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Intraperitoneal chemotherapy of the peritoneal surface using high-intensity ultrasound (HIUS): investigation of technical feasibility, safety and possible limitations
- Source :
- Journal of Cancer
- Publication Year :
- 2020
-
Abstract
- Introduction: The penetration of chemotherapeutic drugs into peritoneal nodules remains at levels well below 1 mm, thus significantly limiting the antitumor effect of intraperitoneal chemotherapy (IPC). Recently, high-Intensity ultrasound (HIUS) has been discovered as a potential tool to significantly improve peritoneal diffusion rates. Despite promising preliminary data, basic aspects regarding its technical feasibility, safety and possible limitations remain unclear. This study aims to enhance our current understanding of HIUS and test its applicability using an ex-vivo swine model. Methods: Three postmortem swine were subject to laparotomy and consecutive lavage with 0.9%NaCl saline and HIUS application. For this purpose, a large HIUS radiating pen was introduced into the abdominal cavity and HIUS was applied on two of the four abdominal quadrants for 300 seconds each at an output power of 70 W, 50 % amplitude and 20 kHz frequency. Following the procedure, small intestinal tissue samples were retrieved for further analyses. Results: Peritoneal and subperitoneal layers showed structural changes only visible on a microscopic level. The peritoneal layer was transformed into a mesh-like structure while the subperitoneal layer (depth of 142 +/- 28 µm) exhibited microcavities and vascular detachment from surrounding tissues. No bowel rupture or vascular perforations were observed. Conclusions: Our data indicate that HIUS is a technically feasible and safe add-on procedure for intraperitoneal chemotherapy (IPC) with measurable microscopic changes on the peritoneal surface. Pretreatment of the abdominal cavity with HIUS could significantly improve IPC efficacy. Further studies are required to optimize and evaluate this novel approach.
- Subjects :
- peritoneal
Peritoneal surface
business.industry
medicine.medical_treatment
High intensity
Ultrasound
high-intensity ultrasound
Intraperitoneal chemotherapy
Abdominal cavity
030218 nuclear medicine & medical imaging
03 medical and health sciences
Abdominal quadrants
0302 clinical medicine
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Laparotomy
Medicine
surface
HIUS
business
Nuclear medicine
Saline
Research Paper
Subjects
Details
- ISSN :
- 18379664
- Volume :
- 11
- Issue :
- 24
- Database :
- OpenAIRE
- Journal :
- Journal of Cancer
- Accession number :
- edsair.doi.dedup.....facfacb6f26f57408eaffd31dc863eea