Planning of Electroporation-Based Treatments Using Web-Based Treatment-Planning Software

Abstract

Electroporation-based treatment combining high-voltage electric pulses and poorly permanent cytotoxic drugs, i.e., electrochemotherapy (ECT), is currently used for treating superficial tumor nodules by following standard operating procedures. Besides ECT, another electroporation-based treatment, nonthermal irreversible electroporation (N-TIRE), is also efficient at ablating deepseated tumors. To perform ECT or N-TIRE of deep-seated tumors, following standard operating procedures is not sufficient and patient-specific treatment planning is required for successful treatment. Treatment planning is required because of the use of individual long-needle electrodes and the diverse shape, size and location of deepseated tumors. Many institutions that already perform ECT of superficial metastases could benefit from treatmentplanning software that would enable the preparation of patient-specific treatment plans. To this end, we have developed a Web-based treatment-planning software for planning electroporation-based treatments that does not require prior engineering knowledge from the user (e.g., the clinician). The software includes algorithms for automatic tissue segmentation and, after segmentation, generation of a 3D model of the tissue. The procedure allows the user to define how the electrodes will be inserted. Finally, electric field distribution is computed, the position of electrodes and the voltage to be applied are optimized using the 3D model and a downloadable treatment plan is made available to the user.

Electrochemotherapy as treatment option for hepatocellular carcinoma, a prospective pilot study

“…Placement is aided with US guidance and electrodes are placed according to the treatment plan [15]. The pre-treatment plan was used in treatment of deep seated tumors, as well as in tumors larger than 3 cm in diameter and those in close vicinity of the major hepatic vessels [34,35]. Both the previous and the current study provided evidence that such a technological approach is feasible and safe with a high tumor response rate.…”

Electroporation-Based Technologies for Medicine: Principles, Applications, and Challenges

“…These problems could potentially be understood through better integrating imaging for treatment planning and by using optimization algorithms for electrode positioning. Development and integration of standard electroporation treatment planning methods are essential for therapy success (175). This integration will provide more precise treatment with fewer side effects.…”

Electroporation-based applications in biotechnology

“…To reduce field nonhomogeneity the electric field delivery to a tissue must be carefully designed; a numerical model of the tissue is built, taking into account its particular structure; the number, size, shape, and positioning of the electrodes are then iteratively optimized until sufficient field homogeneity is achieved inside the tissue or in a sub tissue of interest, for example, a tumor inside a larger tissue such as the liver [19].…”