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Cytoreductive Surgical Treatment of Pleural Mesothelioma in a Porcine Model Using Magnetic-Resonance-Guided Focused
Marcia Costa1, Carolina Fernandes1, Matt Eames2
1Faculdade de Ciencias, Universidade de Lisboa, 1749-016 Lisboa, Portugal.
Abstract:
A combination of surgery and chemotherapy is the most effective treatment available for Malignant Pleural Mesothelioma (MPM). However, both cause significant collateral damage and cannot eliminate residual microscopic disease. This investigation aimed to compare and determine the feasibility of utilizing Radiofrequency Ablation (RFA) and Magnetic-Resonance-guided Focused Ultrasound Surgery (MRgFUS) as alternative treatments for MPM. A large animal tumor model was developed in 13 Yorkshire female pigs using the MSTO211H cell line. Two pigs were initially used to determine the cyclosporine dose required for immunosuppression and tumor development. Subsequently, 11 other pigs underwent tumor development. Of these 11, 2 died during cell inoculation. Small tumor masses and adhesions were present in the other 9, indicating mesothelioma development. Five pigs then received RFA treatment, and 4 pigs received MRgFUS treatment. Tumor model development and effect of the two treatments were examined using MRI and by necropsy. RFA and MRgFUS both successfully ablated approximately the same sized area in the same treatment time. This study demonstrates that RFA and MRgFUS are feasible for tumor debulking, and while MRgFUS requires more pretreatment planning compared to RFA, MRgFUS is a completely noninvasive procedure.
Insights
Radiofrequency Ablation (RFA) and Magnetic-Resonance-guided Focused Ultrasound Surgery (MRgFUS) show feasibility for Malignant Pleural Mesothelioma (MPM) tumor debulking. Both minimally invasive techniques offer comparable ablation, with MRgFUS being noninvasive.
Area of Science:
- Oncology
- Minimally Invasive Surgery
- Medical Imaging
Background:
- Malignant Pleural Mesothelioma (MPM) treatment relies on surgery and chemotherapy, which have significant side effects and limitations in eradicating microscopic disease.
- There is a need for alternative, less invasive treatment options for MPM that can effectively reduce tumor burden.
Purpose of the Study:
- To compare the feasibility of Radiofrequency Ablation (RFA) and Magnetic-Resonance-guided Focused Ultrasound Surgery (MRgFUS) as alternative treatments for MPM.
- To evaluate the efficacy of RFA and MRgFUS in tumor debulking using a large animal model.
Main Methods:
- Development of a large animal tumor model for MPM in Yorkshire female pigs using the MSTO211H cell line.
- Treatment of established tumors in pigs using either RFA or MRgFUS.
- Assessment of treatment effectiveness through Magnetic Resonance Imaging (MRI) and necropsy.
Main Results:
- Both RFA and MRgFUS demonstrated feasibility for tumor debulking in the MPM animal model.
- Both treatments achieved ablation of comparable tumor sizes within the same treatment duration.
- MRgFUS, while requiring more extensive pretreatment planning, offers a completely noninvasive approach compared to RFA.
Conclusions:
- Radiofrequency Ablation (RFA) and Magnetic-Resonance-guided Focused Ultrasound Surgery (MRgFUS) are feasible minimally invasive techniques for MPM tumor debulking.
- MRgFUS presents a noninvasive alternative to conventional treatments, though it necessitates thorough pretreatment planning.
- Further research into these modalities could lead to improved therapeutic strategies for Malignant Pleural Mesothelioma.
