Theranostics 2018; 8(9):2377-2386. doi:10.7150/thno.23567

Research Paper

A Supramolecular Approach for Liver Radioembolization

Silvia J. Spa1,2*, Mick M. Welling1*, Matthias N. van Oosterom1, Daphne D. D. Rietbergen1,3, Mark C. Burgmans4, Willem Verboom5, Jurriaan Huskens5, Tessa Buckle1, Fijs W. B. van Leeuwen1,2✉

1. Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
2. Department of Agrotechnology and Food services, subdivision BioNanoTechnology, Wageningen University, Wageningen, The Netherlands
3. Department of Radiology, Nuclear Medicine Section, Leiden University Medical Center, Leiden The Netherlands.
4. Interventional Radiology, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
5. Molecular NanoFabrication group, MESA+ Institute for Nanotechnology, University of Twente, Enschede, The Netherlands
*These authors contributed equally to this work

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license ( See for full terms and conditions.
Spa SJ, Welling MM, van Oosterom MN, Rietbergen DDD, Burgmans MC, Verboom W, Huskens J, Buckle T, van Leeuwen FWB. A Supramolecular Approach for Liver Radioembolization. Theranostics 2018; 8(9):2377-2386. doi:10.7150/thno.23567. Available from

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Hepatic radioembolization therapies can suffer from discrepancies between diagnostic planning (scout-scan) and the therapeutic delivery itself, resulting in unwanted side-effects such as pulmonary shunting. We reasoned that a nanotechnology-based pre-targeting strategy could help overcome this shortcoming by directly linking pre-interventional diagnostics to the local delivery of therapy.

Methods: The host-guest interaction between adamantane and cyclodextrin was employed in an in vivo pre-targeting set-up. Adamantane (guest)-functionalized macro albumin aggregates (MAA-Ad; d = 18 μm) and (radiolabeled) Cy5 and β-cyclodextrin (host)-containing PIBMA polymers (99mTc-Cy50.5CD10PIBMA39; MW ~ 18.8 kDa) functioned as the reactive pair. Following liver or lung embolization with (99mTc)-MAA-Ad or (99mTc)-MAA (control), the utility of the pre-targeting concept was evaluated after intravenous administration of 99mTc-Cy50.5CD10PIBMA39.

Results: Interactions between MAA-Ad and Cy50.5CD10PIBMA39 could be monitored in solution using confocal microscopy and were quantified by radioisotope-based binding experiments. In vivo the accumulation of the MAA-Ad particles in the liver or lungs yielded an approximate ten-fold increase in accumulation of 99mTc-Cy50.5CD10PIBMA39 in these organs (16.2 %ID/g and 10.5 %ID/g, respectively) compared to the control. Pre-targeting with MAA alone was shown to be only half as efficient. Uniquely, for the first time, this data demonstrates that the formation of supramolecular interactions between cyclodextrin and adamantane can be used to drive complex formation in the chemically challenging in vivo environment.

Conclusion: The in vivo distribution pattern of the cyclodextrin host could be guided by the pre-administration of the adamantane guest, thereby creating a direct link between the scout-scan (MAA-Ad) and delivery of therapy.

Keywords: Nanotechnology, Interventional radiology, Pre-targeting, Supramolecular chemistry, Radioembolization