Correction: Time-Dependent Impact of Irreversible Electroporation on Pancreas, Liver, Blood Vessels and Nerves: A Systematic Review of Experimental Studies

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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Conductivity Rise During Irreversible Electroporation: True Permeabilization or Heat?

Ruarus

Vroomen

Puijk

et al. 2018

Cardiovasc Intervent Radiol

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Successful ablation of lymph nodes using irreversible electroporation (IRE) in a porcine survival model

Fritz

Sommer

Longerich

et al. 2017

Langenbecks Arch Surg

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3D mixed-reality visualization of medical imaging data as a supporting tool for innovative, minimally invasive surgery for gastrointestinal tumors and systemic treatment as a new path in personalized treatment of advanced cancer diseases

Wierzbicki¹,

Pawłowicz²,

Job³

et al. 2021

J Cancer Res Clin Oncol

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Background The purpose of this study was to investigate the potential of a combination of 3D mixed-reality visualization of medical images using CarnaLife Holo (MedApp, Poland) system as a supporting tool for innovative, minimally invasive surgery/irreversible electroporation—IRA, Nano-Knife), microwave ablation (MWA)/for advanced gastrointestinal tumors. Eight liver and pancreatic tumor treatments were performed. In all of the patients undergoing laparoscopy or open surgery volume and margin were estimated by preoperative visualization. In all patients, neoplastic lesions were considered unresectable by standard methods. Methods Preoperative CT or MRI were transformed into holograms and displayed thanks to the HoloLens 2. During operation, the surgeon’s field of view was augmented with a 3D model of the patient’s relevant structures. Results The intraoperative hologram contributed to better presentation of tumor size and locations, more precise setting of needles used to irreversible electroporation and for determining ablation line in case of liver metastases. Surgeons could easily compare the real patient's anatomy to holographic visualization just before the operations. Conclusions The combination of 3D mixed-reality visualization using CarnaLife Holo with IRA, MWA and next systemic treatment (chemotherapy) might be a new way in personalized treatment of advanced cancers.

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Correction: Time-Dependent Impact of Irreversible Electroporation on Pancreas, Liver, Blood Vessels and Nerves: A Systematic Review of Experimental Studies

Cited by 30 publications

References 2 publications

Conductivity Rise During Irreversible Electroporation: True Permeabilization or Heat?

Conductivity Rise During Irreversible Electroporation: True Permeabilization or Heat?

Successful ablation of lymph nodes using irreversible electroporation (IRE) in a porcine survival model

3D mixed-reality visualization of medical imaging data as a supporting tool for innovative, minimally invasive surgery for gastrointestinal tumors and systemic treatment as a new path in personalized treatment of advanced cancer diseases

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