JP5889337B2 - Mriマーカー、送達および抜取りシステムならびにこれらの製造方法および使用方法 - Google Patents
Mriマーカー、送達および抜取りシステムならびにこれらの製造方法および使用方法 Download PDFInfo
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- JP5889337B2 JP5889337B2 JP2013550638A JP2013550638A JP5889337B2 JP 5889337 B2 JP5889337 B2 JP 5889337B2 JP 2013550638 A JP2013550638 A JP 2013550638A JP 2013550638 A JP2013550638 A JP 2013550638A JP 5889337 B2 JP5889337 B2 JP 5889337B2
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Description
この出願は、2011年1月20日に出願された米国仮特許出願第61/434,719号の35U.S.C 119条に基づく利益を主張し、この内容全体は、参照により本明細書に組み込まれる。
該当なし
該当なし
式(I)中、nは、1または2の整数であり、および/または、水中での塩化コバルトの濃度は、約0.1重量%から約10重量%の範囲であり、水中でのNACの濃度は、約0.1重量%から約20重量%の範囲である。本開示の更なる態様において、造影剤は、水溶性である。
下記の定義は、当業者が、本発明の詳細な説明を理解するのを補助するために提供される。単位、接頭語および記号は、SIで認められる種類を意味してもよい。特に断らない限り、核酸は、左から右に、5’から3’の方向に記載し、アミノ酸配列は、左から右に、アミノからカルボキシ方向にそれぞれ記載する。数値範囲は、範囲を規定する数値を含み、規定された範囲内の各整数を含む。本明細書において、アミノ酸は、一般に既知の3文字表記(例えば、プロリンについて、Pro)または、IUPAC−IUB Biochemical Nomenclature Commissionにより推奨される1文字表記のいずれかにより、表されてもよい。同様に、核酸は、一般に受け入れられている1文字コードにより表されてもよい。以下に規定される用語は、明細書での言及により、総じてより十分に規定される。
前述の図面ならびに、後述の具体的な構造および機能の明細書は、出願人が発明したものの範囲、または、添付の特許請求の範囲の範囲を限定するものではない。むしろ、図面および明細書は、特許保護されようとしている発明を、当業者が製作および使用するための教示を提供する。当業者は、明確性および理解の目的において、本発明の商業的実施例の全ての特徴が記載されておらず、示されていないことを理解するであろう。当業者は、商業的実施例についての開発者の最終目的を達成するには、本発明の態様を包含する実際の商業的実施例について、多くの具体的な決定を実行する必要があるであろうことも理解するであろう。このような具体的な決定の実行は、限定されないが、システムへの準拠に関する制約、ビジネスに関する制約、関係官庁に関する制約および他の制約を含み得る。前記制約は、具体的な実行、場所により、この時々に変化し得る。開発者の試みは、複雑で、絶対的な感覚で多大な時間を必要としたであろう一方、これにもかかわらずこのような試みは、この開示の利益を有する当業者における所定の仕事である。本明細書に開示され、教示される発明は、多くの種々の修飾および他の形態に影響を受けやすいことを理解されたい。最後に、これに限定されないが、単数形の用語である「a」等の使用は、項目数を限定することを意図していない。これに限定されないが、関係語である「上端(top)」、「底面(bottom)」、「左(left)」、「右(right)」、「上方の(upper)」、「下方の(lower)」、「下に(down)」、「上に(up)」、「側に(side)」等は、図面における具体的な関係性を明確にするために、明細書において使用され、本発明の範囲または添付の特許請求の範囲の範囲を限定することを意図していない。
A.組成物
MRIは、超音波およびCTスキャン(コンピュータ断層撮影、「CATスキャン」とも言う)より、前立腺ならびに、直腸、尿道および神経血管構造等の周囲の重要な臓器の描写に優れている。しかしながら、ニードルトラック、スペーサおよびシード(特にチタンシード)が、ネガティブコントラスト画像として表れるため、今まで、MRIでの使用において、個々の治療シードおよび他の医療用具を、見つけ出し、および/または、特定するのが困難である。例えば、Frank,S.J.,et al.,「A Novel MRI Marker For Prostate Brachytherapy」,International Journal of Radiation Oncology Biology Physics,2008,71(1):5‐8を参照のこと。
図3および4に、本開示の他の実施形態を示す。同図は、造影剤20がケーシング15内に配置された構成のマーカーを示す。マーカー10’は、さらに、1つ以上の個々の治療シードまたは診断化合物30を含む。図3に示されるマーカー配置において、造影剤20間の中間に位置する個々の治療シードまたは診断化合物30により、造影剤20は、マーカー10’の両端に間隔を空けて位置する。シード30および造影剤20は、スペーサにより間隔を空けられる。好ましくは、前記スペーサは、マーカーケーシング15と同様の材料で製造される。同図においてさらに示されるように、マーカー10’の両端には、マーカーケーシング15と同種(例えば、生分解性または非生分解性)の典型的な材料製のポリマー栓17がある。ポリマー栓17により、記載の配置でマーカーを製造でき、本明細書でさらに記載されるであろうように、最初にマーカーが形成された後、造影剤20用の区画が、所望の造影剤(例えば、CoCl2−NAC)で満たされ、ついで、造影剤区画の開口内にポリマー栓17を挿入することにより、末端が密封される。図4に、他の配置を示す。同図において、マーカー10’は、ケーシング15内に含まれ、スペーサにより区切られた、1つの個々の治療シード30および1つの造影剤20を含む。本開示のこの実施形態において、マーカー10’は、1つのポリマー栓17のみを使用して、マーカーケーシング内のこの区画内に造影剤20を保持する。図3および図4の両図において、マーカーの寸法としては、例えば、治療シード30が長さ約4.5mでもよく、マーカーの直径が約0.3mmから約1mmの範囲でもよく、マーカー10’の全長が約10から約15mmの範囲でもよく、ケーシング壁厚が約0.1mm等を示す。例えば、図4において、封入された造影剤マーカー10’は、限定されないが、ポリカーボネート、PMMAまたはPEEKの押出ミクロチュービング(外径(θ)=0.8から1.0mm、内径=0.6から0.8mm)製でもよい。後者は、材料分散を防止する優れた能力を有し、必要に応じて、以下でさらに詳細に記載するのと同様の生分解性(例えば、グリコリド/L−ラクチド)または非生分解性材料を有する。ミクロチュービングを、所望の長さ(ここでは、l=10mm)に切断して、端部を形成する。外径が約0.6mmの治療シード30を、チュービング内を通過させ、チュービング材料スペーサを挿入し、ついで、高圧ステンレス鋼シリンジまたは同等物を使用して、造影剤(例えば、CoCl2−NAC)をチューブ内に注入する。ついで、小型のポリマープラグである栓17を、チューブ10’の開口端に留め、造影剤の少しの漏えいをも防止するために、局所加熱によりこの箇所に固定する。ついで、マーカー10’を、局所的な前立腺ガンの処置用、または、本明細書に記載の他の用途の一時的なインプラントまたは恒久的なインプラントとして、使用してもよい。
図5および図6に、本開示の更なる態様を示す。同図に、本開示に基づく造影剤20と、1つ以上の治療剤/薬剤40とを組み合わせて含むマーカー10’’を概ね示す。前述のように、両者は、生分解性または非生分解性のケーシング15内に含まれる。図5に示すように、マーカー10’’は、造影剤20および治療剤40を、ケーシング15内に互いに隣接して、スペーサにより区切られて含んでもよい。本開示のこの実施形態において、マーカー10’’は、1つのポリマー栓17のみを使用して、マーカーケーシング15内のこの区画内に造影剤20を保持する。図6において、他の配置を示す。マーカー10’’は、スペーサにより造影剤20と治療剤40とがそれぞれ区切られた状態で、ケーシング15内に含まれる造影剤20のいずれかの側の、1つの個々の造影剤20と、1つの治療剤40とを含む。本開示のこの実施形態において、マーカーケーシング内の造影剤20の区画内に造影剤20を保持するために、マーカー10’’は、マーカー10’’の長手方向の両端に、ポリマー栓17のみを使用する。
1.ホルモン治療(アンドロゲン受容体遮断薬)
上記で示唆したように、本開示のマーカー10は、ケーシング15内に造影剤20だけでなく、1つ以上の薬剤も含んでもよい。本明細書に記載のマーカーおよび組成物で使用するのに適したこのような薬剤は、ホルモン治療薬を含み、前立腺ガンの処置に重要な役割を果たすため、特にアンドロゲン受容体遮断薬を含む。
本開示の造影剤は、制御因子と共に含まれてもよい。前記制御因子は、1つ以上のウイルスに対する中和抗体を阻害する因子である。
本明細書に示すように、本発明の造影剤20は、単独または、お互いおよび/もしくは各種の疾患の処置に有用な他の適切な治療剤40との組み合わせで使用されてもよい。本開示の一態様に基づいて、治療剤40は、化学療法剤、抗ガン剤および細胞毒性剤を含む。
本明細書に記載の造影剤と組み合わせて使用され得る薬剤の他の分類としては、前立腺特異的抗原(PSA)活性化生物毒素があげられる。本開示の造影剤およびマーカーと共に使用するのに適したPSA活性化生物毒素としては、限定されないが、例えば、プロアエロリシン(PA)ならびに、PSA活性化ドキソルビシンプロドラッグ(例えば、PSA特異的ペプチド担体に結合したドキソルビシン(Dox)からなるプロドラッグ)またはPSA活性化ビンブラスチンプロドラッグ等の細胞毒性薬のプロドラッグがあげられる。
電離放射線を使用する腫瘍の処置は、腫瘍細胞の放射線感受性を向上させることにより、向上され得る。放射線感受性を向上させるために提案された一手法は、電子に高い親和性を有する化合物を、外部から投与することである。前記化合物は、理想的に腫瘍に集中する。本明細書で使用するのに適した提案の放射性増感剤としては、ハロゲン化ピリミジン、ニトロイミダゾールおよび、五座大環テキサフィリンのガドリニウム(III)錯体、現在、脳転移ガンの処置用の第III相臨床試験中であるモテキサフィンガドリニウム(MGd、ガドリニウム(III)テキサフィリン錯体)(モテキサフィンガドリニウムは、PCI−0120、XCYTRIN(登録商標)、MGdまたはGdTexと呼ばれることがある。)、ならびに、関連するルテニウム(III)同族体(PCI−0123、LUTRIN(登録商標)、LuTex)等の化合物があげられる。
本開示の更なる態様に基づいて、本開示に基づくMRIマーカーは、他の映像診断法用の多機能マーカーを含んでもよい。図7に模式的に示し得るように、マーカー10’’’は、生分解性または非生分解性ケーシングまたはカプセル15内に、MRI造影剤20と、CTマーカー60または同様の診断マーカーとを含んでもよい。本開示のこの実施形態において、マーカー10’’’は、1つのポリマー栓17のみを使用して、マーカーケーシング15内のCTマーカー60の区画に、CTマーカー60を保持する。本開示のこの態様に基づいて、CTマーカー60は、CT(コンピュータ断層撮影法)スキャナにより画像を形成可能なマーカーである。造影剤マーカー20は、適切な磁気共鳴システムまたは放射性映像システムにより画像を形成可能である。CTマーカーの成分は、MRI剤用の担体としても作用する。セラミックまたは酸化ジルコニウム(ZrO2)等の、固形で多孔質のCTで識別可能な材料が使用され得るためである。この態様に基づいて、MRI剤の溶液は、多孔質のCTで識別可能な材料/CTマーカーが有する多孔質の空洞内に吸収されてもよい。続いて、多孔質のCTで識別可能な材料/CTマーカーは、生体適合性のケーシングまたはハウジング内に含まれてもよい。同図には示されないが、マーカー10’’’は、ケーシング15内に、1つ以上の更なる薬剤をも含み得ることが想定される。更なる薬剤は、必要に応じてポリマー性のスペーサにより区画される。前記薬剤も、ポジトロン放出断層撮影法(PET)、単一光子放出型コンピュータ断層撮影法(SPECT)および蛍光映像法を含む、各種画像化技術の全ての様式により、画像を形成可能である。なお、蛍光透視法および超音波等の旧来の標準的な画像化技術は、CTマーカー60と共に使用することが検討されてもよい。本開示に基づいて、MRI/CT、MRI/PET、MRI/SPECT等の混成された画像化の取り組みは、「多診断映像法」と呼ばれる。この混成された取り組みは、同じ造影剤(または、本件ではマーカー)により、異なる画像化プラットフォームで異なるスケールで、同じ標的を調査できるため有用である。限定しない例示の目的で、PET/MRI造影マーカーシステム10’’’において、高感度なPETを使用して、対象の身体内における、標的となるPET/MRI剤の当該吸収領域を決定する。ついで、この同じ薬剤の高分解能MR映像法により、本開示の造影剤に焦点を合わせる。PETシグナルが観察された場合、局部集中された領域においてのみ、MR画像を取得する。
本明細書に記載のマーカー10−10’’’、特に生分解性ポリマーミクロキャピラリーチューブ等のポリマー封入体15内に含まれる、特に本開示に基づく少なくとも1つの造影剤20を含むものを、手動の製造過程または自動の製造過程、ならびに、手動の製造過程および自動の製造過程の両方を含む製造工程を使用して製造してもよい。
本開示の一態様に基づいて、生分解性ポリマー部材等のポリマー封入部材内に含まれる本発明のマーカーを、手動の製造過程を使用して製造し得る。この過程における段階について、図8のフロー図に概要を説明し、図9から12に全体を示す。これらの図は、互いに組み合わせて記載される。
本明細書に記載のマーカー、特に、生分解性ポリマーミクロキャピラリーチューブ等のポリマー封入体20内のマーカーを、自動化された過程またはシステムを使用して製造してもよい。図13に、典型的な高生産性自動化造影剤分注製造システム200の斜視図を示す。図14に、自動化された分注製造過程に使用する、典型的なテンプレートの平面図を示す。図15に、図14のテンプレートのA−A線に沿った断面図を示す。これらの図は、互いに関連して検討される。
本開示の更なる態様に基づいて、上記段階に基づいて製造されたマーカー用の包装を準備してもよい。包装を、滅菌し得る。包装の滅菌は、上記製造過程ついての追加段階でもよい。滅菌は、エチレンオキサイド、γ線照射、電子ビーム、過酸化水素、蒸気または他の既知の滅菌法およびこれらの組み合わせの使用によるものでもよい。
1)材料が、好ましくは(必ずしも必要ではない。)、透明であること;
2)材料が、水に対する良好なバリアを提供しなければならないこと;
3)材料が、ガス(例えば、酸素および二酸化炭素)に対する良好なバリアを提供しなければならないこと;
4)材料が、保存料(例えば、フェノールおよびメタ−クレゾール)に対する良好なバリアを提供しなければならないこと;
5)材料が、臭気(例えば、保存料)に対する良好なバリアを提供しなければならないこと;
6)材料が、環境ストレスクラッキング(例えば、オイル、香料)に対する抵抗性を有さなければならないこと;
7)材料が、曲げクラックに対する抵抗性を有さなければならないこと;
8)材料が、良好な密封特性(例えば、溶着による。)を有さなければならないこと;および
9)材料が、保存および使用中に著しく緩んではならないこと
1)材料が、患者の健康および安全性に影響を与え得る、造影剤、同位体および/または薬剤についての物質(一般に「溶出物」と呼ばれる。)を発してはならないこと;
2)材料が、非常に低レベルの抽出物しか有してはならないこと;および
3)材料が、造影剤、造影剤/同位体または造影剤/薬剤の製剤に適合すべきこと
さらに、本開示の態様に基づいて、本明細書に記載の造影剤は、小線源療法の線源、MRIマーカー等の配置等の処置送達用途に使用するための、ニードル、カニューレおよびカテーテルに使用され得る。これらの概念は、図16から18に全体を示す。
本明細書に記載の造影剤、造影マーカーおよびシードは、各種ガンの処置に使用されてもよく、特に、小線源療法においてマーカーおよび薬剤と組み合わせたC4造影剤の使用等の、前立腺ガンに関連する処置、モニターおよび/または治療と併せて使用されてもよい。
C4造影剤の調製
塩化コバルト・六水和物(CoCl2−6H2O(mw=237.9g/mol、Acrosより入手))およびNAC(N−アセチル−L−システイン、HSCH2CH(NHCOCH3)CO2H(mw=163.19g/mol、Sigmaより入手)を、水に溶解し、塩化コバルト(II)−N−アセチルシステイン(CoCl2−NAC)が形成された。本明細書において、Co−NAC造影剤と言う。全ての化学物質を、商業的供給源から購入し、任意の更なる精製を行わずに使用した。毒性試験について、塩化コバルトを低濃度(1重量%)および高濃度(10%)で含む、2種類のCo−NAC溶液を調製した。両方の場合において、溶液中のNACの濃度を、2重量%とした。低濃度の塩化コバルトを含むCo−NAC溶液を、9.7mLの蒸留水に、100mg(0.42mmol)のCoCl2−6H2Oおよび200mg(1.22mmol)のNACに溶解することで調製した。高濃度の塩化コバルトを含む溶液を、8.8mLの蒸留水に、1000mg(4.2mmol)のCoCl2−6H2Oおよび200mg(1.22mmol)のNACに溶解することで調製した。両方の場合において、溶液を、室温で15分間、超音波で分解し、成分を完全に溶解した。任意の汚染および細菌の繁殖を防止するために、新鮮なCo−NAC溶液を、6日間毎朝調製し、毒性試験において、直ちに供給した(以下の実施例2を参照)。
コバルト造影剤の毒性試験
前立腺内に投与された二塩化コバルト(II)−N−アセチルシステイン(CoCl2−NAC)の毒性研究および薬物動態研究を、Department of Veterinary Medicine and Surgery(DVMS)施設におけるPharmaceutical Development Center、U.T.M.D Anderson Cancer Center(Houston、TX)により、ラットモデルにおいて行った。CoCl2−NACは、MRI下における埋め込まれた放射性シードの位置特定に使用する、開発中の前立腺小線源療法用の新規のMRIマーカーである。近年、封入された造影マーカー(Co−NAC−ECAMとも言う)の有効性が、インビボでのイヌ科の動物モデルにおいて示されている。この研究の目的は、オスのラットモデルでの、インサイチュにおけるCo−NAC−ECAMの破壊に由来する潜在的な漏出に対して、二次的なCo−NACの全身暴露の分布および潜在的な毒性を評価することである。
CoCl2−NACの注入量(9μl)を、埋め込み後にヒトの前立腺に80から120シードで漏出すると仮定して定め、150グラムのオスのラットモデルに合わせて減らした。血漿および組織におけるコバルトの性質、ならびに臓器毒性を評価した。薬物動態群について、60匹のオスのラット(20匹/群)を、2つの投与群および1つの媒体コントロール群に割り当てた。1%(低濃度)および10%(高濃度)のCoCl2−NACまたは媒体コントロールを、前立腺への注射として投与した。投与に続けて、各投与レベルから5匹の動物を1群として、薬物投与終了から5分間、30分間、60分間および6時間で犠牲にした。全ての動物からの特定の臓器(脾臓、心臓、脳、前立腺、肺、腎臓、肝臓、消化管)を摘出し、ふき取り、重さを量った。さらに3匹の動物に、高濃度を投与し、代謝ケージ内でそれぞれ生かして置いた。尿および糞を、投与前および投与の翌日において、60分、6時間および24時間後の間隔で採取した。全てのサンプルについて、誘導結合プラズマ(ICP)分析により、総コバルト含有量を分析した。毒性群について、30匹のオスのラット(10匹/群)を、2つの投与群および1つの媒体コントロール群に割り当てた。1%および10%のCoCl2−NACまたは媒体コントロールを、前立腺への注射として投与した。研究日1日目(24時間)および14日目に、動物群を犠牲にし、解剖した。臨床病理学および臓器毒性の評価用に、血液および組織を採取した。
本研究では、罹患率または死亡率に関する試験項目は、観察されなかった。薬物動態:高濃度投与群(10%)において、前立腺周辺の平均ピーク濃度が、5分間で、組織1gあたり163μgとなったが、60分では、5匹の動物のうち4匹で、定量化できなかった。低濃度投与群(1%)における5分の時点において、5匹の動物のうち2匹でしか前立腺組織において、コバルトを測定できなかった。血漿サンプルでは、コントロール群または低濃度投与群において、コバルトを測定できず、高濃度投与群において、5分から60分の一時的にのみ、1.40μg/mlの平均ピーク濃度で、コバルトを測定できた。腎臓組織では、コントロール群および低濃度投与群において、コバルトを測定できなかったが、高濃度投与群では、6時間を通して、平均トラフ濃度が1.37μg/gで測定できた。コントロール群における肝臓でのコバルトの平均濃度は、高濃度投与群(群III)において観測された濃度と比較して、低かった(5分から6時間において、組織1gあたり0.03から0.06μg)。高濃度投与群では、平均濃度は、5分間で組織1gあたり2.14μgの範囲であり、30分でピークとなり(組織1gあたり3.42μg)、6時間で組織1gあたり1.54μgに動的様式で低下した。コバルト投与前の日にサンプリングした尿および糞には、有意な検出レベルのコバルトは示されず、1匹の動物についてのみの6から24時間で採取した糞が、検出レベルであった(0.46μg/g)。10%のCoCl2−NACの注射の翌日に、60分以内の尿にコバルトが検出され、6時間での尿における平均ピーク濃度は、11.6μg/mlであった。注射後60分および6時間で採取した糞は、利用できなかったが(恐らくは、手術または麻酔のため)、6から24時間で採取した糞における平均濃度は、3.28μg/gであった。通常の代謝回転と比較して、糞での排泄が投与後に8倍となっていることが示された。
毒性群において、全部で5匹の動物が、本研究で死亡した。これらの内の3匹はコントロール群であり、1匹は低濃度投与群、1匹は高濃度投与群であった。全て、手術または麻酔に関連するものであった。他の全ての動物は、予定した期間の間、生き残った。不都合な臨床兆候に関する試験事項は、観察されなかった。
この研究の条件下、および、臨床病理学、臓器重量、全体の病理学検査および顕微鏡的な病理学検査に基づいて、この化合物についての無毒性量(NOAEL)は、単独の前立腺内投与し、試験された最も高い用量である、10% CoCl2−NAC溶液である。ヒトの臨床研究において経験され得る10から100倍より高いと算出される、この暴露レベルでさえ、血漿薬物濃度は、低く、短期間であり、前立腺周辺組織から、直ちにCoCl2−NACが除去された。腎臓および肝臓対血液における2倍高い濃度が、高暴露群において観察された。このことは、この化合物について仮定される腎臓経路および肝臓経路による排除が示される。以前のMRIデータと結び付けられるこれらのデータは、CoCl2−NACが、ヒトの臨床試験において低暴露レベルで使用される場合、安全で効果的であろうことを示す。
画像化目的用のイヌ科の動物の前立腺におけるマーカーの使用
マーカー
潜在的な造影マーカーを特定するために、商業的に入手できる、および、研究室で合成される両方の、多くの薬剤について、常磁性特性および超常磁性特性により調査した。常磁性造影剤としては、各種濃度の、オムニスキャン(ガドジアミド)、L−PG−Bz−DPTA−Gdおよび塩化コバルト(II)NAC化合物があげられる。超常磁性造影剤としては、フェリデックスIV、Fe3O4、CoFe2O4、Mn−ZnおよびNi−Zn−フェライトのコロイド状ナノ粒子溶液があげられる。Co2+イオンに基づくMRI造影剤を、上記で概要を示したように、無水塩化コバルト(II)とN−アセチル−システインとの反応物を使用して調製した。試薬を、Sigma Aldrich、Acros Organicsまたは同等の供給源から購入し、さらに精製することなく使用した。反応物中の比を、下記化学量論:(CoCl2)1(NAC)3で設定した。反応物を、脱イオン水に溶解し、60℃で攪拌した。ゆっくり水を蒸発させることにより、CoCl2−NACの混合水溶液から、合成化合物の結晶を成長させた。合成により、図1Aに示す化合物の結晶を得た。ついで、結晶を、脱イオン水に0.3から10重量%の量で溶解し、60℃で攪拌した。
最初に、チタンおよびアクリルシードを、外径および内径がそれぞれ、3mmおよび1.5mm、外側長および内側中空長がそれぞれ、4.5mmおよび3.5mmを有するように特注した。塩化コバルト錯体(CoCl2−NAC)造影剤を、製造されたシード内に注入した後、MRIを、シードおよびストランド様組み合わせに行った。イヌ科の動物の前立腺実験について、基準となる非放射性チタンシードを、合成されたストランド内に組み込んだ。前記ストランドは、外径を0.8mm、長さを5.5mmに切断され、CoCl2−NAC剤(2mL)が注入され、両端を2つのポリマー栓で閉じられた、アクリルおよびガラスチューブを有する。
動物または動物組織に関与する全ての研究を、Institutional Animal Care and Use Committeeにより承認されたプロトコルに基づいて行った。この実験について、他の調査員のインビボ実験の完了後、イヌ科の動物の前立腺を解剖により摘出し、通常の生理食塩水中に入れ、アガロースゲル(10重量%、Type A、Sigma−Aldrich、St.Louis、MO)に固定した。続けて、ECAMを、前立腺内に挿入し、MRIを使用して撮像した。同様に、ECAMを、社内で製造された、直接可視化用のアガロースファントム内に挿入した。アガロースおよび前立腺組織のシグナル強度は、T1強調MRI上、同様であった。このことによりECAMの相対的なコントラストの実質的な予備評価が、組織に基づくファントムでなくとも可能にした。造影マーカー用の1.5T MRI T1強調シーケンスを、試験する。
試験された各種薬剤のうち、Co−NAC剤([Co(NAC)1]+および[Co(NAC)2]+の両方の化学量論を有する。)が、ファントムにおいて、従来の三次元T1強調スポイル型グラディエントリコールエコー収集上で、最も高いシグナルを示した。0.5から5μLのCo−NAC水溶液(0.3から10重量%)を含むアクリルおよびガラスの中空シードは、ファントムにおいて、1.5TのMRIを使用して十分に可視化された。緩和測定を、緩和率対濃度の強調最小二乗回帰の勾配を使用して得た。1.5Tでのスピン−格子緩和(r1)の測定により、0.093±0.022mM−1s−1(ピアソンR2=0.99)であり、スピン−スピン緩和(r2)の測定により、0.105±0.01mM−1s−1(ピアソンR2=0.99)であった。緩和比は、>1(r2/r1=1.21±0.29)であり、T1強調陽性造影剤と一致する。
Co−NAC造影剤は、ポリマーシード内の0.5から10%濃度を使用して、ファントムにおいて、T1−強調MRI上のシグナルを増加生成し得た。Co−NAC剤は、チタンシード内で可視化され得なかった。Co−NAC剤は、プラスチックシードにおいて低濃度で、陽性のT1−強調コントラストを有し、ファントムにおける非放射性のチタンシードの位置を確実に特定し得た(図19を参照)。
シードの[アクリル/ガラス]−チタン−[アクリル/ガラス]列およびチタン−[アクリル/ガラス]−チタン列の各種組み合わせを、アガロースファントム内のイヌ科の動物の前立腺において可視化した。ECAMからチタンシードの中心までの距離を、計算により確認した(図20)。
造影マーカー10を、前立腺ファントム内に埋め込み、造影マーカー10の画像化能を試験し、インビトロにおける前立腺および、周囲の重要な臓器構造のMRIに基づく線量測定評価を最適化し得る。腫瘍を有するイヌ科の動物の前立腺および重要な臓器構造のMRIに基づく線量測定評価の促進に関する造影マーカー10の性能を試験するために、造影マーカー10を伴うMRIかん流、拡散、分光法のインビボにおける予備実験を、行い得る。ガンを持つ大きな動物のインビボモデルにおいて、機能的なMRIの利用が、造影マーカー10により可能となり、前立腺小線源療法の送達および線量測定評価を向上させるかどうかを、測定し得る。
Radiation Oncology DICOM storage server Evercore(TeraMedica、Milwaukee、Wis)に移し得る。ファントム内の前立腺および臓器の構造は、取得された画像から輪郭を示され得る。造影マーカーを特定した後、治療シードの位置を測定でき、各処置計画に対する線量を計算し得る。
Claims (15)
- コバルトイオンと
コバルトイオンの配位子として、N−アセチル−L−システイン(NAC)と
を含む、造影剤。 - 式(I)
[Co(Cl)m(NAC)n] (I)
の化合物を含む造影剤であって、式(I)中、mは、0、1または2の整数であり、ならびにnは、1または2の整数であり、ならびにNACは、N−アセチル−L−システインである、造影剤。 - NACが、回転異性体、配座異性体、溶媒和物、水和物またはこれらのうちの1つの誘導体の形態のN−アセチル−システインである、請求項2に記載の造影剤。
- NACが、医薬的に許容される塩、溶媒和物またはこれらのエステルの形態のN−アセチル−システインである、請求項2に記載の造影剤。
- 造影剤が、式(II)
[CoCl2(NAC)n] (II)
(ここで、nは、1または2の整数である)の化合物を含み、ならびに
水中でのCoCl2(塩化コバルト)の濃度は、0.1wt%から10wt%の範囲であり、ならびに水中でのNAC(N−アセチル−L−システイン)の濃度は、0.1wt%から20wt%の範囲である、請求項2に記載の造影剤。 - 造影システムであって、
生体適合性または生分解性の封入外側構造体、および
式(II)
[CoCl2(NAC)n] (II)
(ここで、nは、1または2の整数である)の化合物を含む造影剤を含み、ならびに
水中でのCoCl2(塩化コバルト)の濃度は、0.1wt%から10wt%の範囲であり、ならびに水中でのNAC(N−アセチル−L−システイン)の濃度は、0.1wt%から20wt%の範囲である、造影システム。 - 造影システムであって、
生体適合性または生分解性の封入外側構造体、
式(II)
[CoCl2(NAC)n] (II)
(ここで、nは、1または2の整数である)の化合物を含む造影剤、および
酸化ジルコニウム、酸化アルミニウム、硫酸バリウム、アミドトリゾ酸ナトリウム、アミドトリゾ酸メグルミン、ジアトリゾ酸ナトリウム、エデト酸カルシウムナトリウム、イオジキサノールもしくはトリフェニルビスマスの単独またはこれらの組み合わせからなる群から選択される放射線不透過性材料
を含む、造影システム。 - 放射線不透過性材料が、造影剤用の担体である、請求項8に記載の造影システム。
- 放射線不透過性材料が、固形で多孔質のCTで識別可能な材料であり、ならびに造影剤が、放射線不透過性材料の多孔質の空洞内に吸収される溶液状のMRI剤である、請求項9に記載の造影システム。
- 造影システムであって、
生体適合性または生分解性の封入外側構造体、
式(II)
[CoCl2(NAC)n] (II)
(ここで、nは、1または2の整数である)の化合物を含む造影剤、および
酸化ジルコニウム(ZrO2)を含む放射線不透過性材料
を含み、造影剤が、溶液状であり、ならびに放射線不透過性材料が、固形で多孔質であり、造影剤が、放射線不透過性材料の多孔質の空洞内に吸収される、造影システム。 - 造影システムを製造する方法であって、
生体適合性または生分解性の封入外側構造体を提供すること、および
少なくとも1つの造影剤を外側構造体内に置くこと
を含み、
造影剤が、式(II)
[CoCl2(NAC)n] (II)
(ここで、nは、1または2の整数である)の化合物を含む、
方法。 - 固形で多孔質の担体を外側構造体内に置くことをさらに含み、
固形で多孔質の担体が、少なくとも1つの造影剤を吸収する、
請求項12に記載の造影システムを製造する方法。 - 固形で多孔質の担体が、酸化ジルコニウム、酸化アルミニウム、硫酸バリウム、アミドトリゾ酸ナトリウム、アミドトリゾ酸メグルミン、ジアトリゾ酸ナトリウム、エデト酸カルシウムナトリウム、イオジキサノールもしくはトリフェニルビスマスの単独またはこれらの組み合わせからなる群から選択される放射線不透過性材料である、請求項13に記載の造影システムを製造する方法。
- 造影システムを製造する方法であって、
生体適合性または生分解性の封入外側構造体を提供すること、
酸化ジルコニウム(ZrO2)を含む、固形で多孔質の担体を外側構造体内に置くこと、
少なくとも1つの造影剤を外側構造体に提供することであって、造影剤が、式(II)
[CoCl2(NAC)n] (II)
(ここで、nは、1または2の整数である)の化合物を含み、
少なくとも1つの造影剤が、溶液状であり、ならびに固形で多孔質の担体内に吸収される、
方法。
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