A novel, lipid-based platform nanotechnology has been designed to overcome limitations of in vivo fluorescent imaging, multidrug resistance (MDR) phenotypes hindering breast cancer chemotherapy, and shortcomings of magnetic resonance imaging (MRI) thermometry. Using this platform, three nanoparticle systems have been developed: QD-SLN (quantum dot-loaded solid lipid nanoparticles), DMsPLN (doxorubicin and mitomycin C co-loaded polymer-lipid hybrid nanoparticles), and HLN (hydrogel-lipid hybrid nanoparticles). Stealth, near-infrared emitting QD-SLN were developed for deep tissue fluorescence imaging, which were capable of extending the depth of penetration beyond 2 cm, with near complete probe clearance and good tolerability in vivo. The QD-SLN was used to evaluate the biodistribution of non-targeted SLN and actively targeted RGD-conjugated SLN. Non-targeted SLN accumulated in breast tumors and evaded liver uptake. The RGD-SLN showed prolonged retention in breast tumor neovasculature at the cost of lesser tumor accumulation due to enhanced liver uptake. With this information, a long circulating, non-targeted DMsPLN with a synergistic cancer chemotherapeutic combination of doxorubicin and mitomycin C was formulated to overcome MDR, enhancing breast cancer chemotherapy. Extensive tumor cell uptake and perinuclear trafficking of DMsPLN overcame the MDR phenotype of breast tumor cells in vitro. The DMsPLN provided the most efficacious chemotherapy reported in literature against aggressive mouse mammary tumors in vivo with significant reduction in whole animal and cardiotoxicity as compared to clinically applied liposomal doxorubicin. In establishing our tumor models, the impact of Matrigel™ on the tumor microenvironment was investigated, demonstrating altered tumor vascular and lymphatic anatomy and physiology, and significantly impacting nanomedicines assessment in mouse models of cancer. In all in vivo studies, tumors were established without use of Matrigel™. To guide thermotherapy of solid tumors, a novel HLN was formulated for use in MRI thermometry, presenting the first contrast agent capable of indicating a tunable, absolute two-point temperature window. In using specific limitations of therapeutic and imaging modalities to inform rational nanoparticle design, this lipid-based platform nanotechnology has extended the application of fluorescence imaging in vivo, enhanced the utility of nanoparticulate chemotherapeutics against breast cancer independent of MDR status, and provided novel functionality for MRI thermometry.

A novel, lipid-based platform nanotechnology has been designed to overcome limitations of in vivo fluorescent imaging, multidrug resistance (MDR) phenotypes hindering breast cancer chemotherapy, and shortcomings of magnetic resonance imaging (MRI) thermometry. Using this platform, three nanoparticle systems have been developed: QD-SLN (quantum dot-loaded solid lipid nanoparticles), DMsPLN (doxorubicin and mitomycin C co-loaded polymer-lipid hybrid nanoparticles), and HLN (hydrogel-lipid hybrid nanoparticles). Stealth, near-infrared emitting QD-SLN were developed for deep tissue fluorescence imaging, which were capable of extending the depth of penetration beyond 2 cm, with near complete probe clearance and good tolerability in vivo. The QD-SLN was used to evaluate the biodistribution of non-targeted SLN and actively targeted RGD-conjugated SLN. Non-targeted SLN accumulated in breast tumors and evaded liver uptake. The RGD-SLN showed prolonged retention in breast tumor neovasculature at the cost of lesser tumor accumulation due to enhanced liver uptake. With this information, a long circulating, non-targeted DMsPLN with a synergistic cancer chemotherapeutic combination of doxorubicin and mitomycin C was formulated to overcome MDR, enhancing breast cancer chemotherapy. Extensive tumor cell uptake and perinuclear trafficking of DMsPLN overcame the MDR phenotype of breast tumor cells in vitro. The DMsPLN provided the most efficacious chemotherapy reported in literature against aggressive mouse mammary tumors in vivo with significant reduction in whole animal and cardiotoxicity as compared to clinically applied liposomal doxorubicin. In establishing our tumor models, the impact of Matrigel™ on the tumor microenvironment was investigated, demonstrating altered tumor vascular and lymphatic anatomy and physiology, and significantly impacting nanomedicines assessment in mouse models of cancer. In all in vivo studies, tumors were established without use of Matrigel™. To guide thermotherapy of solid tumors, a novel HLN was formulated for use in MRI thermometry, presenting the first contrast agent capable of indicating a tunable, absolute two-point temperature window. In using specific limitations of therapeutic and imaging modalities to inform rational nanoparticle design, this lipid-based platform nanotechnology has extended the application of fluorescence imaging in vivo, enhanced the utility of nanoparticulate chemotherapeutics against breast cancer independent of MDR status, and provided novel functionality for MRI thermometry.

High intensity focused ultrasound (HIFU) provides a wide range of noninvasive therapies ranging from drug delivery to the destruction of kidney stones. In particular, thermal ablation by HIFU presents an effective noninvasive method for the treatment of deep seated solid tumours. HIFU’s further uptake is limited by a need for improved treatment planning and monitoring. Two nonlinear acoustic phenomena that play key roles in HIFU treatment: finite amplitude effects that lead to the generation of harmonics and steepening of wavefronts, and acoustic cavitation. The former must be taken into careful consideration for treatment planning purposes, while the latter has the potential to provide fast, real-time, cost effective treatment monitoring. The first half of this thesis provides new measurements for the nonlinear acoustic properties of tissue, assesses the validity of two common modelling techniques for simulating HIFU fields. The second half develops a new method for combining passive acoustic mapping- an ultrasound monitoring technique- with MR thermometry, to assess estimates of cavitation enhanced heating derived from passive acoustic maps. In the first results chapter B/A was measured in ex-vivo bovine liver, over a heating/ cooling cycle replicating temperatures reached during HIFU ablation, adapting a finite amplitude insertion technique (FAIS), which also allowed for measurement of sound-speed and attenuation. The method measures the nonlinear progression of a plane-wave through liver and B/A was chosen so that numerical simulations matched measured waveforms. Results showed that attenuation initially decreased with heating then increased after denaturation, sound-speed initially increased with temperature and then decreased, and B/A showed an increase with temperature but no significant post-heating change. These data disagree with other reports that show a significant change and suggest that any nonlinear enhancement in the received ultrasound signal post-treatment is likely due to acoustic cavitation rather than changes in tissue nonlinearity. In the second results chapter two common methods of modelling HIFU fields were compared with hydrophone measurements of nonlinear HIFU fields at a range of frequencies and pressures. The two methods usedwere the KZK equation and the commercial package PZFlex. The KZK equation has become the standard method for modelling focused fields, while the validity of PZFlex for modelling these types of transducers is unclear. The results show that the KZK equation is able to match hydrophone measurements, but that PZFlex underestimates the magnitude of the harmonics. Higher order harmonics in PZFlex are not the correct shape, and do not peak around the focus. PZFlex performs worse at higher pressures and frequencies, and should be used with caution. In the final two chapters a system for estimating cavitation-enhanced heating from acoustic maps is developed and benchmarked against magnetic resonance thermometry methods. The first chapter shows that the ultrasound and MR monitoring systems are compatible, and registers the two imaging systems. The HIFUfocus is clearly visible in passive maps acquired in the absence of cavitation and these coincide with the centre of heating in MR temperature images. When cavitation occurs, it coincides spatially and temporally with the appearance of a clear spike in temperature, especially when the passive maps are processed using the Robust Capon Beamformer algorithm. The final chapter shows how passive maps can be converted into thermal heating inputs, and used to estimate cavitation-enhanced temperature increases. These estimates have the potential to closely match maximum temperature rise, and estimated thermal dose after the estimated temperature rise is spatially averaged. However, themethod is not always successful. This is partly due to uncertainties in MR thermometry estimates, partly due to uncertainties in the acoustic properties of tissue.

<p>Numerous studies have shown that the combination of radiation therapy and hyperthermia, when delivered at moderate temperatures (40°-45°C) for sustained times (30-90 minutes), can help to provide palliative relief and augment tumor response, local control, and survival. However, the dependence of treatment success on achieved temperature highlights the need for accurate thermal dosimetry, so that the prescribed thermal dose can be delivered to the tumor. This can be achieved noninvasively with MR thermometry. However, there are many challenges to performing MR thermometry in the breast, where hyperthermia of locally advanced breast cancer can provide a benefit. These include magnetic field system drift, fatty tissue, and breathing motion.</p> <p>The purpose of this research was to develop a system for the hyperthermia treatment of LABC while performing MR thermometry. A hardware system was developed for performing the hyperthermia treatment within the MR bore. Methods were developed to correct for magnetic field system drift and to correct for breath hold artifacts in MR thermometry of the tumor using measurement of field changes in fat references. Lastly, techniques were developed for measuring temperature in the fatty tissue using multi-echo fat water separation methods, reducing the error of performing MR thermometry in such tissues. All of these methods were characterized with phantom and in vivo experiments in a 1.5T MR system. </p> <p>The results of this research can provide the means for successful hyperthermia treatment of LABC with MR thermometry. With this thermometry, accurate thermal doses can be obtained, potentially providing improved outcomes. However, these results are not only applicable in the breast, but can also be used for improved MR thermometry in other areas of the body, such as the extremities or abdomen.</p> / Dissertation

This thesis presents technical and methodological developments aiming tooffer a viable alternative for the treatment of digestive cancers (rectum and esophagus). Compared to the standard methods of therapy, the high intensity contact ultrasound guided by MRI is a less invasive approach. MRI offers 2 advantages: good spatial resolution, and real-time temperature control. This treatment method requires efficacy and safety. Three prototypes of RF coil integrated with ultrasound transducers were built in order to increase the spatial and temporal resolution ofthe MR images, and the accuracy of the temperature measurement. The integrated coils showed a better sensitivity compared to a standard extracorporeal coil. Anatomical (voxel 0.4x0.4x5 mm3)and thermometry (voxel 0.75x0.75x8 mm3, 2s/image) high resolution MR images were acquired in-vivo. The temperature was measured, within a radius of 20 mm from the balloon, with a standard deviation <1°C. The flow artifacts caused by the water circulating inside the cooling balloon could be shifted out of the region of interest. The temperature evolution was controlled automatically, at different depths, with one control point per beam. The controller showed a good accuracy during in-vivo experiments (standard deviation less than 5%). The phased-arrayultra sound transducer permits the successive activation of multiple beams during the same dynamic of sonication. Simulations were conducted in order to offer an optimal treatment planning for a defined tumor. A new design of ultrasound transducer with 256 elements with revolution symmetry, based on a natural geometrical focalization, was proposed.

Cette thèse présente des développements techniques et méthodologiques visant une alternative viable pour le traitement des cancers digestifs (rectum, œsophage). Par rapport aux méthodes standards de thérapie, les ultrasons de contact de haute intensité sous guidage IRM sont une approche moins invasive. L’IRM offre 2 avantages: bonne résolution spatiale et contrôle en temps réel de la température. Cette méthode de traitement demande efficacité et sécurité. Trois prototypes d’antenne RF intégrées à des transducteurs ultrasonores ont été réalisés afin d’améliorer la résolution spatiale et temporelle des images IRM et la précision de la mesure de température. Les antennes intégrées ont montré une meilleure sensibilité par rapport à une antenne extra corporelle standard. Des images IRM haute résolution, anatomiques (voxel0.4x0.4x5 mm3) et de thermométrie (voxel 0.75x0.75x8 mm3, 2s/image) ont été acquises in-vivo.La température a été mesurée, dans un rayon de 20 mm au-delà du ballon, avec un écart type<1°C. Les artéfacts de flux causés par l’eau circulante à l’intérieur du ballon de refroidissement ont pu être projetés hors de la région d’intérêt. L’évolution de la température a été contrôlée automatiquement, à des profondeurs variables, avec un point de contrôle par faisceau. Le contrôleur a montré une grande précision in-vivo (écart type <5%). Le transducteur ultrasonore matriciel permet d’activer successivement plusieurs faisceaux pendant la même dynamique de tir.Des simulations ont été conduites afin de proposer une planification du traitement optimale pour une tumeur désignée. Un nouveau concept de sonde ultrasonore à 256 éléments avec focalisation géométrique naturelle a été proposé. / This thesis presents technical and methodological developments aiming tooffer a viable alternative for the treatment of digestive cancers (rectum and esophagus). Compared to the standard methods of therapy, the high intensity contact ultrasound guided by MRI is a less invasive approach. MRI offers 2 advantages: good spatial resolution, and real-time temperature control. This treatment method requires efficacy and safety. Three prototypes of RF coil integrated with ultrasound transducers were built in order to increase the spatial and temporal resolution ofthe MR images, and the accuracy of the temperature measurement. The integrated coils showed a better sensitivity compared to a standard extracorporeal coil. Anatomical (voxel 0.4x0.4x5 mm3)and thermometry (voxel 0.75x0.75x8 mm3, 2s/image) high resolution MR images were acquired in-vivo. The temperature was measured, within a radius of 20 mm from the balloon, with a standard deviation <1°C. The flow artifacts caused by the water circulating inside the cooling balloon could be shifted out of the region of interest. The temperature evolution was controlled automatically, at different depths, with one control point per beam. The controller showed a good accuracy during in-vivo experiments (standard deviation less than 5%). The phased-arrayultra sound transducer permits the successive activation of multiple beams during the same dynamic of sonication. Simulations were conducted in order to offer an optimal treatment planning for a defined tumor. A new design of ultrasound transducer with 256 elements with revolution symmetry, based on a natural geometrical focalization, was proposed.