Towards FUS lung cancer ablation: the lung flooding process from a physiological and physical view point
© Wolfram and Lesser; licensee BioMed Central Ltd. 2015
Published: 30 June 2015
Unilateral lung flooding replaces air with saline in lung parenchyma. It has been shown, that in flooded condition ultrasound guidance and HIFU ablation of central lung cancer tissue is feasible. The flooding process generates a saline-lung compound which is different than known parenchymal tissue. Complete understanding of the flooding process is essential for its implementation in a HIFU cancer ablation scheme.
Therefore a detailed excurse of the flooding mechanism and its influences in acoustic and physiological conditions will be discussed. However, before initiating the first human pilot, several issues remain. So far the usability of MR guiding and aspects of HIFU effects on flooded lung parenchyma are unknown.
Human lung lobes, containing Non Small Cell Lung Cancer (NSCLC), are resected after complete intra-surgical atelectasis. The lobes are flooded in vitro with degased saline under static pressure of 30 cm water column. Images based on T1w, T2w sequences were acquired by MRI (Achieva 1.5T, Phillips, The Netherlands). A broadband acoustic immersion technique is used to determine the attenuation properties of flooded lung parenchyma. In vivo lung flooding was performed in a porcine large animal model “deutsches Landschwein” ca. 30kg. For ventilation a model specific double lumen catheter was trans-bronchially inserted. After 30min FIO 1.0 oxygen ventilation, the left lung wing was flooded with saline under static pressure of 30cm H2O column. Flooding was maintained for 90 min under continuous monitoring of vital parameters (SO2, pCO2, pAp, HR).
Results and conclusions
The study was supported by the the SRH Waldklinikum Gera (Germany) and the Focused Ultrasound Foundation. Animal experiments were performed with permission of the Veterinary Department of the Thuringian State Authority (TLLV) in compliance with the National Animal Protection Act.
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