Background: Surgical resection for cancer is becoming more minimally invasive with smaller incisions and less patient morbidity. However, this process switches the burden to the surgeon to remove all the disease with suboptimal visualization. This project proposes to develop a technique to employ preoperative injection of ultra- sound contrast enhancement stationary microbubbles and micro/[nano]shells to enable intraoperative detection of tumors even in cases with small skin incisions to allow surgeons to better identify and completely resect tumors and decease patient morbidity.
Aims : To determine the optimal dose and lifetime of stationary microbubbles in a rabbit model as an ultrasound contrast agent in order to localize small breast tumors for surgical resection. To study the localization ability of a novel gas filled silica micro/[nano]shells compared to microbubbles as an ultrasound contrast agent and localization method for occult breast cancers using a rabbit model. Conclusion: Surgical resection of small early cancers remains important in local control and prevention of metastases, techniques to improve its efficacy in visualizing and removing tumors completely can have a major impact on breast and other cancer treatment. It is critical to improve the localization and visualization of non- palpable cancers due to the inability to detect these tumors during surgery. This fact is particularly important in this era in which tiny cancers are detected by imaging and more advanced techniques are needed for localizing tumors. This project may be able to decrease positive margins, local recurrence and possible cure of early stage cancers.

Public Health Relevance

The purpose of this project is to test an improved technique for intraoperative guidance using microbubbles or [nanoshells] for breast tumor resection. It is known that using current techniques during breast conservation therapy, many patients must undergo a second surgery due to incomplete tumor resection which has been attributed to poor guidance or tumor marking. The proposed project has developed a novel guidance technique which may be used to improve the current standard of care for patients which will result in fewer second surgeries and potentially fewer cases in which incomplete tumor resection leads to morbidity.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Predoctoral Individual National Research Service Award (F31)
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Special Emphasis Panel (ZRG1)
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Vallejo-Estrada, Yolanda
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University of California San Diego
Engineering (All Types)
Schools of Arts and Sciences
La Jolla
United States
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Ward, Erin P; Wang, James; Mendez, Natalie et al. (2016) Utilization of iron (III)-doped nanoshells for in vivo marking of nonpalpable tumors using a VX2 rabbit model. Am J Surg 212:1140-1146
Liberman, A; Wang, J; Lu, N et al. (2015) Mechanically Tunable Hollow Silica Ultrathin Nanoshells for Ultrasound Contrast Agents. Adv Funct Mater 25:4049-4057
Liberman, Alexander; Mendez, Natalie; Trogler, William C et al. (2014) Synthesis and surface functionalization of silica nanoparticles for nanomedicine. Surf Sci Rep 69:132-158
Liberman, Alexander; Wu, Zhe; Barback, Christopher V et al. (2014) Hollow iron-silica nanoshells for enhanced high intensity focused ultrasound. J Surg Res 190:391-8