The Tatsui laboratory is evaluating the effect of tumor treating fields (TTFs) on tumor progression using 3D culture models comprised of tumor cells and demineralized cancellous bone scaffold. We have been able to demonstrate several cells lines with affinity to bone are able to engraft, grow in multilayers with a much longer viability than in monolayer cell culture dishes. Our ongoing studies test and determine: the frequencies of TTFs that are most effective in slowing tumor cell growth; the effect of titanium pins (that simulate the titanium frame in spinal fusion procedures) on TTFs in the 3D culture model; and the effect of TTFs on tumor progression in vivo in a mouse model. These studies will pave the way for clinical translation of TTFs in post-operative management of spinal metastases that are refractory to radiation.
We are also evaluating the radiological properties and benefits of carbon fiber pedicle screws for spine stabilization as compared with titanium implants. Specifically, we will determine whether the carbon fiber pedicle screws produce fewer artifacts which would greatly facilitate surveillance imaging. Another project evaluates whether the position of the spinal cord in the MRI matches its position in the CT myelogram, in the context of carbon fiber pedicle screws in comparison with titanium implants. A CT myelogram, which is currently the gold standard for radiation planning, is more invasive and may be hindered by extradural sample collection; if carbon fiber pedicle screws enable better MR images that ae comparable to a CT myelogram, this would be an advantage in clinical practice and management of spine metastases.
Other projects include establishing a database of clinical images and associated technical files of MRI guided laser ablation of spinal tumors can be used to support research and a retrospective comparison of patients treated with open surgery and spinal laser interstitial thermotherapy (visualase) for spinal metastasis.
Tumor Treating Fields in the Therapy of Spinal Metastases
A Study of the Utilization of Titanium and Carbon Fiber Spinal Implants in Patients with Spinal Tumors
Retrospective Comparison of Patients Treated with Open Surgery and Spinal Laser Interstitial Thermotherapy (Visualase) for Spinal Metastasis
Visualase Visualization Database