Toward a clinical real time tissue ablation technology: combining electroporation and electrolysis (E2)

Background: Percutaneous image-guided tissue ablation (IGA) plays a growing role in the clinical management of solid malignancies. Electroporation is used for IGA in several modalities: irreversible electroporation (IRE), and reversible electroporation with chemotoxic drugs, called electrochemothera...

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Bibliographic Details
Authors: Guenther, Enric, Klein, Nina, Mikus, Paul, Botea, Florin, Pautov, Mihail, Lugnani, Franco, Macchioro, Matteo, Popescu, Irinel, Stehling, Michael Klaus, Rubinsky, Boris
Format: article
Status:Published version
Publication Date:2020
Country:España
Institution:Universitat Pompeu Fabra
Repository:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/46744
Online Access:http://hdl.handle.net/10230/46744
http://dx.doi.org/10.7717/peerj.7985
Access Level:Open access
Keyword:Electrolysis
Irreversible electroporation
Electro chemo theraphy
Image guided tissue ablation
Medtec
Cancer treatment
Description
Summary:Background: Percutaneous image-guided tissue ablation (IGA) plays a growing role in the clinical management of solid malignancies. Electroporation is used for IGA in several modalities: irreversible electroporation (IRE), and reversible electroporation with chemotoxic drugs, called electrochemotherapy (ECT). It was shown that the combination of electrolysis and electroporation—E2—affords tissue ablation with greater efficiency, that is, lower voltages, lower energy and shorter procedure times than IRE and without the need for chemotoxic additives as in ECT. Methods: A new E2 waveform was designed that delivers optimal doses of electroporation and electrolysis in a single waveform. A series of experiments were performed in the liver of pigs to evaluate E2 in the context of clinical applications. The goal was to find initial parameter boundaries in terms of electrical field, pulse duration and charge as well as tissue behavior to enable real time tissue ablation of clinically relevant volumes. Results: Histological results show that a single several hundred millisecond long E2 waveform can ablate large volume of tissue at relatively low voltages while preserving the integrity of large blood vessels and lumen structures in the ablation zone without the use of chemotoxic drugs or paralyzing drugs during anesthesia. This could translate clinically into much shorter treatment times and ease of use compared to other techniques that are currently applied.