Changes of apoptosis in tumor tissues with time after irreversible electroporation

Kim, Hong Bae; Sung, Chang Kyu; Baik, Ku Youn; Moon, Kee Wook; Kim, Hyung Sik; Yi, Jeong-Han; Jung, Jong Hyun; Moon, Min Hoan; Choi, Ohc Kyung

doi:10.1016/j.bbrc.2013.05.039

Cited by 38 publications

(31 citation statements)

References 12 publications

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“…These findings are in line with previous findings that indicate IRE ablation zones may not be fully developed directly after the intervention but rather after 24 hours [25]. The immediate effects of IRE prevalent in the central ablation zone appear to be attributable to necrotic cell death due to loss of homeostasis.…”

Section: Discussionsupporting

confidence: 92%

“…Coagulative necrosis of all cellular structures combined with hyperemia and hemorrhage can be observed through H&E stains. However, in the periphery a ring of apoptosis that initiates at the time of ablation and takes 24 hours to complete can be observed [25]. In addition to these effects, there may also be indirect effects due to disruption of local vasculature and immunological response [26].…”

Section: Discussionmentioning

confidence: 99%

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Planning Irreversible Electroporation in the Porcine Kidney: Are Numerical Simulations Reliable for Predicting Empiric Ablation Outcomes?

Wimmer

Srimathveeravalli

Gutta

et al. 2014

Cardiovasc Intervent Radiol

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Purpose Numerical simulations are used for treatment planning in clinical applications of irreversible electroporation (IRE) to determine ablation size and shape. To assess the reliability of simulations for treatment planning, we compared simulation results with empiric outcomes of renal IRE using computed tomography (CT) and histology in an animal model. Materials and Methods The ablation size and shape for 6 different IRE parameter sets (70–90 pulses, 2000–2700V, 70–100μs) for monopolar and bipolar electrodes was simulated using a numerical model. Employing these treatment parameters 35 CT-guided IRE ablations were created in both kidneys of 6 pigs and followed-up with CT immediately and after 24 hours. Histopathology was analyzed from post-ablation day 1. Results Ablation zones on CT measured 81±18% (day 0, p≤0.05) and 115±18% (day 1, p≤0.09) of the simulated size for monopolar electrodes, 190±33% (day 0, p≤0.001) and 234±12% (day 1, p≤0.0001) for bipolar electrodes. Histopathology indicated smaller ablation zones than simulated (71±41%, p≤0.047) and measured on CT (47±16%, p≤0.005) with complete ablation of kidney parenchyma within the central zone and incomplete ablation in the periphery. Conclusions Both numerical simulations for planning renal IRE and CT measurements may overestimate the size of ablation when compared to histology and ablation effects may be incomplete in the periphery.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Planning Irreversible Electroporation in the Porcine Kidney: Are Numerical Simulations Reliable for Predicting Empiric Ablation Outcomes?

Wimmer

Srimathveeravalli

Gutta

et al. 2014

Cardiovasc Intervent Radiol

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“…Reversible electroporation has been used to introduce genes and drugs into the cell, after which the cellular membrane recovers [5, 6]. In IRE, the combination of a high-magnitude electrical field and long exposure time to this electrical field is used, leading to permanent disrupted cell membranes and eventually apoptosis [7]. …”

Section: Introductionmentioning

confidence: 99%

Conductivity Rise During Irreversible Electroporation: True Permeabilization or Heat?

Ruarus

Vroomen

Puijk

et al. 2018

Cardiovasc Intervent Radiol

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PurposeIrreversible electroporation (IRE) induces apoptosis with high-voltage electric pulses. Although the working mechanism is non-thermal, development of secondary Joule heating occurs. This study investigated whether the observed conductivity rise during IRE is caused by increased cellular permeabilization or heat development.MethodsIRE was performed in a gelatin tissue phantom, in potato tubers, and in 30 patients with unresectable colorectal liver metastases (CRLM). Continuous versus sequential pulsing protocols (10-90 vs. 10-30-30-30) were assessed. Temperature was measured using fiber-optic probes. After temperature had returned to baseline, 100 additional pulses were delivered. The primary technique efficacy of the treated CRLM was compared to the periprocedural current rise. Seven patients received ten additional pulses after a 10-min cool-down period.ResultsTemperature and current rise was higher for the continuous pulsing protocol (medians, gel: 13.05 vs. 9.55 °C and 9 amperes (A) vs. 7A; potato: 12.70 vs. 10.53 °C and 6.0A vs. 6.5A). After cooling-down, current returned to baseline in the gel phantom and near baseline values (Δ2A with continuous- and Δ5A with sequential pulsing) in the potato tubers. The current declined after cooling-down in all seven patients with CRLM, although baseline values were not reached. There was a positive correlation between current rise and primary technique efficacy (p = 0.02); however, the previously reported current increase threshold of 12–15A was reached in 13%.ConclusionThe observed conductivity rise during IRE is caused by both cellular permeabilization and heat development. Although a correlation between current rise and efficacy exists, the current increase threshold seems unfeasible for CRLM.Electronic supplementary materialThe online version of this article (10.1007/s00270-018-1971-7) contains supplementary material, which is available to authorized users.

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“…This study of IRE in renal tumors demonstrated no evidence of major complications, and 35% of patients had minor complications, suggesting IRE is as safe as RF ablation or cryoablation (35). We theorize that the lack of major complications compared with RF ablation or cryotherapy might be due to the small diameter of the IRE probe (19 gauge) and the IRE technique itself.…”

Section: Discussionmentioning

confidence: 80%

Minimally Invasive Percutaneous Treatment of Small Renal Tumors with Irreversible Electroporation: A Single-Center Experience

Trimmer

Khosla

Morgan

et al. 2015

Journal of Vascular and Interventional Radiology

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Changes of apoptosis in tumor tissues with time after irreversible electroporation

Cited by 38 publications

References 12 publications

Planning Irreversible Electroporation in the Porcine Kidney: Are Numerical Simulations Reliable for Predicting Empiric Ablation Outcomes?

Planning Irreversible Electroporation in the Porcine Kidney: Are Numerical Simulations Reliable for Predicting Empiric Ablation Outcomes?

Conductivity Rise During Irreversible Electroporation: True Permeabilization or Heat?

Minimally Invasive Percutaneous Treatment of Small Renal Tumors with Irreversible Electroporation: A Single-Center Experience

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