title: Exploring the Spatial Drug Distribution Pattern of Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC).
abstract: BACKGROUND
  Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a novel approach to delivering intraperitoneal chemotherapy (IPC) as a pressurized aerosol. One of the assumed advantages is the homogeneous drug distribution in the intraperitoneal cavity compared with conventional liquid in situ chemotherapy. However, to date, the spatial drug distribution pattern of PIPAC has not been investigated in detail.
  
  
  METHODS
  Doxorubicin was aerosolized in an ex vivo PIPAC model containing native fresh tissue samples of swine peritoneum at a pressure of 12 mmHg CO2 at 36 °C. In the center of the top cover of the PIPAC chamber, a PIPAC micropump was installed. Tissue specimens were placed as follows: (A) bottom of the plastic box, (B) margin of the aerosol jet covered with a bilaterally open tunnel, (C) side wall, and (D) top cover, respectively. In-tissue doxorubicin penetration was measured using fluorescence microscopy on frozen thin sections.
  
  
  RESULTS
  The depth of doxorubicin penetration was found to be significantly higher in tissues directly exposed to the aerosol jet (A: 215 ± 79 µm) compared with the side wall (C: 77 ± 18 µm; p < 0.01) and the top of the box (D: 65 ± 17 µm; p < 0.01). The poorest penetration was observed for peritoneal tissue covered under a bilaterally open plastic tunnel (B: 34 ± 19 µm; p < 0.001).
  
  
  CONCLUSIONS
  The study data suggest that the spatial drug distribution pattern of ex vivo PIPAC is heterogeneous.
authors.affiliation: Department of General Surgery & Therapy Center for Peritonealcarcinomatosis, St. Mary's Hospital Herne, Ruhr University Bochum, Herne, Germany.|Basic Research Laboratory Department of Surgery, St. Mary's Hospital Herne, Ruhr University Bochum, Herne, Germany.
authors.forename: Veria
authors.initials: V
authors.lastname: Khosrawipour
authors.affiliation: Basic Research Laboratory Department of Surgery, St. Mary's Hospital Herne, Ruhr University Bochum, Herne, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Khosrawipour
authors.affiliation: Department of Hematology & Medical Oncology, St. Mary's Hospital Herne, Ruhr University Bochum, Herne, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Diaz-Carballo
authors.affiliation: Department of Neuroanatomy and Molecular Brain Research, Ruhr University Bochum, Herne, Germany.
authors.forename: Eckart
authors.initials: E
authors.lastname: Förster
authors.affiliation: Department of General Surgery & Therapy Center for Peritonealcarcinomatosis, St. Mary's Hospital Herne, Ruhr University Bochum, Herne, Germany.|Basic Research Laboratory Department of Surgery, St. Mary's Hospital Herne, Ruhr University Bochum, Herne, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Zieren
authors.affiliation: Department of General Surgery & Therapy Center for Peritonealcarcinomatosis, St. Mary's Hospital Herne, Ruhr University Bochum, Herne, Germany. urs.pabst@marienhospital-herne.de.|Basic Research Laboratory Department of Surgery, St. Mary's Hospital Herne, Ruhr University Bochum, Herne, Germany. urs.pabst@marienhospital-herne.de.
authors.forename: Urs
authors.initials: U
authors.lastname: Giger-Pabst
mesh_terms: D000336:Aerosols; D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D004317:Doxorubicin / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D010535:Laparoscopy; D010537:Peritoneum / Q000187:drug effects / Q000378:metabolism*; D011312:Pressure; D013552:Swine; D014018:Tissue Distribution
chemical_list: D000336:Aerosols; D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin