# Patent

## Title
Nano-scale contrast agents and methods of use

## Abstract

Compositions and methods are disclosed for evaluating a subject's vasculature integrity, for differentiating between a malignant lesion and a benign lesion, for evaluating the accessibility of a tumor to nano-sized therapeutics, for treating tumors, and for live or real time monitoring of a nano-probe's biodistribution.

## Background
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a continuation of U.S. patent application Ser. No. 12/357,950, filed on Jan. 22, 2009, which is a continuation-in-part of U.S. patent application Ser. No. 11/595,808, filed on Nov. 10, 2006, and U.S. patent application Ser. No. 11/568,936, filed on Dec. 27, 2007, both of which are continuations-in-part of U.S. patent application Ser. No. 10/830,190,filed on Apr. 21, 2004. The above-referenced applications are incorporated herein by reference in their entireties.


STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT
This invention was made with United States Government support under NSF Grant No. 0401627 and NSF ERC Grant No. EEC9731643, both of which were awarded by the National Science Foundation. The United States Government has certain rights in the invention.


BACKGROUND
In compromised vasculature and microvasculature systems, blood vessels may display increased leakiness through the blood vessel walls. Diseases where vasculature may be compromised may include cancer, stroke, aneurysm, and internal bleeding. The development of compositions and methods to identify leaky vasculature would be beneficial for early detection and for prognosis of such conditions. Currently, no adequate clinical tool exists to transparently and non-invasively identify and characterize leaky and compromised vasculature.
A related need exists for compositions and methods useful for patient specific, customized tumor characterization and therapy. Nano-systems exist for the diagnosis and treatment of many diseases, especially cancer. Nano-systems offer the possibility of multifunctionality and are being actively developed for in vivo imaging, biomolecular profiling of biomarkers, and targeted drug delivery. Such systems offer the potential to enhance the therapeutic index of anti-cancer agents, either by increasing the drug concentration in the tumor site, decreasing the exposure of healthy tissue, or both.
Most solid tumors require a complex microvasculature network for their growth. This blood microvessel network includes a dense immature blood vessel system with a high degree of tortuosity and increased leakiness through the vessel wall. The success of chemotherapeutic nano-agent therapy for solid tumors is dependent, at least in part, on the access that these agents have to tumors via the so-called leaky vasculature of the tumor. The development and effectiveness of the above described nano-systems is currently limited because no adequate clinical tool exists to transparently and non-invasively predetermine whether the blood vessels of the tumor may be amenable to nano-carrier-mediated therapy in an individualized, patient-specific manner—that is, to determine whether the tumor has a leaky vasculature.
Moreover, no adequate clinical tool exists for co-encapsulation of therapeutic or anticancer agents with non-radioactive contrast enhancing agent to allow for direct X-ray visualization of the biodistribution of the therapeutic or anticancer agents in the body of a subject.
SUMMARY
In one embodiment, a method for evaluating a subject's vasculature integrity is provided, the method comprising: introducing a composition into the subject's vasculature, the composition comprising: liposomes, the liposomes encapsulating one or more nonradioactive contrast-enhancing agents, and the liposomes comprising: cholesterol, at least one phospholipid, and at least one phospholipid which is derivatized with a polymer chain, wherein the average diameter of the liposomes is less than 150 nanometers; generating images of the subject's vasculature; and analyzing the images to detect a leak in the subject's vasculature.
In another embodiment, a method for differentiating between a malignant lesion and a benign lesion is provided, the method comprising: introducing a composition into a lesion of interest, the composition comprising: liposomes, a plurality of the liposomes comprising: at least one first lipid or phospholipid; at least one second lipid or phospholipid which is derivatized with one or more polymers; and at least one sterically bulky excipient capable of stabilizing the liposomes, wherein the average diameter of the liposomes is less than 150 nanometers, and wherein a plurality of the liposomes encapsulate at least one nonradioactive contrast enhancing agent; generating images of the lesion of interest; and analyzing the images to determine the extent of accumulation of the composition in the lesion of interest.
In another embodiment, a method for evaluating the accessibility of a tumor to nano-sized therapeutics is provided, the method comprising: introducing a composition into the tumor, the composition comprising: liposomes, each liposome comprising: at least one first lipid or phospholipid; at least one second lipid or phospholipid which is derivatized with one or more polymers; and at least one sterically bulky excipient capable of stabilizing the liposomes, wherein the average diameter of the liposomes is less than 150 nanometers, and wherein each liposome encapsulates at least one nonradioactive contrast enhancing agent; generating images of the tumor; and analyzing the images to determine the extent of accumulation of the composition in the tumor.
In another embodiment, a composition is provided, the composition comprising: liposomes having an average diameter of less than 150 nanometers, the liposomes comprising: a first lipid or phospholipid; a second lipid or phospholipid which is derivatized with a polymer; and a sterically bulky excipient capable of stabilizing the liposomes; wherein the liposomes co-encapsulate a nonradioactive contrast enhancing agent and a bio-active agent.



BRIEF DESCRIPTION OF THE DRAWINGS
The accompanying figures, which are incorporated in and constitute a part of the specification, illustrate various example compositions, methods, results, and so on, and are used merely to illustrate various example embodiments.
FIG. 1 shows a 13762 MAT B III mammary adenocarcinoma tumor growth curve in Fischer 344 rats.
FIG. 2 shows whole body images of a rat with a breast tumor in its right flank obtained using a clinical digital mammography system before (a) and 1 minute after administration of a “high” dose (1,244 mgl/kg) of an example nano-probe (b) resulting in vasculature visualization of the tumor site as well as normal tissues. A 72-hour post-contrast image of a different rat injected with a “low” does (455 mgl/kg) of the example nano-probe (c) reveals the accumulation of the nano-probe in the tumor and the spleen, while the vasculature is not visible.
FIG. 3 shows whole body images of a rat (rat 3 as indicated in FIG. 4) obtained using a clinical digital mammography system before and 24, 72, and 120 hours after administration of a “low” dose (455 mgl/kg) of the example nano-probe.
FIG. 4 shows a comparison of (a) the uptake of the example nano-probe by the breast tumor of seven rats over five days as imaged by a clinical mammography system; and (b) the uptake of the example nano-probe by the normal tissue of the same seven rats over the same time frame.
FIG. 5 shows an example of mammography images of a breast tumor with high uptake of the example nano-probe (rat 3) and a breast tumor with moderate uptake of the example nano-probe (rat 4) over a five day time period.
FIG. 6 shows whole body images of a rat obtained using a clinical digital mammography system injected with saline of equal volume of the volume with the example nano-probe. The time points coincide with pre- and post-contrast images of the nano-probed rats.
FIG. 7 shows whole body images of a rat obtained using a clinical digital mammography system before and 10, 32, 63, 125, 182, 315, 430, and 578 seconds after administration with a “high” dose (1,344 mgl/kg) of a conventional contrast agent (iohexol).
FIG. 8 shows example results of the administration of a high dose (1,344 mgl/kg) of a conventional contrast agent (iohexol) to a rat, which exhibited negligible tumor enhancement due to rapid renal clearance.
FIG. 9 shows a comparison of the uptake of the example nano-probe by the breast tumor of 15 rats within the period of three days as imaged by a clinical mammography system.
FIG. 10 shows tumor growth curves of a control (untreated) group and group treated with liposomal doxorubicin.
FIG. 11 shows tumor growth curves of a control (untreated) group and group treated with liposomal doxorubicin.



DETAILED DESCRIPTION
The design, fabrication, characterization, and application of nano-scale contrast agents (or “nano-probe”(s)) is provided.
A typical nano-probe comprises a liposomal composition comprising a lipid or phospholipid, a stabilizing excipient such as cholesterol, and a polymer-derivatized lipid or phospholipid. Suitable examples of lipids or phospholipids, stabilizing excipients, and polymer-derivatized lipids or phospholipids are set forth in, for example, U.S. patent application Ser. Nos. 10/830,190, 11/595,808, and 11/568,936.
The liposomal compositions typically encapsulate a contrast enhancing agent. Suitable contrast enhancing agents include, for example, non-radioactive iodinated compounds such as iohexol and iodixanol, as described in U.S. patent application Ser. Nos. 10/830,190, 11/595,808, and 11/568,936. The nano-probe may carry high amounts of iodinated contrast agent. For example, the nano-probes may carry as much as 130-200 mg of iodinated compound per mL of liposomal composition. A typical concentration of iodinated compound may be approximately 155 mg/mL.
Other suitable contrast enhancing agents known in the art may be included, as necessary or desirable, to effect imaging by other imaging technologies, such as, for example, ultrasonagraphy, electron beam (EBT), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), positron emission tomography, and optical imaging, including fluorescence and bioluminescence. For example, in certain embodiments, suitable contrast agents may include fluorescent dyes, such as, for example, fluorescein iso-thiocynate and MRI contrast agents including lanthanide aminocarboxylate complexes such as Gadolinium (III) DTPA and its variants.
The nano-probes are typically about or approximately 100 nm in average diameter, but may range from about 15 to about 150 nm in average diameter. Thus, a suitable liposome average diameter may be less than about 150 nm, less than about 120 nm, and less than about 100 nm. The nano-probes typically have long blood circulation times (e.g., t1/2≈18 h in rats).
The nano-probes may be prepared, for example, by the methods disclosed in U.S. patent application Ser. Nos. 10/830,190, 11/595,808, and 11/568,936, and in Example 1, below.
Generally speaking, the nano-probe may be detected using at least one of the following X-ray diagnostic techniques: computed topography (CT), micro-CT, mammography, and chest X-ray. In other embodiments, the nano-probe may be imaged using at least one of MRI, magnetic resonance spectroscopy, bioluminescence imaging, ultrasound, optical imaging, and optical spectroscopy.
In one embodiment, a method for evaluating a subject's vasculature integrity is provided. The method, exemplified in Example 2, below, comprises: introducing a composition (a nano-probe) into the subject's vasculature, the composition comprising: liposomes, each liposome encapsulating one or more nonradioactive contrast-enhancing agents, and each liposome comprising: cholesterol, at least one phospholipid, and at least one phospholipid which is derivatized with a polymer chain, wherein the average diameter of the liposomes is less than 150 nanometers; generating X-ray images of the subject's vasculature; and analyzing the X-ray images to detect a leak in the subject's vasculature. According to one embodiment of the method, the nano-probes can interrogate and quantify the extent of blood vessel integrity non-invasively using X-ray based imaging techniques.
In one embodiment of the method, analyzing the X-ray images comprises distinguishing areas having an enhanced X-ray signal from areas having little or no X-ray signal. In another embodiment of the method, the composition is characterized in that the composition accumulates in an extravascular region of the subject's vasculature when a leak exists in the subject's vasculature, in comparison to an intravascular region of the subject's vasculature, thereby achieving enhanced X-ray signal in the extravascular region. In one embodiment of the method, a low nano-probe dose containing a small amount of non-radioactive iodinated compound may achieve X-ray signal enhancement of the extravascular space of a leaky vasculature while the low intravascular levels of the iodinated nano-probe produce little or no signal enhancement.
In another embodiment of the method, generating X-ray images comprises generating X-ray images using at least one of CT, micro-CT, mammography, and chest X-ray.
In one embodiment, the leak is indicative of at least one of cancer, inflammation, stroke, aneurism, wound healing or other reparative processes, and trauma. As such, in one embodiment, the nano-probes may facilitate the detection of injured, leaky blood vessels caused by a variety of diseases such as cancer, inflammation, stroke, aneurism, internal bleeding due to trauma, and angiogenesis due to regenerative processes such as wound healing.
In another embodiment, a method is provided for differentiating between a malignant lesion and a benign lesion. The method comprises: introducing a composition (e.g., a nano-probe) into a lesion of interest, the composition comprising: liposomes, the liposomes comprising: at least one first lipid or phospholipid; at least one second lipid or phospholipid which is derivatized with one or more polymers; and at least one sterically bulky excipient capable of stabilizing the liposomes, wherein the average diameter of the liposomes is less than 150 nanometers, and wherein the liposomes encapsulate at least one nonradioactive contrast enhancing agent. In one embodiment of the method, the composition may be characterized in that the composition accumulates in a malignant lesion to a greater extent than in a benign lesion because malignant tumors have an increased permeability to 5-200 nm sized particles. The method further comprises generating X-ray images of the lesion of interest and analyzing the X-ray images to determine the extent of accumulation of the composition in the lesion of interest.
In another embodiment, a method is provided for evaluating the accessibility of a tumor to nano-sized therapeutics. The method, exemplified in Example 4, below, comprises: introducing a composition (a nano-probe) into a tumor of interest, the composition comprising: liposomes, a plurality of the liposomes comprising: at least one first lipid or phospholipid; at least one second lipid or phospholipid which is derivatized with one or more polymers; and at least one sterically bulky excipient capable of stabilizing the liposomes, wherein the average diameter of the liposomes is less than 150 nanometers, and wherein a plurality of the liposomes encapsulate at least one nonradioactive contrast enhancing agent; generating X-ray images of the tumor; and analyzing the X-ray images to determine the extent of accumulation of the composition in the tumor.
In yet another embodiment, a composition is provided. The composition, an example of which is provided at Example 5, below, may comprise: liposomes having an average diameter of less than 150 nanometers, each liposome comprising: a first lipid or phospholipid; a second lipid or phospholipid which is derivatized with a polymer; and a sterically bulky excipient capable of stabilizing the liposomes; wherein each liposome co-encapsulates a nonradioactive contrast enhancing agent and at least one bio-active agent, including, but not limited to, a chemotherapeutic, a gene, a protein, a small molecule, and a peptide. In one embodiment of the composition, the first lipid or phospholipid comprises 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC). In another embodiment of the composition, the sterically bulky excipient capable of stabilizing the liposomes comprises cholesterol. In another embodiment of the composition, the second lipid or phospholipid which is derivatized with a polymer comprises 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[methoxy(poly(ethylene glycol))-2000] (mPEG2000-DSPE). In another embodiment of the composition, the first lipid or phospholipid, the second lipid or phospholipid which is derivatized with a polymer, and the sterically bulky excipient capable of stabilizing the liposomes, are present in a ratio of 55:40:5. In another embodiment of the composition, the chemotherapeutic comprises doxorubicin. In another embodiment of the composition, the liposomes have an average diameter of about 100 nm.
In one embodiment, the composition may allow for live or real time monitoring of the nano-probe biodistribution, thereby allowing for patient-specific therapies. In another embodiment, non-invasive pharmacokinetics of a therapeutic agent may be achieved when the therapeutic agent is co-encapsulated with contrast agent within the nano-probe as described with respect to the composition. In another embodiment, the nano-probe is further multi-functional in that the nano-probe may be actively targeted via antibodies and peptides.
One example therapeutic that may be suitable for co-encapsulation is anthracyclines. Liposomal anthracyclines have been developed to increase the therapeutic index of the anthracycline by maintaining antitumor efficacy while improving the safety profile. Anthracyclines, including doxorubicin, are among the most potent chemotherapeutic agents. However, this family of chemotherapeutics exemplifies the limitation of many potent anticancer drugs in that they are limited by highly problematic system toxicities, which result in myelosuppression, acute nausea and vomiting, stomatitis, and cardiotoxicity. Polyethylene glycol-coated (PEGylated) liposomal doxorubicin, a 100 nm lipid sac with a long blood circulation (t1/2≈55 h), has been approved in the United States for clinical use for treatment of refractory Kaposi's sarcoma and ovarian cancer. PEGylated liposomal doxorubicin has also been investigated for breast cancer therapy, and has shown similar efficacy and significantly lower cardiotoxicity when compared to conventional doxorubicin. Many other drugs loaded into liposomes are approved or undergoing clinical evaluation for cancer therapy, and may be suitable for co-encapsulation as described herein, including, but not limited to, vincristine, lurtotecan, all-trans retinoic acid, platinum compounds, annamycin, and DNA plasmid encoding HLA-B7 and β2 microglobulin.
In certain embodiments, suitable imaging techniques for the detecting the composition may include, for example, at least one of the following X-ray diagnostic techniques: computed topography (CT), micro-CT, mammography, and chest X-ray. In other embodiments, the nano-probe may be imaged or detected using at least one of MRI, ultrasound, and optical imaging, including fluorescence or bioluminescence imaging.
EXAMPLES
Example 1
Preparation and Characterization of an Example Nano-Probe
A highly concentrated iodine solution (600 mgl/mL) was prepared by dissolving iodixanol powder (lyophilized from Visapaque 320, GE Healthcare) in ultrapure water under continuous stirring and heating at 70° C. A lipid solution in ethanol comprising 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC), cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[methoxy(poly(ethylene glycol))-2000] (mPEG2000-DSPE) in the molar ratio 55:40:5 was hydrated with the iodine solution at 70° C., followed by sequential extrusion on a Lipex Thermoline extruder (Northern Lipids, Vancouver, Canada). This resulted in encapsulation of the iodine solution within the central aqueous core of polyethylene glycol-stabilized (PEGylated) liposomes. Free, un-encapsulated iodixanol was replaced by a saline solution (300 mM NaCl) with the same osmolarity as the internal iodinated phase of the liposome using a two day dialysis against 300 mM NaCl using a 100,000 MWCO dialysis tubing. Following concentration via diafiltration using MicroKros modules (Spectrum Laboratories, California) with a 50 nm cutoff pore size, the liposomal iodine and lipid content were measured to be 155 mg/mL (all encapsulated) and 165 mM, respectively. The average diameter of the liposomes was 96 nm (sd=8 nm) as determined by dynamic light scattering. The 596 mOsm/kg water osmolality of the formulation allowed intravenous injection, since the liposomal walls can sustain the osmotic pressures expected to occur in isotonic environments. Indeed, in vitro leakage experiments against isotonic phosphate buffered saline exhibited negligible leakage of the encapsulated iodine (less than 5% of the initial payload) over the period of three days.
Example 2
Imaging Study Using Nano-Probe of Example 1
The nano-probe of Example 1 was tested in a rat breast tumor model developed by inoculation of mammary adenocarcinoma cells (13762 MAT B III from ATCC) into the right flank of Fischer female rats. The imaging studies started on day seven after tumor inoculation (tumor volume approximately 440 mm3; see FIG. 1 for tumor growth curve). Tumor volumes (n=15) were obtained by caliper measurements.
Contrast-enhanced mammography was performed with a commercial digital mammography system (Senographe 2000D, GE Healthcare) at 49 kVp and 63 mAs with a rhodium target and an extra copper filter of 0.3 mm thickness. These settings were used to shape the x-rays to have optimal energies for iodine. Under these conditions, an optimal X-ray spectrum was obtained containing the largest number of X-rays with energies above the k-edge of iodine while X-ray dose was significantly reduced when compared to standard mammography. Initial studies were performed with high doses of the nano-probe to obtain a vascular image. A pre-contrast image (FIG. 2(a)) and post-contrast images were acquired 1, 5, 10, and 15 minutes after tail vein injection of the nano-probe. Blood vessels were clearly visible (FIG. 2(b)) at a 1,300 mgl/kg body weight dose of the nano-probe achieving blood concentrations of 20 mgl/mL. In the case of an adult human, this would correspond to a dose of about 654 mL of the nano-probe (assuming a blood volume of five liters), which is prohibitively large for use in humans. However, this high dose was used to clearly visualize the blood vessels that the mammography system was capable of detecting.
In monitoring the fate of the nano-probe studies, a pre-contrast image (indicated as t=0) and post-contrast images were obtained 24, 72, and 120 hours after administration of the nano-probe at a dose of 455 mgl/kg body weight. This corresponds to 195 mg lipid/kg body weight, which is about two times higher than the highest lipid dose of liposomal drugs when employed in clinical practice. FIG. 2(c) shows an image of an animal obtained 72 h after the nano-probe injection. No blood vessels are visible in the normal tissue (as compared to the enhanced vasculature observed in FIG. 2(b)), while the spleen and the tumor were enhanced. The spleen enhancement was expected since liposomes within the extravascular space of the tumor provided for the detection of the nano-probe (when maximum iodine in the blood circulation was expected), since the iodine levels in the blood were below the detectable threshold.
FIG. 3 displays the timeline of the nano-probe accumulation within the tumor lesion for a period of five days. In the same manner, a group of animals (n=7) was imaged and monitored at the post-contrast defined time points exhibiting a similar behavior. FIG. 4(a) summarizes the time course of the tumor enhancement by quantifying the grey levels of the lesions using ImageJ software (NIH, Bethesda, Md.). A normalized tumor enhancement was calculated by subtracting each post-contrast value (t>0) from its tumors that showed a slow gradual increase of the enhancement during the 120 h time course (indicated as rat 2 and 6 in FIG. 4(a)), whereas other tumors displayed a faster increase (indicated as rat 3, 4, and 5 in FIG. 4(a)). Another tumor exhibited an initial rapid enhancement at t=24 h followed by a plateau. At t=120 h, there were lesions with low enhancement and other lesions with much higher enhancement. This discrepancy suggests that different amounts of the nano-probe leaked into each tumor.
The pattern of tumor enhancement due to the nano-probe was plotted in FIG. 4(b) and compared against the normal tissue of the animals in the same group or the tumor site of a control group (injected with no agent) exhibiting statistical differences. No enhancement was observed in normal tissues, suggesting that the nano-probe levels in the blood were below the detectable threshold of the mammography, and implying that no endogenous changes of the tumor tissue could contribute such a significant enhancement as the one seen in the case of the non-probed lesions. Examples of mammography images of a tumor lesion with high uptake and a tumor lesion with moderate uptake are shown in FIG. 5.
Example 3
Comparative Examples (Control Groups)
Whole body mammograms of a rat injected with no contrast agent (control group) is shown in FIG. 6. Another control group was injected with a conventional iodinated agent (iohexol) at an iodine dose equivalent to the high dose of 1,344 mgl/mL of the nano-probe. (See FIG. 7). Within the first minute after injection, the normal vasculature and the tumor lesion exhibited a slight enhancement, but the iodinated agent was rapidly cleared via the kidneys. (See FIG. 8).
Example 4
Non-Invasive Prediction of Nano-Chemotherapy Success
The prediction accuracy of the nano-probe was tested in a rat breast tumor model developed by inoculation of mammary adenocarcinoma cells (13762 MAT B III from ATCC) into the right flank of Fischer female rats. The imaging studies started on day six after tumor inoculation. Contrast-enhanced mammography was performed with a commercial digital mammography system (Senographe 2000D, GE Healthcare) at 49 kVp and 63 mAs with a rhodium target and an extra copper filter of 0.3 mm thickness. The animals (n=15) were injected with the example nano-probe in an amount of 455 mgl/kg b.w. FIG. 9 summarizes the time course of the tumor enhancement by quantifying the grey levels of the lesions using ImageJ software (t>0) from its pre-contrast value (t=0). It is observed that the enhancement profiles exhibit dissimilar patterns. Immediately after the imaging session (at day 9 after tumor inoculation), the animals were injected with liposomal doxorubicin at a dose of 10 mg doxorubicin per kg b.w.
The response of the tumor to the drug was evaluated by measuring the size of the tumor using a caliper. FIG. 10 summarizes the tumor growth curves of all of the animals obtained by caliper measurements. The growth curves exhibit high variability, implying that each tumor responded differently to the chemotherapeutic. The animals that displayed higher uptake of the nano-probe responded better to the treatment (smaller tumor volumes).
To quantify the relation of the nano-probe prediction to the therapy response, the tumor growth curves (FIG. 10) were fitted to mono-exponential functions (i.e., dV/dt=Ktumor growth*t, where V is tumor volume) to calculate the growth rate constant, Ktumor growth. The Area Under the Curve (AUCprobing) of the nano-probe uptake profiles were calculated from FIG. 9. The Ktumor growth of each animal was plotted against the AUCprobing of each animal in FIG. 11. High AUCprobing means high intratumoral accumulation of the nano-probe predicting high success of the nano-chemotherapeutic, whereas low Ktumor growth means slow tumor growth or good response to the treatment.
Example 5
Preparation and In Vitro Characterization of an Example Nano-Scale Liposome Co-Encapsulating Contrast Agent and Chemotherapeutic
A lipid solution in ethanol comprising DPPC, cholesterol, and mPEG(2000)-DSPE in the molar ratio 55:40:5 was hydrated with a 300 mM ammonium sulfate iodinated solution (iohexol; 350 mgl/mL) at 70° C. followed by sequential extrusion on a Lipex Thermoline extruder (Northern Lipids, Vancouver, Canada). This resulted in encapsulation of the iodine solution within the central aqueous core of PEGylated liposomes. Free, unencapsulated iodixanol was removed from the external phase of the liposome using a two day dialysis against 300 mM ammonium sulfate using a 100,000 MWCO dialysis tubing. The liposomes were then dialyzed for 12 h with a 100 kDa MWCO dialysis tubing against a phosphate-buffered saline (PBS) solution to establish an ammonium sulfate gradient for doxorubicin loading.
The liposomal formulation was actively loaded with doxorubicin by an ammonium sulfate gradient. Briefly, liposomes and doxorubicin were mixed at a ratio of 0.1 mg of doxorubicin per 1 mg of DPPC in the liposomes. The liposome-doxorubicin suspension was heated at 35° C. for 25 min. The liposomes were left overnight at room temperature and dialyzed twice in 100 kDa MWCO membrane against PBS to remove unencapsulated doxorubicin. Following concentration, via diafiltration, using MicroKros modules (Spectrum Laboratories, California) with a 50 nm cutoff pore size, the liposomal iodine and doxorubicin content was measured to be 91 mg/mL and 1.2 mg/mL (all encapsulated), respectively. The average diameter of the liposomes was 102 nm (sd=6 nm) as determined by dynamic light scattering.
It is, of course, not possible to describe every conceivable combination of components or methodologies for purposes of describing the compositions, methods, and so on provided herein. Additional advantages and modifications will readily appear to those skilled in the art. Therefore, the invention, in its broader aspects, is not limited to the specific details and illustrative examples shown and described. Accordingly, departures may be made from such details without departing from the spirit or scope of the applicants' general inventive concept. A person of ordinary skill will readily recognize that optimizing or manipulating any one of these variables may or will require or make possible the manipulation of one or more of the other of these variables, and that any such optimization or manipulation is within the spirit and scope of the present embodiments.
Notwithstanding that the numerical ranges and parameters setting forth the broad scope of the invention are approximations, the numerical values set forth in the specific examples are reported as precisely as possible. Any numerical value, however, inherently contains certain errors necessarily resulting from the standard deviation found in their respective testing measurements. It should be noted that the term “about” may mean up to and including ±10% of the stated value. For example, “about 10” may mean from 9 to 11.
Furthermore, while the compositions, methods, and so on have been illustrated by describing examples, and while the examples have been described in considerable detail, it is not the intention of the applicant to restrict, or in any way, limit the scope of the appended claims to such detail. Thus, this application is intended to embrace alterations, modifications, and variations that fall within the scope of the appended claims. The preceding description is not meant to limit the scope of the invention. Rather, the scope of the invention is to be determined by the appended claims and their equivalents.
Finally, to the extent that the term “includes” or “including” is employed in the detailed description or the claims, it is intended to be inclusive in a manner similar to the term “comprising,” as that term is interpreted when employed as a transitional word in a claim. Furthermore, to the extent that the term “or” is employed in the claims (e.g., A or B) it is intended to mean “A or B or both.” When the applicants intend to indicate “only A or B, but not both,” then the term “only A or B but not both” will be employed. Similarly, when the applicants intend to indicate “one and only one” of A, B, or C, the applicants will employ the phrase “one and only one.” Thus, use of the term “or” herein is the inclusive, and not the exclusive use. See Bryan A. Garner, A Dictionary of Modern Legal Usage 624 (2d. Ed. 1995).

## Claims

1. A method for evaluating a subject's vasculature integrity, the method comprising:
introducing a composition into the subject's vasculature, the composition comprising:
liposomes, the liposomes encapsulating one or more iodinated nonradioactive contrast-enhancing agents, and the liposomes comprising:
cholesterol,
at least one phospholipid, and
at least one phospholipid which is derivatized with a polymer chain,
wherein the average diameter of the liposomes is less than 150 nanometers;

generating images of the subject's vasculature; and
analyzing the images to detect a leak in the subject's vasculature, the leak in the subject's vasculature being caused by inflammation or angiogenesis, provided that the inflammation or angiogenesis excludes cancer, stroke, aneurism, healing, and trauma.

2. The method of claim 1, wherein the generating images comprises generating X-ray images.

3. The method of claim 1, wherein the generating images comprises generating images before and after introducing the composition into the subject's vasculature.

4. The method of claim 1, wherein the analyzing the images comprises distinguishing areas having an enhanced signal from areas having little or no signal.

5. The method of claim 1, wherein the composition is characterized in that the composition accumulates in an extravascular region of the subject's vasculature when a leak exists in the subject's vasculature, in comparison to an intravascular region of the subject's vasculature, thereby enhancing the signal in the extravascular region.

6. The method of claim 2, wherein the generating X-ray images comprises generating X-ray images using at least one of computed tomography, micro-computed tomography, mammography, and chest X-ray.

7. The method of claim 1, wherein the generating images comprises generating images using at least one of MRI, ultrasound, and optical imaging, including fluorescence or bioluminescence imaging.

8. A method for predicting a probability of success of a nano-chemotherapy in a subject having a tumor, the method comprising:
introducing a composition into the subject's vasculature, the composition comprising:
liposomes, the liposomes encapsulating one or more iodinated nonradioactive contrast-enhancing agents, and the liposomes comprising:
cholesterol,
at least one phospholipid, and
at least one phospholipid which is derivatized with a polymer chain,
wherein the average diameter of the liposomes is less than 150 nanometers;

generating one or more images of the tumor in a subject; determining an uptake of the composition by the tumor in the subject according to the one or more images of the tumor in the subject; and
predicting the response of the tumor in the subject to the nanoparticle chemotherapy according to the uptake of the composition by the tumor in the subject.

9. The method of claim 8, the determining the uptake of the composition by the tumor in the subject comprising:
generating a first image of the one or more images of the tumor in the subject before introducing the composition into the subject's vasculature;
generating a second image of the one or more images of the tumor in the subject after introducing the composition into the subject's vasculature; and
determining a contrast enhancement in the second image compared to the first image, the uptake of the composition by the tumor in the subject corresponding to the contrast enhancement.

10. The method of claim 8, the predicting the response of the tumor in the subject to the nanoparticle chemotherapy further comprising:
comparing the uptake of the composition by the tumor to a calibration curve of tumor growth rate versus uptake of the composition to determine a tumor growth rate in the subject; and
quantitatively predicting the response of the tumor in the subject to the nanoparticle chemotherapy according to the tumor growth rate in the subject.

11. The method of claim 10, the calibration curve of tumor growth rate versus uptake of the composition being determined by:
providing a time course of tumor contrast enhancement in a plurality of experimental subjects administered the composition, each experimental subject having a tumor;
determining an area under the curve (AUC) for each time course of tumor contrast enhancement;
providing a tumor growth curve for each of the plurality of experimental subjects upon administration of the nano-chemotherapy;
determining a rate of tumor growth Ktumor growth by fitting a change in tumor volume, dV,versus time, dt, according to:


dV/dt=Ktumor growth*t; and


preparing the calibration curve by plotting Ktumor growth versus AUC for each of the plurality of experimental subjects.

12. The method of claim 10, further comprising determining the calibration curve of tumor growth rate versus uptake of the composition by:
providing a time course of tumor contrast enhancement in a plurality of experimental subjects administered the composition, each experimental subject having a tumor;
determining an area under the curve (AUC) for each time course of tumor contrast enhancement;
providing a tumor growth curve for each of the plurality of experimental subjects upon administration of the nano-chemotherapy;
determining a rate of tumor growth Ktumor growth by fitting a change in tumor volume, dV,versus time, dt, according to:


dV/dt=Ktumor growth*t; and


preparing the calibration curve by plotting Ktumor growth versus AUC for each of the plurality of experimental subjects.

13. The method of claim 10:
the AUC being correlated with success of the nano-chemotherapy; and/or
the Ktumor growth growth being inversely correlated with success of the nano-chemotherapy.

14. A method for treating a subject having a tumor with a nano-chemotherapy, the method comprising:
introducing a composition into the subject's vasculature, the composition comprising:
liposomes, the liposomes encapsulating one or more iodinated nonradioactive contrast-enhancing agents, and the liposomes comprising:
cholesterol,
at least one phospholipid, and
at least one phospholipid which is derivatized with a polymer chain,
wherein the average diameter of the liposomes is less than 150 nanometers;

generating one or more images of the tumor in a subject; determining an uptake of the composition by the tumor in the subject according to the one or more images of the tumor in the subject;
predicting the response of the tumor in the subject to the nanoparticle chemotherapy according to the uptake of the composition by the tumor in the subject; and
administering the nano-chemotherapy to the subject according to the predicted response of the tumor to the nanoparticle chemotherapy.

15. The method of claim 14, the determining the uptake of the composition by the tumor in the subject comprising:
generating a first image of the one or more images of the tumor in the subject before introducing the composition into the subject's vasculature;
generating a second image of the one or more images of the tumor in the subject after introducing the composition into the subject's vasculature; and
determining a contrast enhancement in the second image compared to the first image, the uptake of the composition by the tumor in the subject corresponding to the contrast enhancement.

16. The method of claim 14, the predicting the response of the tumor in the subject to the nanoparticle chemotherapy further comprising:
comparing the uptake of the composition by the tumor to a calibration curve of tumor growth rate versus uptake of the composition to determine a tumor growth rate in the subject; and
quantitatively predicting the response of the tumor in the subject to the nanoparticle chemotherapy according to the tumor growth rate in the subject.

17. The method of claim 16, the calibration curve of tumor growth rate versus uptake of the composition being determined by:
providing a time course of tumor contrast enhancement in a plurality of experimental subjects administered the composition, each experimental subject having a tumor;
determining an area under the curve (AUC) for each time course of tumor contrast enhancement;
providing a tumor growth curve for each of the plurality of experimental subjects upon administration of the nano-chemotherapy;
determining a rate of tumor growth Ktumor growth by fitting a change in tumor volume, dV,versus time, dt, according to:


dV/dt=Ktumor growth*t; and


preparing the calibration curve by plotting Ktumor growth versus AUC for each of the plurality of experimental subjects.

18. The method of claim 17:
the AUC being correlated with success of the nano-chemotherapy; and/or
the Ktumor growth growth being inversely correlated with success of the nano-chemotherapy.