuscript describes the potency and versatility of the FMD technology platform through its development in various biomedical applications.

Browsing by Author "Rossmeisl, John H. Jr."

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