Usefulness of thermographic analysis to control temperature homogeneity in the development and implementation of a closed recirculating CO 2 chemohyperthermia model

Abstract

Purpose: To determine the effectiveness of thermography to control the distribution of abdominal temperature in the development of a closed chemohyperthermia model. Materials and methods: For thermographic analysis, we divided the abdominopelvic cavity into nine regions according to a modification of carcinomatosis peritoneal index. A difference of 2.5 °C between and within the quadrants, and thermographic colours, were used as asymmetric criteria. Preclinical study:· Rats Model: Six athymic nude rats, male, rnu/rnu. They were treated with closed technique and open technique. Porcine Model: 12 female large white pigs. Four were treated with open technique and eight with closed recirculation CO 2 technique. Clinical Pilot Study, EUDRACT 2011-006319-69: 18 patients with ovarian cancer were treated with cytoreductive surgery and hyperthermia intraperitoneal chemotherapy, HIPEC, with a closed recirculating CO 2 system. Thermographic control and intra-abdominal temperature assessment was performed at the baseline, when outflow temperature reached 41 °C, and at 30´. Results: The thermographic images showed a higher homogeneity of the intra-abdominal temperature in the closed model respect to the open technique. The thermogram showed a temperature distribution homogeneity when starting the circulation of chemotherapy. There was correlation between the temperature thermographic map in the closed porcine model and pilot study, and reached inflow and outflow temperatures, at half time of HIPEC, of 42/41.4 °C and 42 ± 0.2/41 ± 0.8 °C, respectively. There was no significant impact to the core temperature of patients after reaching the homogeneous temperature distribution. Conclusions: To control homogeneity of temperature distribution is feasible using infra-red digital images in a closed HIPEC with CO 2 recirculation.