Combinatorial protein libraries based on a protein template offer a vast potential for deriving protein variants harboring new receptor specificity while retaining other tem-plate functions to serve as library search-engines, cell-routing sequences and therapeutic domains. This concept was tested with the design and synthesis of protein libraries where short random peptide motifs were embedded directly within the catalytic A subunit of the bacterial ribosome-inactivating protein (RIP) known as Shiga-like toxin 1 (SLT-1). More precisely, a seven amino acid peptide epitope (PDTRPAP) was inserted between residues 245-246 of its A subunit (SLT-1APDTRPAP) and shown to preserve catalytic function while exposing the epitope. SLT-1 A chain libraries harboring tripep-tide and heptapeptide random elements were subsequently constructed, screened and shown to express more than 90% of expected cytotoxic A chain variants. Finally, more than 9,000 purified SLT-1 A chain variants were screened using their ribosome-inactivating function in a cell-based assay to identify mutants that are able to kill human melanoma 518-A2 cells. This search led to the striking discovery of a single chain RIP that displays selectivity for a panel of human melanoma cell lines as well as minimal immunogenicity when injected repeatedly into mice. This directed evolution of a RIP template provides a broad platform for identifying cell type specific cytotoxic agents.

Microscopic imaging in the biomedical sciences allows for detailed study of the structure and function of normal and abnormal (i.e., diseased) states of cells and tissues. The expression patterns of proteins and/or physiological parameters within these specimens can be related to disease progression and prognosis, and are often heterogeneously spread throughout the entire specimen. With conventional microscopy, a large number of individual image ‘tiles’ must be captured and subsequently combined into a mosaic of the entire specimen. This has the potential to introduce artefacts at the image seams, as well as introducing non-uniform illumination of the entire specimen. A further limitation often encountered in biomedical fluorescence microscopy is the high background due to the autofluorescence (AF) of endogenous compounds within cells and tissues. Often, AF can prevent the detection and/or accurate quantification in fluorescently- labelled tissues and, in general, can reduce the reliability of results obtained from such specimens. AF spectra are relatively broad and so can be present across a large number of image spectral channels. The intensity of AF also increases as the excitation wavelength is decreased, causing increasing amounts of autofluorescence when exciting in the blue and near-UV range of the spectrum (400 - 500 nm). This thesis reports the development of hyperspectral, fluorescence and brightfield imaging of entire, paraffin-embedded, formalin-fixed (PEFF) tissue slides using a prototype confocal scanner with a large field of view (FOV). This technology addresses the challenges of imaging large tissue sections through the use of a telecentric f-theta laser scan lens thus allowing an entire microscope slide (22x70 mm) to be imaged in a single scan at resolution equivalent to a 10x microscope objective. The development and optimization of brightfield and single-channel fluorescence imaging modes are discussed in the first half of this thesis, while the second half and appendices concentrate on the spectral properties of the system and removal of AF from PEFF tissue sections. The hyperspectral imaging mode designed for this system allows the fluorescence emission spectrum of each image pixel to be sampled at 6.7 nm/channel over a spectral range of 500-700 nm. This results in the ability to separate distinct fluorescence signatures from each other, and enables quantification even in situations where the AF completely masks the signal from the applied labels.

Applied cancer research is heavily focused on the development of diagnostic tools with high sensitivity and specificity that are able to accurately detect the presence and anatomical location of neoplastic cells, as well as therapeutic strategies that are effective at curing or controlling the disease while being minimally invasive and having negligible side effects. Recently, much effort has been placed on the development of nanoparticles as diagnostic imaging and therapeutic agents, and several of these nanoplatforms have been successfully adopted in both the research and clinical arenas. This thesis describes the development of a nanoparticulate liposome system for use in a number of applications including multimodality imaging with computed tomography (CT) and magnetic resonance (MR), longitudinal vascular imaging, image-based biodistribution assessment, and CT detection of neoplastic and inflammatory lesions. Extensive in vitro and in vivo characterization was performed to determine the physico-chemical properties of the liposome agent, including its size, morphology, stability and agent loading, as well as its pharmacokinetics, biodistribution, tumor targeting and imaging performance. Emphasis was placed on the in vivo CT-based quantification of liposome accumulation and clearance from healthy and tumor tissues in a VX2 carcinoma rabbit model, gaining insight not only on the spatial but also the temporal biodistribution of the agent. The thesis concludes with a report that describes the performance of liposomes and CT imaging to detect and localize tumor and inflammatory lesions as compared to that of 18F-fluorodeoxyglucose (FDG) – positron emission tomography (PET). The outcome of the study suggests that liposome-CT could be employed as a competitive method for whole body image-based disease detection and localization. Overall, this work demonstrated that this liposome agent along with quantitative imaging systems and analysis tools, has the potential to positively impact cancer treatment outcome through improved diagnosis and staging, as well as enable personalization of treatment delivery via target delineation. However, in order to prove clinical benefit, steps must be taken to advance this agent through the regulatory stages and obtain approval for its use in humans. Ultimately, the clinical adoption of this multifunctional agent may offer improvements for disease detection, spatial delineation and therapy guidance.

The PI3K-PKB/Akt-PTEN signal transduction pathway orchestrates a variety of fundamental cell processes and its deregulation is implicated in several human diseases, including cancer. While the importance of this pathway to many cellular functions is well established, the mechanisms leading to context-specific physiological outcomes in response to a variety of stimuli remain largely unknown. Spatial restriction of signaling events is one of the means to coordinate specific cellular responses. To investigate the subcellular locus-specific roles of the major PI3K effector PKB/Akt in various cell processes, I have devised a novel experimental system employing cellular compartment-directed PKB/Akt pseudosubstrate inhibitors. The work herein describes the development and characterization of the localized PKB/Akt pseudosubstrate inhibitor system and its application to investigate potential locus-specific functions in established PKB/Akt-regulated cellular processes. Subcellular compartment-restricted PKB/Akt inhibition in the 3T3L1 adipocyte differentiation model revealed that nuclear and plasma membrane, but not cytoplasmic, PKB/Akt activity is required for terminal adipocyte differentiation. Nuclear and plasma membrane pools of PKB/Akt were found to contribute to distinct stages of adipocyte differentiation, revealing that PKB/Akt activity impacts multiple points of this program. The localized PKB/Akt pseudosubstrate inhibitor system was also utilized to investigate the importance of distinct subcellular pools of PKB/Akt in breast epithelial cells. MCF-10A human breast epithelial cells can be grown in three-dimensional culture to form acinar structures that recapitulate in vivo mammary glandular architecture. Expression of the plasma membrane PKB/Akt inhibitor during cell growth in three-dimensional culture severely impaired acinar formation. On the other hand, expression of the nuclear PKB/Akt inhibitor during acinar development resulted in the formation of large, misshapen, multi-acinar structures. Assessment of the migratory capacity of MCF-10A cells upon localized PKB/Akt inhibition revealed that nuclear PKB/Akt inhibition promoted, while plasma membrane PKB/Akt inhibition impaired, MCF-10A cell migration. The development of locus-specific PKB/Akt inhibitors represents the first attempt to prioritize the targets of this kinase based on their subcellular localization. This work and its immediate extensions will further our understanding of the biology of PKB/Akt, a multi-tasking kinase with profound roles in development, cellular and organismal homeostasis and disease.

The clinical management of glioma remains a challenge. The prognosis is poor—for glioblastoma multiforme, the most virulent of these brain cancers, survival is only ~1 year. Surgical resection of the tumor is the first line of defense. Several studies demonstrate a survival advantage in patients who undergo near-complete tumor resection; however, achieving complete resection is limited by the difficulty of visualizing residual tumor after de-bulking. Intraoperative fluorescence guidance is a promising candidate to better visualize residual tumor. The most clinically developed form uses protoporphyrin IX fluorescence, the precursor to heme in its biosynthesis which preferentially accumulates in tumor cells after the administration of 5-aminolevulinic acid. Challenges remain in quantitatively assessing the fluorescence to reduce variability of outcome and improve tumor detection specificity, and in observing sub-surface tumor fluorescence. To these ends, this work outlines the development of intraoperative techniques to 1) quantify tissue fluorescence using a handheld fiberoptic probe and 2) improve detection by reconstructing the depth-resolved fluorescence topography of sub-surface tumor. As a critical component to achieve these objectives, a technique to measure the tissue optical properties was developed. This technique used diffuse reflectance measurements mediated by a handheld fiberoptic probe to derive the tissue optical properties. The handheld fiberoptic probe was further developed to include fluorescence spectroscopy. A novel algorithm to combine the fluorescence measurement and the tissue optical properties was derived in order to extract the quantitative fluorescence spectrum, i.e. fluorescence without confounding effects of tissue optical properties. The concentration of fluorescent tumor biomarker can then be extracted. The quantitative fluorescence work culminated in deployment of the fiberoptic probe in clinical trials for the resection of intracranial tumors. The quantitative fluorescence probe out-performed a state-of-the-art fluorescence surgical microscope for a broad range of brain tumor pathologies. A novel technique for depth-resolved fluorescence detection was developed utilizing multi-excitation fluorescence imaging. An algorithm to extract depth information from the multi-excitation images was derived, with validation in phantoms and a rat brain tumor model. This demonstrates the potential for depth-resolved fluorescence imaging, which there is a clear need for in tumor resection guidance.

Prostate cancer is the most prevalent cancer and the third-leading cause of cancer-related death among men in the developed world, with the number of cases expected to double within the next 15 years. Conventional therapies offer good control of local disease but are associated with high complication rates reducing long-term health-related quality-of-life significantly. MRI-guided transurethral ultrasound therapy has emerged as an attractive, minimally-invasive alternative for the treatment of localized prostate cancer, where the entire gland is heated to temperatures sufficient to cause irreversible thermal coagulation. A device inserted in the urethra uses multiple ultrasound transducers to produce directional heating patterns directly in the prostate. Adjusting the ultrasound power, frequency and device rotation rate enables high spatial control of the thermal lesion. MRI provides information essential to the accurate targeting of the prostate; anatomical images for device positioning and treatment planning, and quantitative temperature measurements within the prostate to compensate for dynamic tissue changes, using feedback control. This thesis develops a complete treatment delivery strategy for producing conformal regions of thermal coagulation shaped to whole-gland prostate volumes, while limiting the thermal impact to the surrounding important anatomy. First, acoustic and thermal simulations incorporating a novel temperature feedback controller were used to model and shape regions of coagulation to human prostate geometries with a high degree of accuracy. Second, treatment delivery strategies were developed and simulated to reduce thermal injury to the surrounding anatomy, below the threshold for sustained damage. Third, experiments in tissue-mimicking gel phantoms confirmed the predictive accuracy of the simulations and the feasibility of producing conformal volumes of coagulation using transurethral ultrasound devices and MRI-temperature feedback. This work forms the basis of clinical treatment delivery methods and supports the use of the simulations as a planning tool to enhance the inherent compromise between safety and efficacy on a patient-specific basis.

Focused ultrasound (FUS) can temporarily increase blood-brain barrier (BBB) permeability and locally deliver therapeutic agents to the brain. To date, applications of FUS for treatment of Alzheimer’s disease (AD) have not been explored. Here, I propose that FUS can facilitate a rapid reduction in amyloid-β peptide (Aβ) pathology in a mouse model of AD. Firstly, FUS was used to enhance delivery of an antibody directed against Aβ, which aggregates and forms extracellular plaques. FUS mediated the delivery of antibodies to the targeted right cortex by 4 hours post-treatment and antibodies remained bound to Aβ plaques for 4 days. At 4 days post-treatment, stereological quantification of plaque burden demonstrated a significant reduction of 23%. Secondly, FUS treatment alone resulted in a significant reduction in plaque load (13%). I then investigated effects of FUS that may contribute to Aβ plaque reduction, specifically the delivery of endogenous antibodies to the brain and, activation of microglia and astrocytes. Endogenous immunoglobulin was found bound to plaques within the treated cortex at 4 days post-FUS. Western blot analysis confirmed that immunoglobulin levels were increased significantly. Further, FUS led to a time-dependent increase in glial response. The expression of ionized calcium-binding adaptor molecule 1, a marker of phagocytic microglia, was increased at 4 hours and 4 days, and it was resolved by 15 days. Astrocytes had a slightly delayed response, with an increase in the expression of glial fibrillary acidic protein at 4 days, which declined by 15 days. After 4 days, microglia and astrocytes had significantly greater volumes and surface areas, signifying enhanced activation in the FUS-treated cortex, without an apparent increase in cell count. Co-localization of Aβ within activated glia revealed a significant increase in Aβ internalization following FUS. In conclusion, it was demonstrated that the delivery of exogenous antibodies by FUS, and FUS alone can lead to plaque reduction. Mechanisms by which FUS alone reduces plaque load may include entry of endogenous antibodies to the brain and the induction of a transient glial response. This work details acute effects of FUS that highlight the promise of this delivery method for AD treatment.

The goal of radiotherapy is to operate within the therapeutic window - delivering doses of ionizing radiation to achieve locoregional tumour control, while minimizing normal tissue toxicity. A greater therapeutic ratio can be achieved by utilizing radiosensitizing agents designed to enhance the effects of radiation at the tumour. Gold nanoparticles (AuNP) represent a novel radiosensitizer with unique and attractive properties. AuNPs enhance local photon interactions, thereby converting photons into localized damaging electrons. Experimental reports of AuNP radiosensitization reveal this enhancement effect to be highly sensitive to irradiation source energy, cell line, and AuNP size, concentration and intracellular localization. This thesis explored the physics and some of the underlying mechanisms behind AuNP radiosensitization. A Monte Carlo simulation approach was developed to investigate the enhanced photoelectric absorption within AuNPs, and to characterize the escaping energy and range of the photoelectric products. Simulations revealed a 10^3 fold increase in the rate of photoelectric absorption using low-energy brachytherapy sources compared to megavolt sources. For low-energy sources, AuNPs released electrons with ranges of only a few microns in the surrounding tissue. For higher energy sources, longer ranged photoelectric products travelled orders of magnitude farther. A novel radiobiological model called the AuNP radiosensitization predictive (ARP) model was developed based on the unique nanoscale energy deposition pattern around AuNPs. The ARP model incorporated detailed Monte Carlo simulations with experimentally determined parameters to predict AuNP radiosensitization. This model compared well to in vitro experiments involving two cancer cell lines (PC-3 and SK-BR-3), two AuNP sizes (5 and 30 nm) and two source energies (100 and 300 kVp). The ARP model was then used to explore the effects of AuNP intracellular localization using 1.9 and 100 nm AuNPs, and 100 and 300 kVp source energies. The impact of AuNP localization was most significant for low-energy sources. At equal mass concentrations, AuNP size did not impact radiosensitization unless the AuNPs were localized in the nucleus. This novel predictive model of AuNP radiosensitization could help define the optimal use of AuNPs in potential clinical strategies by determining therapeutic AuNP concentrations, and recommending when active approaches to cellular accumulation are most beneficial.

A number of interventional procedures such as cardiac catheterization, angiography and the deployment of endovascular devices are routinely performed using x-ray fluoroscopy. To minimize the patient’s exposure to ionizing radiation, each fluoroscopic image is acquired using a very low x-ray exposure (~ 1 uR at the detector). At such an exposure, most semiconductor-based digital flat panel detectors (FPD) are not x-ray quantum noise limited (QNL) due to the presence of electronic noise which substantially degrades their imaging performance. The goal of this thesis was to investigate how a FPD based on amorphous selenium (a-Se) with internal avalanche multiplication gain could be used for QNL fluoroscopic imaging at the lowest clinical exposures while satisfying all of the requirements of a FPD for interventional radiology. Towards this end, it was first determined whether a-Se can reliably provide avalanche multiplication gain in the solid-state. An experimental method was developed which enabled the application of sufficiently large electric field strengths across the a-Se. This method resulted in avalanche gains as high as 10000 at an applied field of 105 V/um using optical excitation. This was the first time such high avalanche gains have been reported in a solid-state detector based on an amorphous material. Secondly, it was investigated how the solid-state a-Se avalanche detector could be used to image X-rays at diagnostic radiographic energies (~ 75 kVp). A dual-layered direct-conversion FPD architecture was proposed. It consisted of an x-ray drift region and a charge avalanche multiplication region and was found to eliminate depth-dependent gain fluctuation noise. It was shown that electric field strength non-uniformities in the a-Se do not degrade the detective quantum efficiency (DQE). Lastly, it was determined whether the solid-state a-Se avalanche detector satisfies all of the requirements of interventional radiology. Experimental results have shown that the total noise produced by the detector is negligible and that QNL operation at the lowest fluoroscopic exposures is indeed possible without any adverse effects occurring at much larger radiographic exposures. In conclusion, no fundamental obstacles were found preventing the use of avalanche a-Se in next-generation solid-state QNL FPDs for use in interventional radiology.

This thesis presents the first work, to our knowledge, to evaluate the potential of Optical Coherence Tomography (OCT) as an intravascular imaging modality to characterize and guide interventions on chronic total occlusions (CTOs) in arteries. An ex vivo imaging study using OCT is presented that characterizes various pathologies associated with peripheral CTOs and illustrates the ability to differentiate between the vessel wall and the occluded lumen. We also found that, while OCT could image approximately 1mm through tissue, it was effective for imaging deeper through clarified microchannels seen within the occluded lumen. While others had reported observing such microchannels within the lumen before, little was known about the global architecture of these channels. This motivated a study of the global morphology of microchannels in occlusions using micro computed tomography (microCT). In this microCT study, we found that microchannels within the occluded lumen of the artery appeared to be continuous over several millimeters. However, these channels also exited the artery frequently, suggesting the need for some form of imaging guidance. As a potential intravascular imaging set-up, a forward-viewing OCT catheter was built. This catheter uses a novel scanning mechanism that combines high voltage and a dissipative polymer to achieve fast compact actuation. Doppler OCT results are presented using this catheter to image flow in the forward direction. Doppler OCT imaging of microchannels in vivo is also shown in a surgically exposed occluded artery in situ.