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Optimizing ethyl cellulose-ethanol delivery towards enabling ablation of cervical dysplasia.

Publication ,  Journal Article
Mueller, JL; Morhard, R; DeSoto, M; Chelales, E; Yang, J; Nief, C; Crouch, B; Everitt, J; Previs, R; Katz, D; Ramanujam, N
Published in: Sci Rep
August 19, 2021

In low-income countries, up to 80% of women diagnosed with cervical dysplasia do not return for follow-up care, primarily due to treatment being inaccessible. Here, we describe development of a low-cost, portable treatment suitable for such settings. It is based on injection of ethyl cellulose (EC)-ethanol to ablate the transformation zone around the os, the site most impacted by dysplasia. EC is a polymer that sequesters the ethanol within a prescribed volume when injected into tissue, and this is modulated by the injected volume and delivery parameters (needle gauge, bevel orientation, insertion rate, depth, and infusion rate). Salient injection-based delivery parameters were varied in excised swine cervices. The resulting injection distribution volume was imaged with a wide-field fluorescence imaging device or computed tomography. A 27G needle and insertion rate of 10 mm/s achieved the desired insertion depth in tissue. Orienting the needle bevel towards the outer edge of the cervix and keeping infusion volumes ≤ 500 µL minimized leakage into off-target tissue. These results guided development of a custom hand-held injector, which was used to locate and ablate the upper quadrant of a swine cervix in vivo with no adverse events or changes in host temperature or heart rate. After 24 h, a distinct region of necrosis was detected that covered a majority (> 75%) of the upper quadrant of the cervix, indicating four injections could effectively cover the full cervix. The work here informs follow up large animal in vivo studies, e.g. in swine, to further assess safety and efficacy of EC-ethanol ablation in the cervix.

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Published In

Sci Rep

DOI

EISSN

2045-2322

Publication Date

August 19, 2021

Volume

11

Issue

1

Start / End Page

16869

Location

England

Related Subject Headings

  • Uterine Cervical Dysplasia
  • Tomography, X-Ray Computed
  • Swine
  • Reproducibility of Results
  • Needles
  • Models, Animal
  • Injections
  • Fluorescein
  • Female
  • Ethanol
 

Citation

APA
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Mueller, J. L., Morhard, R., DeSoto, M., Chelales, E., Yang, J., Nief, C., … Ramanujam, N. (2021). Optimizing ethyl cellulose-ethanol delivery towards enabling ablation of cervical dysplasia. Sci Rep, 11(1), 16869. https://doi.org/10.1038/s41598-021-96223-9
Mueller, Jenna L., Robert Morhard, Michael DeSoto, Erika Chelales, Jeffrey Yang, Corrine Nief, Brian Crouch, et al. “Optimizing ethyl cellulose-ethanol delivery towards enabling ablation of cervical dysplasia.Sci Rep 11, no. 1 (August 19, 2021): 16869. https://doi.org/10.1038/s41598-021-96223-9.
Mueller JL, Morhard R, DeSoto M, Chelales E, Yang J, Nief C, et al. Optimizing ethyl cellulose-ethanol delivery towards enabling ablation of cervical dysplasia. Sci Rep. 2021 Aug 19;11(1):16869.
Mueller, Jenna L., et al. “Optimizing ethyl cellulose-ethanol delivery towards enabling ablation of cervical dysplasia.Sci Rep, vol. 11, no. 1, Aug. 2021, p. 16869. Pubmed, doi:10.1038/s41598-021-96223-9.
Mueller JL, Morhard R, DeSoto M, Chelales E, Yang J, Nief C, Crouch B, Everitt J, Previs R, Katz D, Ramanujam N. Optimizing ethyl cellulose-ethanol delivery towards enabling ablation of cervical dysplasia. Sci Rep. 2021 Aug 19;11(1):16869.

Published In

Sci Rep

DOI

EISSN

2045-2322

Publication Date

August 19, 2021

Volume

11

Issue

1

Start / End Page

16869

Location

England

Related Subject Headings

  • Uterine Cervical Dysplasia
  • Tomography, X-Ray Computed
  • Swine
  • Reproducibility of Results
  • Needles
  • Models, Animal
  • Injections
  • Fluorescein
  • Female
  • Ethanol