Cargando…

Intraperitoneal chemotherapy of the peritoneal surface using high-intensity ultrasound (HIUS): investigation of technical feasibility, safety and possible limitations

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 significant...

Descripción completa

Detalles Bibliográficos
Autores principales: Lau, Hien, Khosrawipour, Tanja, Mikolajczyk, Agata, Frelkiewicz, Piotr, Nicpon, Jakub, Arafkas, Mohamed, Pigazzi, Alessio, Knoefel, Wolfram Trudo, Khosrawipour, Veria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ivyspring International Publisher 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646163/
https://www.ncbi.nlm.nih.gov/pubmed/33193884
http://dx.doi.org/10.7150/jca.48519
_version_ 1783606740199145472
author Lau, Hien
Khosrawipour, Tanja
Mikolajczyk, Agata
Frelkiewicz, Piotr
Nicpon, Jakub
Arafkas, Mohamed
Pigazzi, Alessio
Knoefel, Wolfram Trudo
Khosrawipour, Veria
author_facet Lau, Hien
Khosrawipour, Tanja
Mikolajczyk, Agata
Frelkiewicz, Piotr
Nicpon, Jakub
Arafkas, Mohamed
Pigazzi, Alessio
Knoefel, Wolfram Trudo
Khosrawipour, Veria
author_sort Lau, Hien
collection PubMed
description 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.
format Online
Article
Text
id pubmed-7646163
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Ivyspring International Publisher
record_format MEDLINE/PubMed
spelling pubmed-76461632020-11-12 Intraperitoneal chemotherapy of the peritoneal surface using high-intensity ultrasound (HIUS): investigation of technical feasibility, safety and possible limitations Lau, Hien Khosrawipour, Tanja Mikolajczyk, Agata Frelkiewicz, Piotr Nicpon, Jakub Arafkas, Mohamed Pigazzi, Alessio Knoefel, Wolfram Trudo Khosrawipour, Veria J Cancer Research Paper 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. Ivyspring International Publisher 2020-10-18 /pmc/articles/PMC7646163/ /pubmed/33193884 http://dx.doi.org/10.7150/jca.48519 Text en © The author(s) This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
spellingShingle Research Paper
Lau, Hien
Khosrawipour, Tanja
Mikolajczyk, Agata
Frelkiewicz, Piotr
Nicpon, Jakub
Arafkas, Mohamed
Pigazzi, Alessio
Knoefel, Wolfram Trudo
Khosrawipour, Veria
Intraperitoneal chemotherapy of the peritoneal surface using high-intensity ultrasound (HIUS): investigation of technical feasibility, safety and possible limitations
title Intraperitoneal chemotherapy of the peritoneal surface using high-intensity ultrasound (HIUS): investigation of technical feasibility, safety and possible limitations
title_full Intraperitoneal chemotherapy of the peritoneal surface using high-intensity ultrasound (HIUS): investigation of technical feasibility, safety and possible limitations
title_fullStr Intraperitoneal chemotherapy of the peritoneal surface using high-intensity ultrasound (HIUS): investigation of technical feasibility, safety and possible limitations
title_full_unstemmed Intraperitoneal chemotherapy of the peritoneal surface using high-intensity ultrasound (HIUS): investigation of technical feasibility, safety and possible limitations
title_short Intraperitoneal chemotherapy of the peritoneal surface using high-intensity ultrasound (HIUS): investigation of technical feasibility, safety and possible limitations
title_sort intraperitoneal chemotherapy of the peritoneal surface using high-intensity ultrasound (hius): investigation of technical feasibility, safety and possible limitations
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646163/
https://www.ncbi.nlm.nih.gov/pubmed/33193884
http://dx.doi.org/10.7150/jca.48519
work_keys_str_mv AT lauhien intraperitonealchemotherapyoftheperitonealsurfaceusinghighintensityultrasoundhiusinvestigationoftechnicalfeasibilitysafetyandpossiblelimitations
AT khosrawipourtanja intraperitonealchemotherapyoftheperitonealsurfaceusinghighintensityultrasoundhiusinvestigationoftechnicalfeasibilitysafetyandpossiblelimitations
AT mikolajczykagata intraperitonealchemotherapyoftheperitonealsurfaceusinghighintensityultrasoundhiusinvestigationoftechnicalfeasibilitysafetyandpossiblelimitations
AT frelkiewiczpiotr intraperitonealchemotherapyoftheperitonealsurfaceusinghighintensityultrasoundhiusinvestigationoftechnicalfeasibilitysafetyandpossiblelimitations
AT nicponjakub intraperitonealchemotherapyoftheperitonealsurfaceusinghighintensityultrasoundhiusinvestigationoftechnicalfeasibilitysafetyandpossiblelimitations
AT arafkasmohamed intraperitonealchemotherapyoftheperitonealsurfaceusinghighintensityultrasoundhiusinvestigationoftechnicalfeasibilitysafetyandpossiblelimitations
AT pigazzialessio intraperitonealchemotherapyoftheperitonealsurfaceusinghighintensityultrasoundhiusinvestigationoftechnicalfeasibilitysafetyandpossiblelimitations
AT knoefelwolframtrudo intraperitonealchemotherapyoftheperitonealsurfaceusinghighintensityultrasoundhiusinvestigationoftechnicalfeasibilitysafetyandpossiblelimitations
AT khosrawipourveria intraperitonealchemotherapyoftheperitonealsurfaceusinghighintensityultrasoundhiusinvestigationoftechnicalfeasibilitysafetyandpossiblelimitations