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Gabay B, Levkov K, Berl A, Wise J, Shir-Az O, Vitkin E, Saulis G, Shalom A, Golberg A. Electroporation-Based Biopsy Treatment Planning with Numerical Models and Tissue Phantoms. Ann Biomed Eng 2024; 52:71-88. [PMID: 37154990 DOI: 10.1007/s10439-023-03208-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/10/2023] [Indexed: 05/10/2023]
Abstract
Molecular sampling with vacuum-assisted tissue electroporation is a novel, minimally invasive method for molecular profiling of solid lesions. In this paper, we report on the design of the battery-powered pulsed electric field generator and electrode configuration for an electroporation-based molecular sampling device for skin cancer diagnostics. Using numerical models of skin electroporation corroborated by the potato tissue phantom model, we show that the electroporated tissue volume, which is the maximum volume for biomarker sampling, strongly depends on the electrode's geometry, needle electrode skin penetration depths, and the applied pulsed electric field protocol. In addition, using excised human basal cell carcinoma (BCC) tissues, we show that diffusion of proteins out of human BCC tissues into water strongly depends on the strength of the applied electric field and on the time after the field application. The developed numerical simulations, confirmed by experiments in potato tissue phantoms and excised human cancer lesions, provide essential tools for the development of electroporation-based molecular markers sampling devices for personalized skin cancer diagnostics.
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Affiliation(s)
- Batel Gabay
- Porter School of Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Klimentiy Levkov
- Porter School of Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ariel Berl
- Department of Plastic Surgery, Meir Medical Center, Kfar Sava, Israel
| | - Julia Wise
- Porter School of Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ofir Shir-Az
- Department of Plastic Surgery, Meir Medical Center, Kfar Sava, Israel
| | - Edward Vitkin
- Porter School of Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Gintautas Saulis
- Faculty of Natural Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Avshalom Shalom
- Department of Plastic Surgery, Meir Medical Center, Kfar Sava, Israel
| | - Alexander Golberg
- Porter School of Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel.
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Nakagawa H, Castellvi Q, Neal R, Girouard S, Laughner J, Ikeda A, Sugawara M, An Y, Hussein AA, Nakhla S, Taigen T, Srounbek J, Kanj M, Santangeli P, Saliba WI, Ivorra A, Wazni OM. Effects of Contact Force on Lesion Size During Pulsed Field Catheter Ablation: Histochemical Characterization of Ventricular Lesion Boundaries. Circ Arrhythm Electrophysiol 2024; 17:e012026. [PMID: 38152949 DOI: 10.1161/circep.123.012026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 12/12/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Effects of contact force (CF) on lesion formation during pulsed field ablation (PFA) have not been well validated. The purpose of this study was to determine the relationship between average CF and lesion size during PFA using a swine-beating heart model. METHODS A 7F catheter with a 3.5-mm ablation electrode and CF sensor (TactiCath SE, Abbott) was connected to a PFA system (CENTAURI, Galvanize Therapeutics). In 5 closed-chest swine, biphasic PFA current was delivered between the ablation electrode and a skin patch at 40 separate sites in right ventricle (28 Amp) and 55 separate sites in left ventricle (35 Amp) with 4 different levels of CF: (1) low (CF range of 4-13 g; median, 9.5 g); (2) moderate (15-30 g; median, 21.5 g); (3) high (34-55 g; median, 40 g); and (4) no electrode contact, 2 mm away from the endocardium. Swine were sacrificed at 2 hours after ablation, and lesion size was measured using triphenyl tetrazolium chloride staining. In 1 additional swine, COX (cytochrome c oxidase) staining was performed to examine mitochondrial activity to delineate reversible and irreversible lesion boundaries. Histological examination was performed with hematoxylin and eosin and Masson trichrome staining. RESULTS Ablation lesions were well demarcated with triphenyl tetrazolium chloride staining, showing (1) a dark central zone (contraction band necrosis and hemorrhage); (2) a pale zone (no mitochondrial activity and nuclear pyknosis, indicating apoptosis zone); and a hyperstained zone by triphenyl tetrazolium chloride and COX staining (unaffected normal myocardium with preserved mitochondrial activity, consistent with reversible zone). At constant PFA current intensity, lesion depth increased significantly with increasing CF. There were no detectable lesions resulting from ablation without electrode contact. CONCLUSIONS Acute PFA ventricular lesions show irreversible and reversible lesion boundaries by triphenyl tetrazolium chloride staining. Electrode-tissue contact is required for effective lesion formation during PFA. At the same PFA dose, lesion depth increases significantly with increasing CF.
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Affiliation(s)
- Hiroshi Nakagawa
- Department of Cardiovascular Medicine, Cleveland Clinic, OH (H.N., M.S., Y.A., A.A.H., S.N., T.T., J.S., M.K., P.S., W.I.S., O.M.W.)
| | - Quim Castellvi
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain (Q.C., A. Ivorra)
| | - Robert Neal
- Galvanize Therapeutics, Inc, Redwood City, CA (R.N., S.G., J.L.)
| | - Steven Girouard
- Galvanize Therapeutics, Inc, Redwood City, CA (R.N., S.G., J.L.)
| | - Jacob Laughner
- Galvanize Therapeutics, Inc, Redwood City, CA (R.N., S.G., J.L.)
| | - Atsushi Ikeda
- Department of Cardiology, Nihon University, Tokyo, Japan (A. Ikeda)
| | - Masafumi Sugawara
- Department of Cardiovascular Medicine, Cleveland Clinic, OH (H.N., M.S., Y.A., A.A.H., S.N., T.T., J.S., M.K., P.S., W.I.S., O.M.W.)
| | - Yoshimori An
- Department of Cardiovascular Medicine, Cleveland Clinic, OH (H.N., M.S., Y.A., A.A.H., S.N., T.T., J.S., M.K., P.S., W.I.S., O.M.W.)
| | - Ayman A Hussein
- Department of Cardiovascular Medicine, Cleveland Clinic, OH (H.N., M.S., Y.A., A.A.H., S.N., T.T., J.S., M.K., P.S., W.I.S., O.M.W.)
| | - Shady Nakhla
- Department of Cardiovascular Medicine, Cleveland Clinic, OH (H.N., M.S., Y.A., A.A.H., S.N., T.T., J.S., M.K., P.S., W.I.S., O.M.W.)
| | - Tyler Taigen
- Department of Cardiovascular Medicine, Cleveland Clinic, OH (H.N., M.S., Y.A., A.A.H., S.N., T.T., J.S., M.K., P.S., W.I.S., O.M.W.)
| | - Jakub Srounbek
- Department of Cardiovascular Medicine, Cleveland Clinic, OH (H.N., M.S., Y.A., A.A.H., S.N., T.T., J.S., M.K., P.S., W.I.S., O.M.W.)
| | - Mohamed Kanj
- Department of Cardiovascular Medicine, Cleveland Clinic, OH (H.N., M.S., Y.A., A.A.H., S.N., T.T., J.S., M.K., P.S., W.I.S., O.M.W.)
| | - Pasquale Santangeli
- Department of Cardiovascular Medicine, Cleveland Clinic, OH (H.N., M.S., Y.A., A.A.H., S.N., T.T., J.S., M.K., P.S., W.I.S., O.M.W.)
| | - Walid I Saliba
- Department of Cardiovascular Medicine, Cleveland Clinic, OH (H.N., M.S., Y.A., A.A.H., S.N., T.T., J.S., M.K., P.S., W.I.S., O.M.W.)
| | - Antoni Ivorra
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain (Q.C., A. Ivorra)
| | - Oussama M Wazni
- Department of Cardiovascular Medicine, Cleveland Clinic, OH (H.N., M.S., Y.A., A.A.H., S.N., T.T., J.S., M.K., P.S., W.I.S., O.M.W.)
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Andrade DLLS, Pintarelli GB, Rosa JV, Paro IB, Pagano PJT, Silva JCN, Suzuki DOH. Musa acuminata as electroporation model. Bioelectrochemistry 2023; 154:108549. [PMID: 37639773 DOI: 10.1016/j.bioelechem.2023.108549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 08/31/2023]
Abstract
Electrochemotherapy (ECT) and Irreversible electroporation (IRE) are cancer treatments based on electric field distribution in tissues. Solanum tuberosum (potato tissue) phantom is known to mimic changes in the electrical conductivity that occur in animal tissues during electroporation (EP). Electric field distribution is assessed through enzymatic staining. However, the 24-h wait for this assessment could slow agile response scenarios. We developed and validated the Musa acuminata (cavendish banana) conductivity model, which quickly evaluates EP by tissue staining. We investigated the frequency response of the tissue using impedance spectroscopy analysis, conductivity changes, and enzymatic staining. We optimized three usual EP models: adapted Gompertz, smoothed Heaviside, and the sigmoid or logistic function. We found dielectric parameters in banana tissue similar to those in potato (electrical conductivity of 0.035 S/m and relative permittivity of 4.1×104). The coefficients of determination R2 were 99.94% (Gompertz), 99.85% (Heaviside), and 99.58% (sigmoid). The sigmoid and Heaviside functions described the calibration and validation electric currents with 95% confidence. We observed the electroporated areas in bananas 3h30m after EP. Staining was significant after 450 V/cm. The conductivity model of Musa acuminata suits treatment planning, hardware development, and training scenarios. Banana phantom supports the 3Rs practice and is a reliable alternative for potato in EP studies.
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Affiliation(s)
- Daniella L L S Andrade
- Institute of Biomedical Engineering, Department of Electrical and Electronics Engineering, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Guilherme B Pintarelli
- Department of Control and Automation Engineering, Federal University of Santa Catarina, Blumenau, SC, Brazil
| | - Juliana V Rosa
- Institute of Biomedical Engineering, Department of Electrical and Electronics Engineering, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Isabela B Paro
- Institute of Biomedical Engineering, Department of Electrical and Electronics Engineering, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Pedro J T Pagano
- Institute of Biomedical Engineering, Department of Electrical and Electronics Engineering, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Julia C N Silva
- Institute of Biomedical Engineering, Department of Electrical and Electronics Engineering, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Daniela O H Suzuki
- Institute of Biomedical Engineering, Department of Electrical and Electronics Engineering, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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Kim SH, Kang JM, Park Y, Jeong S, Na Y, Jung HD, An J, Kim HS, Lee SS, Park JH. Self-Expandable Electrode Based on Chemically Polished Nickel-Titanium Alloy Wire for Treating Endoluminal Tumors Using Bipolar Irreversible Electroporation. ACS APPLIED MATERIALS & INTERFACES 2023. [PMID: 37452740 DOI: 10.1021/acsami.3c04703] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
The application of irreversible electroporation (IRE) to endoluminal organs is being investigated; however, the current preclinical evidence and optimized electrodes are insufficient for clinical translation. Here, a novel self-expandable electrode (SE) made of chemically polished nickel-titanium (Ni-Ti) alloy wire for endoluminal IRE is developed in this study. Chemically polished heat-treated Ni-Ti alloy wires demonstrate increased electrical conductivity, reduced carbon and oxygen levels, and good mechanical and self-expanding properties. Bipolar IRE using chemically polished Ni-Ti wires successfully induces cancer cell death. IRE-treated potato tissue shows irreversibly and reversibly electroporated areas containing dead cells in an electrical strength-dependent manner. In vivo study using an optimized electric field strength demonstrates that endobiliary IRE using the SE evenly induces well-distributed mucosal injuries in the common bile duct (CBD) with the overexpression of the TUNEL, HSP70, and inflammatory cells without ductal perforation or stricture formation. This study demonstrates the basic concept of the endobiliary IRE procedure, which is technically feasible and safe in a porcine CBD as a novel therapeutic strategy for malignant biliary obstruction. The SE is a promising electrical energy delivery platform for effectively treating endoluminal organs.
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Affiliation(s)
- Song Hee Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Jeon Min Kang
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Yubeen Park
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Seung Jeong
- Department of Biosystems & Biomaterials Science and Engineering, Seoul National University, Seoul 11 08826, Republic of Korea
| | - Yuhyun Na
- Department of Biomedical-Chemical Engineering, The Catholic University of Korea, Bucheon 14662, Republic of Korea
- Department of Biotechnology, The Catholic University of Korea, Bucheon 14662, Republic of Korea
| | - Hyun-Do Jung
- Department of Biomedical-Chemical Engineering, The Catholic University of Korea, Bucheon 14662, Republic of Korea
- Department of Biotechnology, The Catholic University of Korea, Bucheon 14662, Republic of Korea
| | - Jinsu An
- Department of Biomedical Engineering, School of ICT Convergence Engineering, College of Science & Technology, Konkuk University, Chungju-si 22478, Republic of Korea
| | - Hyung-Sik Kim
- Department of Mechatronics Engineering, School of ICT Convergence Engineering, College of Science & Technology, Konkuk University, Chungju-si 22478, Republic of Korea
| | - Sang Soo Lee
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Jung-Hoon Park
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
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Thomas A, Nolte T, Baragona M, Ritter A. Finding an effective MRI sequence to visualise the electroporated area in plant-based models by quantitative mapping. Bioelectrochemistry 2023; 153:108463. [PMID: 37235889 DOI: 10.1016/j.bioelechem.2023.108463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023]
Abstract
Plant-based models can reduce the number of animal studies for electroporation research in medical cancer treatment modalities like irreversible electroporation. Magnetic resonance imaging (MRI) provides volumetric visualisation of electroporated animal or plant tissues; however, contrast behaviour is complex, depending on tissue and sequence parameters. This study numerically analysed contrast between electroporated and non-electroporated tissue at 1.5 T in various MRI sequences (DWI, T1W, T2W, T2*W, PDW, FLAIR) performed 4 h after electroporation in apples (N = 4) and potatoes (N = 8). Sequence parameters (inversion time [TI], echo time [TE], b-value) for optimal contrast and electroporation-mediated changes in T1 and T2 relaxation times and apparent diffusion coefficient (ADC) were determined for potato (N = 4) using quantitative parameter mapping. FLAIR showed the electroporated zone in potatoes with best contrast, whereas no sequence yielded clear visibility in apples. After electroporation, T1 and T2 in potato decreased by 29% ([1245 ± 54 to 886 ± 119] ms) and 12% ([249 ± 17 to 217 ± 12] ms), respectively. ADC increased by 11% ([1303 ± 25 to 1449 ± 28] × 10-6 mm2/s). Optimal contrast was found for TI = 1000 ms, low TE and high b-value. T1 was most sensitive to EP-mediated tissue changes. Future research could use this methodology and findings to obtain high-contrast MR images of electroporated and non-electroporated biological tissues.
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Affiliation(s)
- Athul Thomas
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany.
| | - Teresa Nolte
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany.
| | | | - Andreas Ritter
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
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Lindelauf KHK, Thomas A, Baragona M, Jouni A, Nolte T, Pedersoli F, Pfeffer J, Baumann M, Maessen RTH, Ritter A. Plant-based model for the visual evaluation of electroporated area after irreversible electroporation and its comparison to in-vivo animal data. Sci Prog 2023; 106:368504231156294. [PMID: 36803089 PMCID: PMC10450266 DOI: 10.1177/00368504231156294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Electroporation (EP) is widely used in medicine, such as cancer treatment, in form of electrochemotherapy or irreversible electroporation (IRE). For EP device testing, living cells or tissue inside a living organism (including animals) are needed. Plant-based models seem to be a promising alternative to substitute animal models in research. The aim of this study is to find a suitable plant-based model for visual evaluation of IRE, and to compare the geometry of electroporated areas with in-vivo animal data.For this purpose, a variety of fruit and vegetables were selected and visually evaluated after 0/1/2/4/6/8/12/16/24 h post-EP. Apple and potato were found to be suitable models as they enabled a visual evaluation of the electroporated area. For these models, the size of the electroporated area was determined after 0/1/2/4/6/8/12/16/24 h. For apples, a well-defined electroporated area was visual within two hours, while in potatoes it reached a plateau after eight hours only. The electroporated area of apple, which showed the fastest visual results was then compared to a retrospectively evaluated swine liver IRE dataset which had been obtained for similar conditions. The electroporated area of the apple and swine liver both showed a spherical geometry of comparable size. For all experiments, the standard protocol for human liver IRE was followed. To conclude, potato and apple were found to be suitable plant-based models for the visual evaluation of electroporated area after irreversible EP, with apple being the best choice for fast visual results. Given the comparable range, the size of the electroporated area of the apple may be promising as a quantitative predictor in animal tissue. Even if plant-based models cannot completely replace animal experiments, they can be used in the early stages of EP device development and testing, decreasing animal experiments to the necessary minimum.
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Affiliation(s)
- Kim. H. K. Lindelauf
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
- Philips Research, Eindhoven, The Netherlands
| | - Athul Thomas
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
- Philips Research, Eindhoven, The Netherlands
| | | | - Ali Jouni
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
- Philips Research, Eindhoven, The Netherlands
| | - Teresa Nolte
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Federico Pedersoli
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Joachim Pfeffer
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Martin Baumann
- Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
| | | | - Andreas Ritter
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
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High-Frequency Pulsed Electric Field Ablation in Beagle Model for Treatment of Prostate Cancer. Cancers (Basel) 2022; 14:cancers14204987. [PMID: 36291771 PMCID: PMC9599345 DOI: 10.3390/cancers14204987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/04/2022] [Accepted: 10/09/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Around 248,530 newly diagnosed in 2021, prostate cancer has been the most frequently diagnosed cancer in the USA. Rapid decellularization preserving acellular tissues is essential for accurate treatment and regeneration in affected areas. Our study aimed to assess the safety and efficacy of high-frequency pulsed electric field (HF-PEF) in a beagle model for the treatment of prostate cancer. We confirmed that HF-PEF of 1800 V/cm, 100 μs width, 2 ms interval successfully decellularized the prostate tissue after 4 hours, and the tissues were almost regenerated in 28 days. IRE with HF-PEF has therapeutic potential to treat prostate cancer while minimizing damage to the surrounding tissues. Abstract Conventional irreversible electroporation (IRE) with low-frequency pulsed electric field (LF-PEF) is used to induce cell death; however, it has several disadvantages including a long procedure time and severe muscle contraction due to high-voltage electric field. This study investigates a novel IRE protocol with high-frequency pulsed electric field (HF-PEF) of 500 Hz repetition to ablate the prostate tissue in beagles for treatment of prostate cancer. A finite element analysis was performed to validate optimal electrical field strength for the procedure. In total, 12 beagles received HF-PEF of 500 Hz and were sacrificed at 4 h, 4 days, and 28 days (3 each). The remaining three beagles underwent sham procedure. The outcomes of HF-PEF were assessed by histological responses. HF-PEF successfully decellularized the prostate tissues 4 h after the treatment. The prostate glands, duct, and urethra were well preserved after IRE with HF-PEF. The ablated prostatic tissues were gradually regenerated and appeared similar to the original tissues 28 d after IRE with HF-PEF. Moreover, electrocardiography and hematology demonstrated that IRE with HF-PEF did not seriously affect the cardiac tissue. HF-PEF was effective and safe in the beagle prostate and effectively induced the ablation and gradually recovered with cellular regeneration.
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