Novel CO2 loaded nanoparticle ultrasound-activated contrast agent: A potential urinary catheter-free modality to detect vesicoureteral reflux.

IF 2 3区 医学 Q2 PEDIATRICS Journal of Pediatric Urology Pub Date : 2025-01-08 DOI:10.1016/j.jpurol.2025.01.003
Callum Lavoie, Zoe Nussbaum, Helal Syed, Brian Chun, Van Do, Davin Nguyen, Anvi Surapaneni, Ethan Hamid, Adnan Rayes, Dominic De La Torre, Oliver Ramirez, Eduardo Rosales, Travis J Williams, Jesse T Yen, Andy Y Chang
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Abstract

Background: The current gold-standard for detecting vesicoureteral reflux (VUR) is the voiding cystourethrogram (VCUG). However, VCUGs require ionizing radiation and bladder catheterization that can be challenging to perform and traumatic for pediatric patients and their parents.

Objective: To investigate the feasibility of a novel urinary catheter-free modality for diagnosing VUR using in vitro and ex vivo models.

Design, setting, and participants: Polyethyleneimine (PEI) and pressurized CO2 gas were utilized to formulate our polymer in a standardized and reproducible method. The CO2-loaded PEI solution was stimulated using moderate intensity ultrasound in latex balloons and ev-vivo porcine bladders. Degassed, deionized water served as the control.

Outcome measurements and statistical analysis: A Butterfly iQ ultrasound imaging system connected to a 9th generation iPad was utilized to observe any effervescence (bubbles).

Results: In both the balloon and ex vivo bladder models, CO2 effervescence is reproducible and visualizable from the CO2-loaded polymer solution under US imaging after stimulation.

Conclusions: We have demonstrated the ability to selectively release CO2 from CO2-loaded PEI nanoparticles to serve as an ultrasound contrast agent in both in vitro and ex vivo models. Future combined kidney-bladder porcine model experiments will be a critical step as we work towards validating and translating this agent as an effective modality for the diagnosis of VUR.

Patient summary: In this feasibility study, we evaluated early pre-clinical models of a urinary catheter-free modality for the diagnosis of vesicoureteral reflux. We utilized a novel CO2-loaded nanoparticle solution that creates bubbles when activated with moderate intensity ultrasound. These bubbles were clearly visualizable with regular diagnostic ultrasound imaging in both a latex balloon and porcine bladder model.

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新型CO2负载纳米颗粒超声激活造影剂:一种潜在的无导尿管检测膀胱输尿管反流的方式。
背景:目前检测膀胱输尿管反流(VUR)的金标准是排尿膀胱输尿管造影(VCUG)。然而,vcug需要电离辐射和膀胱导尿,这对儿科患者及其父母来说具有挑战性和创伤性。目的:探讨利用体外和离体模型诊断VUR的新型无导尿管模式的可行性。设计、设置和参与者:聚乙烯亚胺(PEI)和加压CO2气体以标准化和可重复的方法配制我们的聚合物。在乳胶球和离体猪膀胱中使用中等强度超声刺激二氧化碳负载PEI溶液。脱气、去离子水作为对照。结果测量和统计分析:使用连接第9代iPad的Butterfly iQ超声成像系统观察任何起泡(气泡)。结果:在球囊和离体膀胱模型中,在刺激后的US成像下,CO2负载聚合物溶液中CO2气泡是可重现的和可见的。结论:我们已经证明了在体外和离体模型中,PEI纳米颗粒可以选择性地释放二氧化碳,作为超声造影剂。未来的猪肾膀胱联合模型实验将是关键的一步,因为我们正在努力验证和翻译这种药物作为诊断VUR的有效模式。患者总结:在这项可行性研究中,我们评估了无导尿管模式诊断膀胱输尿管反流的早期临床前模型。我们使用了一种新型的二氧化碳负载纳米粒子溶液,当中等强度的超声波激活时,它会产生气泡。在乳胶球囊和猪膀胱模型中,这些气泡在常规超声诊断成像中清晰可见。
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来源期刊
Journal of Pediatric Urology
Journal of Pediatric Urology PEDIATRICS-UROLOGY & NEPHROLOGY
CiteScore
3.70
自引率
15.00%
发文量
330
审稿时长
4-8 weeks
期刊介绍: The Journal of Pediatric Urology publishes submitted research and clinical articles relating to Pediatric Urology which have been accepted after adequate peer review. It publishes regular articles that have been submitted after invitation, that cover the curriculum of Pediatric Urology, and enable trainee surgeons to attain theoretical competence of the sub-specialty. It publishes regular reviews of pediatric urological articles appearing in other journals. It publishes invited review articles by recognised experts on modern or controversial aspects of the sub-specialty. It enables any affiliated society to advertise society events or information in the journal without charge and will publish abstracts of papers to be read at society meetings.
期刊最新文献
Letter to the editors on "International consensus on research priorities in hypospadias using a Delphi study approach". The influence of positive and negative intraoperative feedback in laparoscopic simulation in pediatric urology training. Alkaline urine is associated with increased risk of calcium phosphate nephrolithiasis in medically complex children receiving enteral nutrition. The utilization of a spare ureter to create a continent catheterizable channel to the bladder in pediatric patients. Response to the editorial commentary on 'When you cannot trust what you see: The confounding effect'.
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