Comparing Distribuition and Droplet size of Ultrasonic Aerosolization with Traditional Pipac of Therapeutic Substance in Porcine Models

Author(s): Rafael Seitenfus, Carla Joana Hugueney Franco Lobo, Eduardo Dipp de Barros, Giovanni Luigi Ariza Calvario, Paulo Roberto Walter Ferreira, Ana Carolina Bathelt Fleig, Guilherme watte

Background: The characteristics of peritoneal metastases explain the resistance in the action of systemic chemotherapeutic agents. PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy) optimizes the distribution and penetration depth of chemotherapeutics. Ultrasonic PIPAC brings features that are still unexplored in traditional PIPAC. This paper aims to evaluate the particle distribution of the ultrasonic tool in PIPAC.

Material and Methods: Avaliação da distribuição da aerossolização ultrassônica de solução de nitrato de prata no espaço peritoneal de 5 modelos porcinos por biópsias peritoneais. A descrição das características do aerossol ultrassônico formado e a análise peritoneal das amostras patológicas foram comparadas com 5 modelos de aerossolização por alta pressão realizados em artigo publicado anteriormente.

Droplet size measurement was performed at three percentiles of ultrasonic aerosol formed from two aerosol rod designs and compared with mechanical aerosolization. Moreover, the tissue distribution was observed and compared by pathology. We described the physical characteristics of ultrasonic aerosolization in 5 laparoscopic procedures (porcine models).

Results: The mean ultrasound aerosolization time was 38.1 minutes with maximum temperature of 39°C. The medium of ultrasonic aerosolizations dropless creat was 39,17μm and the hat tip had an average of 33.10μm. We also notice that the droplet size was better at ultrasonic devices (hat and multidirectional), and beyond that, the upper abdomen drug distribution was superior for multidirectional US devices than standart PIPAC.

Conclusions: Ultrasonic aerosolization is feasible with adequate droplet size and the possibility of heating as well as maximize the aerosolization time. But ultrasonic aerosolization also seems to have a better distribution when compared to traditional PIPAC technology.