Download PDF
Semin intervent Radiol 2014; 31(02): 111-117
DOI: 10.1055/s-0034-1373785
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The State of Irreversible Electroporation in Interventional Oncology

Mikhail Silk
1   Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
,
David Tahour
1   Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
,
Govindarajan Srimathveeravalli
1   Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
,
Stephen B. Solomon
1   Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
,
Raymond H. Thornton
1   Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
21 May 2014 (online)

Also available at
    Permissions and Reprints

Abstract

A new ablation modality, irreversible electroporation (IRE), has been of increasing interest in interventional radiology. Its nonthermal mechanism of action of killing tumor cells allows physicians the ability to ablate tumors in areas previously contraindicated for thermal ablation. This article reviews the current published clinical outcomes, imaging follow-up, and the current knowledge gaps in the procedure for patients treated with IRE.

Keywords

irreversible electroporation - interventional oncology - ablation - kidney - liver - lung - pancreas - interventional radiology
 

  • References

  • 1 Coster HG. A quantitative analysis of the voltage-current relationships of fixed charge membranes and the associated property of “punch-through”. Biophys J 1965; 5 (5) 669-686
    CrossrefPubMedGoogle Scholar
  • 2 Davalos RV, Mir IL, Rubinsky B. Tissue ablation with irreversible electroporation. Ann Biomed Eng 2005; 33 (2) 223-231
    CrossrefPubMedGoogle Scholar
  • 3 Breton M, Mir LM. Microsecond and nanosecond electric pulses in cancer treatments. Bioelectromagnetics 2012; 33 (2) 106-123
    CrossrefPubMedGoogle Scholar
  • 4 Charpentier KP, Wolf F, Noble L, Winn B, Resnick M, Dupuy DE. Irreversible electroporation of the liver and liver hilum in swine. HPB (Oxford) 2011; 13 (3) 168-173
    CrossrefPubMedGoogle Scholar
  • 5 Schoellnast H, Monette S, Ezell PC , et al. Acute and subacute effects of irreversible electroporation on nerves: experimental study in a pig model. Radiology 2011; 260 (2) 421-427
    CrossrefPubMedGoogle Scholar
  • 6 Schoellnast H, Monette S, Ezell PC , et al. The delayed effects of irreversible electroporation ablation on nerves. Eur Radiol 2013; 23 (2) 375-380
    CrossrefPubMedGoogle Scholar
  • 7 Silk MT, Wimmer T, Lee KS , et al. Percutaneous ablation of peribiliary tumors with irreversible electroporation. J Vasc Interv Radiol 2014; 25 (1) 112-118
    CrossrefPubMedGoogle Scholar
  • 8 Neal II RE, Smith RL, Kavnoudias H , et al. The effects of metallic implants on electroporation therapies: feasibility of irreversible electroporation for brachytherapy salvage. Cardiovasc Intervent Radiol 2013; 36 (6) 1638-1645
    CrossrefPubMedGoogle Scholar
  • 9 Onik G, Mikus P, Rubinsky B. Irreversible electroporation: implications for prostate ablation. Technol Cancer Res Treat 2007; 6 (4) 295-300
    CrossrefPubMedGoogle Scholar
  • 10 Mandel Y, Laufer S, Belkin M, Rubinsky B, Pe'er J, Frenkel S. Irreversible electroporation of human primary uveal melanoma in enucleated eyes. PLoS ONE 2013; 8 (9) e71789
    CrossrefPubMedGoogle Scholar
  • 11 Garcia PA, Rossmeisl Jr JH, Davalos RV. Electrical conductivity changes during irreversible electroporation treatment of brain cancer. Conf Proc IEEE Eng Med Biol Soc 2011; 2011: 739-742
    PubMedGoogle Scholar
  • 12 Hjouj M, Last D, Guez D , et al. MRI study on reversible and irreversible electroporation induced blood brain barrier disruption. PLoS ONE 2012; 7 (8) e42817
    CrossrefPubMedGoogle Scholar
  • 13 Neal II RE, Rossmeisl Jr JH, D'Alfonso V , et al. In vitro and numerical support for combinatorial irreversible electroporation and electrochemotherapy glioma treatment. Ann Biomed Eng 2013; 42 (3) 475-487
    PubMedGoogle Scholar
  • 14 Gervais DA, Goldberg SN, Brown DB, Soulen MC, Millward SF, Rajan DK. Society of Interventional Radiology position statement on percutaneous radiofrequency ablation for the treatment of liver tumors. J Vasc Interv Radiol 2009; 20 (7, Suppl): S342-S347
    CrossrefPubMedGoogle Scholar
  • 15 Thomson KR, Cheung W, Ellis SJ , et al. Investigation of the safety of irreversible electroporation in humans. J Vasc Interv Radiol 2011; 22 (5) 611-621
    CrossrefPubMedGoogle Scholar
  • 16 Kingham TP, Karkar AM, D'Angelica MI , et al. Ablation of perivascular hepatic malignant tumors with irreversible electroporation. J Am Coll Surg 2012; 215 (3) 379-387
    CrossrefPubMedGoogle Scholar
  • 17 Cannon R, Ellis S, Hayes D, Narayanan G, Martin II RC. Safety and early efficacy of irreversible electroporation for hepatic tumors in proximity to vital structures. J Surg Oncol 2013; 107 (5) 544-549
    CrossrefPubMedGoogle Scholar
  • 18 Goldberg SN, Mallery S, Gazelle GS, Brugge WR. EUS-guided radiofrequency ablation in the pancreas: results in a porcine model. Gastrointest Endosc 1999; 50 (3) 392-401
    CrossrefPubMedGoogle Scholar
  • 19 Pezzilli R, Serra C, Ricci C , et al. Radiofrequency ablation for advanced ductal pancreatic carcinoma: is this approach beneficial for our patients? A systematic review. Pancreas 2011; 40 (1) 163-165
    CrossrefPubMedGoogle Scholar
  • 20 Bower M, Sherwood L, Li Y, Martin R. Irreversible electroporation of the pancreas: definitive local therapy without systemic effects. J Surg Oncol 2011; 104 (1) 22-28
    CrossrefPubMedGoogle Scholar
  • 21 Narayanan G, Hosein PJ, Arora G , et al. Percutaneous irreversible electroporation for downstaging and control of unresectable pancreatic adenocarcinoma. J Vasc Interv Radiol 2012; 23 (12) 1613-1621
    CrossrefPubMedGoogle Scholar
  • 22 Martin II RC, McFarland K, Ellis S, Velanovich V. Irreversible electroporation in locally advanced pancreatic cancer: potential improved overall survival. Ann Surg Oncol 2013; 20 (Suppl. 03) S443-S449
    CrossrefPubMedGoogle Scholar
  • 23 Zagoria RJ, Pettus JA, Rogers M, Werle DM, Childs D, Leyendecker JR. Long-term outcomes after percutaneous radiofrequency ablation for renal cell carcinoma. Urology 2011; 77 (6) 1393-1397
    CrossrefPubMedGoogle Scholar
  • 24 Pettus JA, Werle DM, Saunders W , et al. Percutaneous radiofrequency ablation does not affect glomerular filtration rate. J Endourol 2010; 24 (10) 1687-1691
    CrossrefPubMedGoogle Scholar
  • 25 Park SY, Park BK, Kim CK , et al. Percutaneous radiofrequency ablation of renal cell carcinomas in patients with von Hippel Lindau disease previously undergoing a radical nephrectomy or repeated nephron-sparing surgery. Acta Radiol 2011; 52 (6) 680-685
    CrossrefPubMedGoogle Scholar
  • 26 Pech M, Janitzky A, Wendler JJ , et al. Irreversible electroporation of renal cell carcinoma: a first-in-man phase I clinical study. Cardiovasc Intervent Radiol 2011; 34 (1) 132-138
    CrossrefPubMedGoogle Scholar
  • 27 Zhu JC, Yan TD, Glenn D, Morris DL. Radiofrequency ablation of lung tumors: feasibility and safety. Ann Thorac Surg 2009; 87 (4) 1023-1028
    CrossrefPubMedGoogle Scholar
  • 28 Usman M, Moore W, Talati R, Watkins K, Bilfinger TV. Irreversible electroporation of lung neoplasm: a case series. Med Sci Monit 2012; 18 (6) CS43-CS47
    CrossrefPubMedGoogle Scholar
  • 29 Silk M, Wimmer T, Getrajdman G , et al. Safety of irreversible electroporation (IRE) treatment for metastatic disease in humans. J Vasc Interv Radiol 2013; 24: S21-S22
    PubMedGoogle Scholar
  • 30 Srimathveeravalli G, Wimmer T, Silk M , et al. Treatment planning considerations for IRE in the lung: placement of needle electrodes is critical. J Vasc Interv Radiol 2013; 24: S22
    PubMedGoogle Scholar
  • 31 Ball C, Thomson KR, Kavnoudias H. Irreversible electroporation: a new challenge in “out of operating theater” anesthesia. Anesth Analg 2010; 110 (5) 1305-1309
    CrossrefPubMedGoogle Scholar
  • 32 Silk MT, Lee HM, Wimmer T , et al. Evolution of the ablation zone following irreversible electroporation of liver tumors on computed tomography and possible predictors of recurrence. Paper Presented at: World Conference of Interventional Oncology; May 17, 2013; New York, NY
    PubMedGoogle Scholar
  • 33 Au JT, Kingham TP, Jun K , et al. Irreversible electroporation ablation of the liver can be detected with ultrasound B-mode and elastography. Surgery 2013; 153 (6) 787-793
    CrossrefPubMedGoogle Scholar
  • 34 Schmidt CR, Shires P, Mootoo M. Real-time ultrasound imaging of irreversible electroporation in a porcine liver model adequately characterizes the zone of cellular necrosis. HPB (Oxford) 2012; 14 (2) 98-102
    CrossrefPubMedGoogle Scholar
  • 35 Guo Y, Zhang Y, Nijm GM , et al. Irreversible electroporation in the liver: contrast-enhanced inversion-recovery MR imaging approaches to differentiate reversibly electroporated penumbra from irreversibly electroporated ablation zones. Radiology 2011; 258 (2) 461-468
    CrossrefPubMedGoogle Scholar
  • 36 Rubinsky B, Onik G, Mikus P. Irreversible electroporation: a new ablation modality—clinical implications. Technol Cancer Res Treat 2007; 6 (1) 37-48
    CrossrefPubMedGoogle Scholar
  • 37 Neal II RE, Singh R, Hatcher HC, Kock ND, Torti SV, Davalos RV. Treatment of breast cancer through the application of irreversible electroporation using a novel minimally invasive single needle electrode. Breast Cancer Res Treat 2010; 123 (1) 295-301
    CrossrefPubMedGoogle Scholar
  • 38 Qin Z, Jiang J, Long G, Lindgren B, Bischof JC. Irreversible electroporation: an in vivo study with dorsal skin fold chamber. Ann Biomed Eng 2013; 41 (3) 619-629
    CrossrefPubMedGoogle Scholar
  • 39 Ben-David E, Ahmed M, Faroja M , et al. Irreversible electroporation: treatment effect is susceptible to local environment and tissue properties. Radiology 2013; 269 (3) 738-747
    CrossrefPubMedGoogle Scholar
  • 40 Davalos RV, Rubinsky B. Temperature considerations during irreversible electroporation. Int J Heat Mass Transfer 2008; 51: 5617-5622
    CrossrefPubMedGoogle Scholar
  • 41 Olweny EO, Kapur P, Tan YK, Park SK, Adibi M, Cadeddu JA. Irreversible electroporation: evaluation of nonthermal and thermal ablative capabilities in the porcine kidney. Urology 2013; 81 (3) 679-684
    CrossrefPubMedGoogle Scholar
  • 42 Faroja M, Ahmed M, Appelbaum L , et al. Irreversible electroporation ablation: is all the damage nonthermal?. Radiology 2013; 266 (2) 462-470
    CrossrefPubMedGoogle Scholar