Effects Of High Intensity Focused Ultrasound Treatment On Invasion And Adjacent Peripancreatic Vessels In Pancreatic Cancer

BackgroundPancreatic cancer(PC)is still the most malignant tumor in gastrointestinal malignancies with poor prognosis and extremely low five-year survival rate.In recent years,the incidence and mortality of pancreatic cancer have been increasing year by year.Local ablation has been widely used in clinical treatment of pancreatic cancer.High-intensity Focused Ultrasound(HIFU),as a non-invasive treatment technology,has achieved a good clinical effect in the treatment of pancreatic cancer.However,less attention has been paid to the effect of HIFU in the treatment of pancreatic cancer on its invasion and adjacent blood vessels currently.ObjectiveBy observing vascular morphology and measuring vascular hemodynamics to evaluate the effect of HIFU treatment on pancreatic cancer on its invasion and adjacent blood vessel function,at the same time record the occurrence of vascular adverse events in HIFU treatment of pancreatic cancer.Finally,the safety of HIFU in treatment of pancreatic cancer against invasion and adjacent vessels was evaluated.Methods1.Retrospectively observed and analyzed the clinical data of 51 patients with pancreatic cancer who met the criteria at the Second Affiliated Hospital of Chongqing Medical University from January 2018 to December 2019.Patients were evaluated by Computed Tomography(CT)or Magnetic Resonance Imaging(MRI).Imaging data before and at 1 week,1 month after HIFU treatment were observed to evaluate tumor invasion and adjacent blood vessels.The inner diameter of related vessels was measured,and observed whether there were vascular rupture and bleeding,vascular thrombosis,vascular occlusion and other treatment-related vascular adverse events.2.Retrospectively observed and analyzed the clinical data of 26 patients with pancreatic cancer who met the criteria at the Second Affiliated Hospital of Chongqing Medical University from August 2018 to December 2019.All patients received Color Doppler Flow Imaging(CDFI)assessment.Hemodynamic parameters of tumor invasion and adjacent blood vessels were measured,and related changes of blood vessel hemodynamics and blood vessel function were observed.Results1.In the study of vascular morphological,vessel involvement was recorded in 51 patients before HIFU treatment,including tumor lesions invading 64 veins and 44 arteries;in addition,23 veins and 69 arteries were less than 1 cm from the lesions.The vessel diameter of tumor invasion and adjacent vessels was measured by CT or MRI.There was no significant change in the inner diameter of related vessels before and 1 week after HIFU(P >0.05).No vascular adverse events such as vascular rupture hemorrhage,vascular thrombosis and vascular occlusion were observed after treatment.2.In the study of vascular hemodynamics,vessel involvement was recorded in 19 patients before HIFU treatment,including tumor lesions invading 31 veins and 22 arteries;in addition,14 veins and 37 arteries were less than 1 cm from the lesions.The hemodynamic parameters of peripancreatic vessels were measured by CDFI,including mean blood flow velocity,peak systolic blood flow velocity(PSV),vascular resistance index(RI),vascular pulsatility index(PI),vascular diameter,vascular blood flow and other indicators to assess vascular perfusion in CT/MRI.There were no significant differences in preoperative and postoperative hemodynamic data(P>0.05).All patients were safely treated with HIFU without the occurrence of adverse vascular events.ConclusionFor pancreatic cancer with tumor invasion or compression of adjacent peripancreatic blood vessels,HIFU can be safely ablated without causing significant changes in the hemodynamics and morphology of tumor invasion and adjacent blood vessels and without affecting blood perfusion.No vascular adverse events related to treatment such as vascular rupture hemorrhage,vascular thrombosis and vascular occlusion were observed.