Irreversible Electroporation for Nonthermal Tumor Ablation in the Clinical Setting: A Systematic Review of Safety and Efficacy

Scheffer, Hester J.; Nielsen, Karin; Jong, Marcus C. de; Tilborg, Aukje A. J. M. van; Vieveen, J.M.; Bouwman, R. Arthur; Meijer, Sybren; Kuijk, Cornelis van; Tol, Paul; Meijerink, Martijn R.

doi:10.1016/j.jvir.2014.01.028

Cited by 339 publications

(227 citation statements)

References 51 publications

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“…This may be a favourable factor for clinical application of IRE in pancreas and liver. Previously reported clinical studies comparing thermal ablation (RFA) with IRE show a reduced morbidity and similar pain levels in favour of IRE [53]. Although IRE is thought to be a non-thermal technique [3], IRE-treated lesions often show a centre of white coagulation surrounding the electrodes [3,[27][28][29]35], histologically characterized by streamlined cytoplasm and pyknotic nuclei [28].…”

Section: Discussionmentioning

confidence: 97%

Time-dependent impact of irreversible electroporation on pancreas, liver, blood vessels and nerves: a systematic review of experimental studies

Vogel

Veldhuisen

Agnass

et al. 2017

HPB

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Section: Discussionmentioning

confidence: 97%

Time-dependent impact of irreversible electroporation on pancreas, liver, blood vessels and nerves: a systematic review of experimental studies

Vogel

Veldhuisen

Agnass

et al. 2017

HPB

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“…The solver for the quasi-static Maxwell's equations can be used to simulate capacitive heating methods [64], but is also capable to model the temperature development and distribution during electroporation of tissue; a treatment that is presently investigated by several research groups [65][66][67].…”

Section: Discussionmentioning

confidence: 99%

Planning, optimisation and evaluation of hyperthermia treatments

Kok

Kotte

Crezee

2017

International Journal of Hyperthermia

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Background: Hyperthermia treatment planning using dedicated simulations of power and temperature distributions is very useful to assist in hyperthermia applications. This paper describes an advanced treatment planning software package for a wide variety of applications. Methods: The in-house developed Cþþ software package Plan2Heat runs on a Linux operating system. Modules are available to perform electric field and temperature calculations for many heating techniques. The package also contains optimisation routines, post-treatment evaluation tools and a sophisticated thermal model enabling to account for 3D vasculature based on an angiogram or generated artificially using a vessel generation algorithm. The use of the software is illustrated by a simulation of a locoregional hyperthermia treatment for a pancreatic cancer patient and a spherical tumour model heated by interstitial hyperthermia, with detailed 3D vasculature included. Results: The module-based set-up makes the software flexible and easy to use. The first example demonstrates that treatment planning can help to focus the heating to the tumour. After optimisation, the simulated absorbed power in the tumour increased with 50%. The second example demonstrates the impact of accurately modelling discrete vasculature. Blood at body core temperature entering the heated volume causes relatively cold tracks in the heated volume, where the temperature remains below 40 C. Conclusions: A flexible software package for hyperthermia treatment planning has been developed, which can be very useful in many hyperthermia applications. The object-oriented structure of the source code allows relatively easy extension of the software package with additional tools when necessary for future applications.

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“…The study concluded that when performing IRE ablation, the distance from the heart should be greater than 1.7 cm, or IRE should be performed in synchronized mode to avoid inducing ventricular arrhythmias [10]. Indeed, in an initial clinical study where IRE ablation was performed with cardiac synchronization, only atrial arrhythmias occurred (four cases), and these resolved either spontaneously or within 24 hours after therapy [11].…”

Section: Discussionmentioning

confidence: 99%

“…Based on these early studies, IRE is considered to be safe when it is combined with ECG-synchronized delivery [11]. However, Sugimoto et al reported that a number of transient ventricular extrasystoles occurred when the synchronization device failed to operate properly (unsuccessful synchronization with the R wave).…”

Section: Discussionmentioning

confidence: 99%

Irreversible Electroporation Ablation of Liver Metastases Adjacent to the Heart Induces Ventricular Tachycardia: A Case Report

Niu¹,

Luo²,

Zhang³

et al. 2017

J Hepatol Gastroint Dis

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Irreversible electroporation (IRE) is a new non-thermal ablation therapy that is currently undergoing clinical investigation for treatment of malignant liver and lung tumors; however, there is emerging evidence that is method can interfere with heart function. Here we report the first case of a 61-year-old Malaysian woman who underwent IRE ablation on liver metastases from pancreatic cancer located adjacent to the heart. During IRE ablation, two electrodes were placed on the liver tumor, with minimum distances from the heart of 5.7 mm. Despite using a cardiac synchronization device during the IRE ablation, paroxysmal ventricular tachycardia was induced in this patient. Therefore, care must be taken when treating lesions located near the heart with IRE.

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Irreversible Electroporation for Nonthermal Tumor Ablation in the Clinical Setting: A Systematic Review of Safety and Efficacy

Cited by 339 publications

References 51 publications

Time-dependent impact of irreversible electroporation on pancreas, liver, blood vessels and nerves: a systematic review of experimental studies

Time-dependent impact of irreversible electroporation on pancreas, liver, blood vessels and nerves: a systematic review of experimental studies

Planning, optimisation and evaluation of hyperthermia treatments

Irreversible Electroporation Ablation of Liver Metastases Adjacent to the Heart Induces Ventricular Tachycardia: A Case Report

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