Prevention of tumor seeding during needle biopsy by chemotherapeutic-releasing gelatin sticks

// Ren-Yuan Bai 1 , Verena Staedtke 1 , Xuewei Xia 2 and Gregory J. Riggins 1 1 Department of Neurosurgery and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA 2 Department of Neurosurgery, Affiliated Hospital of Guilin Medical College, Guilin, China Correspondence to: Ren-Yuan Bai, email: // Gregory J. Riggins, email: // Keywords : biopsy, intracranial implantation, tumor seeding, brain tumor, gelatin stick Received : November 02, 2016 Accepted : February 05, 2017 Published : February 16, 2017 Abstract Needle biopsy is an indispensable diagnostic tool in obtaining tumor tissue for diagnostic examination. Tumor cell seeding in the needle track during percutaneous needle biopsies has been reported for various types of cancers. The mechanical force of the biopsy both directly displaces the malignant cells and causes bleeding and fluid movement that can further disseminate cells. To prevent the risk of tumor cell seeding during biopsy, we developed a gelatin stick loaded with chemotherapeutics such as doxorubicin (DXR) that was inserted into the biopsy canal. The gelatin-doxorubicin sticks (GDSs) were created by passively loading precut gelatin foam strips (Gelfoam) with doxorubicin solution. The dried GDSs were inserted into the needle track through the sheath during the needle biopsy and eventually self-absorbed. We showed that this procedure prevented iatrogenic tumor seeding during needle biopsies in two subcutaneous tumor models. In an alternative application, using GDSs in intracranial brain tumor implantation avoided the outgrowth of tumor from the rodent brain, which could otherwise potentially fuse the tumor with the meninges and distort the results in therapeutic studies in rodent brain tumor models.