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Guo F, Luo Z, Zhou W. Considering Joule heating in coupled electroporation and electrodeformation modeling of glioblastoma cells. Comput Biol Med 2024; 177:108678. [PMID: 38833796 DOI: 10.1016/j.compbiomed.2024.108678] [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: 01/18/2024] [Revised: 05/21/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024]
Abstract
Cells exposed to a pulsed electric field undergo electroporation(EP) and electrodeformation(ED) under electric field stress, and a coupled model of EP and ED of glioblastoma(GBM) taking into account Joule heating is proposed. The model geometry is extracted from real cell boundaries, and the effects of Joule heating-induced temperature rise on the EP and ED processes are considered. The results show that the temperature rise will increase the cell's local conductivity, leading to a decrease in the transmembrane potential(TMP). The temperature rise also causes a decrease in the dynamic Young's modulus of the cell membrane, making the cell less resistant to deformation. In addition, GBM cells are more susceptible to EP in the middle portion of the cell and ED in the three tentacle portions under pulsed electric fields, and the cells undergo significant positional shifts. The ED of the nucleus is similar to spherical cells, but the degree of ED is smaller.
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Affiliation(s)
- Fei Guo
- Institute of Ecological Safety, Chongqing University of Posts and Telecommunications, Chongqing, 400065, China.
| | - Zhijun Luo
- Institute of Ecological Safety, Chongqing University of Posts and Telecommunications, Chongqing, 400065, China
| | - Weina Zhou
- Institute of Ecological Safety, Chongqing University of Posts and Telecommunications, Chongqing, 400065, China
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Casciola M, Kaboudian A, Feaster TK, Narkar A, Blinova K. Pulsed electric field performance calculator tool based on an in vitro human cardiac model. Front Physiol 2024; 15:1395923. [PMID: 38911328 PMCID: PMC11190366 DOI: 10.3389/fphys.2024.1395923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/20/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction Pulsed Field Ablation (PFA) is a novel non-thermal method for cardiac ablation, relying on irreversible electroporation induced by high-energy pulsed electric fields (PEFs) to create localized lesions in the heart atria. A significant challenge in optimizing PFA treatments is determining the lethal electric field threshold (EFT), which governs ablation volume and varies with PEF waveform parameters. However, the proprietary nature of device developer's waveform characteristics and the lack of standardized nonclinical testing methods have left optimal EFTs for cardiac ablation uncertain. Methods To address this gap, we introduced a laboratory protocol employing human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) in monolayer format to evaluate the impact of a range of clinically relevant biphasic pulse parameters on lethal EFT and adiabatic heating (AH). Cell death areas were assessed using fluorescent dyes and confocal microscopy, while lethal EFTs were quantified through comparison with electric field numerical simulations. Results and conclusion Our study confirmed a strong correlation between cell death in hiPSC-CMs and the number and duration of pulses in each train, with pulse repetition frequency exerting a comparatively weaker influence. Fitting of these results through machine learning algorithms were used to develop an open-source online calculator. By estimating lethal EFT and associated temperature increases for diverse pulse parameter combinations, this tool, once validated, has the potential to significantly reduce reliance on animal models during early-stage device de-risking and performance assessment. This tool also offers a promising avenue for advancing PFA technology for cardiac ablation medical devices to enhance patient outcomes.
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Affiliation(s)
- Maura Casciola
- Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, United States
| | | | | | | | - Ksenia Blinova
- Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, United States
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Agnass P, Rodermond HM, van Veldhuisen E, Vogel JA, Ten Cate R, van Lienden KP, van Gulik TM, Franken NAP, Oei AL, Kok HP, Besselink MG, Crezee J. Quantitative analysis of contribution of mild and moderate hyperthermia to thermal ablation and sensitization of irreversible electroporation of pancreatic cancer cells. J Therm Biol 2023; 115:103619. [PMID: 37437370 DOI: 10.1016/j.jtherbio.2023.103619] [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: 02/28/2023] [Revised: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION Irreversible electroporation (IRE) is an ablation modality that applies short, high-voltage electric pulses to unresectable cancers. Although considered a non-thermal technique, temperatures do increase during IRE. This temperature rise sensitizes tumor cells for electroporation as well as inducing partial direct thermal ablation. AIM To evaluate the extent to which mild and moderate hyperthermia enhance electroporation effects, and to establish and validate in a pilot study cell viability models (CVM) as function of both electroporation parameters and temperature in a relevant pancreatic cancer cell line. METHODS Several IRE-protocols were applied at different well-controlled temperature levels (37 °C ≤ T ≤ 46 °C) to evaluate temperature dependent cell viability at enhanced temperatures in comparison to cell viability at T = 37 °C. A realistic sigmoid CVM function was used based on thermal damage probability with Arrhenius Equation and cumulative equivalent minutes at 43 °C (CEM43°C) as arguments, and fitted to the experimental data using "Non-linear-least-squares"-analysis. RESULTS Mild (40 °C) and moderate (46 °C) hyperthermic temperatures boosted cell ablation with up to 30% and 95%, respectively, mainly around the IRE threshold Eth,50% electric-field strength that results in 50% cell viability. The CVM was successfully fitted to the experimental data. CONCLUSION Both mild- and moderate hyperthermia significantly boost the electroporation effect at electric-field strengths neighboring Eth,50%. Inclusion of temperature in the newly developed CVM correctly predicted both temperature-dependent cell viability and thermal ablation for pancreatic cancer cells exposed to a relevant range of electric-field strengths/pulse parameters and mild moderate hyperthermic temperatures.
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Affiliation(s)
- P Agnass
- Amsterdam UMC Location University of Amsterdam, Radiation Oncology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Surgery, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Experimental Oncology and Radiobiology, Meibergdreef 9, Amsterdam, the Netherlands.
| | - H M Rodermond
- Amsterdam UMC Location University of Amsterdam, Radiation Oncology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Experimental Oncology and Radiobiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Experimental Molecular Medicine, Meibergdreef 9, Amsterdam, the Netherlands.
| | - E van Veldhuisen
- Amsterdam UMC Location University of Amsterdam, Surgery, Meibergdreef 9, Amsterdam, the Netherlands.
| | - J A Vogel
- Amsterdam UMC Location University of Amsterdam, Gastroenterology & Hepatology, Meibergdreef 9, Amsterdam, the Netherlands.
| | - R Ten Cate
- Amsterdam UMC Location University of Amsterdam, Radiation Oncology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Experimental Oncology and Radiobiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Experimental Molecular Medicine, Meibergdreef 9, Amsterdam, the Netherlands.
| | - K P van Lienden
- Department of Intervention Radiology, St. Antonius Hospital, Nieuwegein, the Netherlands.
| | - T M van Gulik
- Amsterdam UMC Location University of Amsterdam, Surgery, Meibergdreef 9, Amsterdam, the Netherlands.
| | - N A P Franken
- Amsterdam UMC Location University of Amsterdam, Radiation Oncology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Experimental Oncology and Radiobiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Experimental Molecular Medicine, Meibergdreef 9, Amsterdam, the Netherlands.
| | - A L Oei
- Amsterdam UMC Location University of Amsterdam, Radiation Oncology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Experimental Oncology and Radiobiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Experimental Molecular Medicine, Meibergdreef 9, Amsterdam, the Netherlands.
| | - H P Kok
- Amsterdam UMC Location University of Amsterdam, Radiation Oncology, Meibergdreef 9, Amsterdam, the Netherlands; Cancer Center Amsterdam, Treatment and Quality of Life, Cancer Biology and Immunology, Amsterdam, the Netherlands.
| | - M G Besselink
- Amsterdam UMC Location University of Amsterdam, Surgery, Meibergdreef 9, Amsterdam, the Netherlands.
| | - J Crezee
- Amsterdam UMC Location University of Amsterdam, Radiation Oncology, Meibergdreef 9, Amsterdam, the Netherlands; Cancer Center Amsterdam, Treatment and Quality of Life, Cancer Biology and Immunology, Amsterdam, the Netherlands.
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Sieni E, Bazzolo B, Pieretti F, Zamuner A, Tasso A, Dettin M, Conconi MT. Breast cancer cells grown on hyaluronic acid-based scaffolds as 3D in vitro model for electroporation. Bioelectrochemistry 2020; 136:107626. [PMID: 32784105 DOI: 10.1016/j.bioelechem.2020.107626] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/30/2020] [Accepted: 07/30/2020] [Indexed: 12/14/2022]
Abstract
Nowadays, electroporation (EP) represents a promising method for the intracellular delivery of anticancer drugs. To setting up the process, the EP efficiency is usually evaluated by using cell suspension and adherent cell cultures that are not representative of the in vivo conditions. Indeed, cells are surrounded by extracellular matrix (ECM) whose composition and physical characteristics are different for each tissue. So, various three-dimensional (3D) in vitro models, such as spheroids and hydrogel-based cultures, have been proposed to mimic the tumour microenvironment. Herein, a 3D breast cancer in vitro model has been proposed. HCC1954 cells were seeded on crosslinked and lyophilized matrices composed of hyaluronic acid (HA) and ionic complementary self-assembling peptides (SAPs) already known to provide a fibrous structure mimicking collagen network. Herein, SAPs were functionalized with laminin derived IKVAV adhesion motif. Cultures were characterized by spheroids surrounded by ECM produced by cancer cells as demonstrated by collagen1a1 and laminin B1 transcripts. EP was carried out on both 2D and 3D cultures: a sequence of 8 voltage pulses at 5 kHz with different amplitude was applied using a plate electrode. Cell sensitivity to EP seemed to be modulated by the presence of ECM and the different cell organization. Indeed, cells cultured on HA-IKVAV were more sensitive than those treated in 2D and HA cultures, in terms of both cell membrane permeabilization and viability. Collectively, our results suggest that HA-IKVAV cultures may represent an interesting model for EP studies. Further studies will be needed to elucidate the influence of ECM composition on EP efficiency.
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Affiliation(s)
- Elisabetta Sieni
- Department of Theoretical and Applied Sciences, University of Insubria, Via Dunant, 3, 21100 Varese, Italy.
| | - Bianca Bazzolo
- University of Padova, Department of Pharmaceutical and Pharmacological Sciences, 35131 Padova, Italy.
| | - Fabio Pieretti
- University of Padova, Department of Industrial Engineering, Via Marzolo, 9, 35131 Padova, Italy.
| | - Annj Zamuner
- University of Padova, Department of Industrial Engineering, Via Marzolo, 9, 35131 Padova, Italy.
| | - Alessia Tasso
- University of Padova, Department of Pharmaceutical and Pharmacological Sciences, 35131 Padova, Italy
| | - Monica Dettin
- University of Padova, Department of Industrial Engineering, Via Marzolo, 9, 35131 Padova, Italy.
| | - Maria Teresa Conconi
- University of Padova, Department of Pharmaceutical and Pharmacological Sciences, 35131 Padova, Italy.
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5
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Poompavai S, Gowri Sree V, Kaviya Priyaa A. Electrothermal Analysis of the Breast-Tumor Model During Electroporation. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2020. [DOI: 10.1109/trpms.2020.2967558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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6
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Agnass P, van Veldhuisen E, van Gemert MJC, van der Geld CWM, van Lienden KP, van Gulik TM, Meijerink MR, Besselink MG, Kok HP, Crezee J. Mathematical modeling of the thermal effects of irreversible electroporation for in vitro, in vivo, and clinical use: a systematic review. Int J Hyperthermia 2020; 37:486-505. [DOI: 10.1080/02656736.2020.1753828] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Pierre Agnass
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Eran van Veldhuisen
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Martin J. C. van Gemert
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Cees W. M. van der Geld
- Department of Chemical Engineering and Chemistry, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Krijn P. van Lienden
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Thomas M. van Gulik
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Martijn R. Meijerink
- Department of Radiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marc G. Besselink
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - H. Petra Kok
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Johannes Crezee
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
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Dermol-Černe J, Pirc E, Miklavčič D. Mechanistic view of skin electroporation - models and dosimetry for successful applications: an expert review. Expert Opin Drug Deliv 2020; 17:689-704. [PMID: 32192364 DOI: 10.1080/17425247.2020.1745772] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: Skin electroporation is a promising treatment for transdermal drug delivery, gene electrotransfer, skin rejuvenation, electrochemotherapy, and wound disinfection. Although a considerable amount of in vitro and in vivo studies exists, the translation to clinics is not as fast as one would hope. We hypothesize the reason lies in the inadequate dosimetry, i.e. electrode configurations, pulse parameters, and pulse generators used. We suggest adequate dosimetry can be determined by mathematical modeling which would allow comparison of protocols and facilitate translation into clinics.Areas covered: We introduce the mechanisms and applications of skin electroporation, present existing mathematical models and compare the influence of different model parameters. We review electrodes and pulse generators, prototypes, as well as commercially available models.Expert opinion: The reasons for slow translation of skin electroporation treatments into clinics lie in uncontrolled and inadequate dosimetry, poor reporting rendering comparisons between studies difficult, and significant differences in animal and human skin morphology often dismissed in reports. Mathematical models enable comparison of studies, however, when the parameters of the pulses and electrode configuration are not adequately reported, as is often the case, comparisons are difficult, if not impossible. For each skin electroporation treatment, systematic studies determining optimal parameters should be performed and treatment parameters standardized.
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Affiliation(s)
- Janja Dermol-Černe
- Faculty of Electrical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Eva Pirc
- Faculty of Electrical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Damijan Miklavčič
- Faculty of Electrical Engineering, University of Ljubljana, Ljubljana, Slovenia
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Ren F, Li Q, Gao X, Zhu K, Zhang J, Chen X, Yan X, Chu D, Hu L, Gao Z, Wu Z, Wu R, Lv Y. Electrical and thermal analyses of catheter-based irreversible electroporation of digestive tract. Int J Hyperthermia 2019; 36:854-867. [PMID: 31452435 DOI: 10.1080/02656736.2019.1646928] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Fenggang Ren
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine and Regenerative Medicine and Surgical Engineering Research Center of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qingshan Li
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine and Regenerative Medicine and Surgical Engineering Research Center of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xuyao Gao
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi’an, China
| | - Kun Zhu
- Department of Pathogenic Microbiology and Immunology, School of Basic Medical Sciences, Xi’an Jiaotong University, Xi’an, China
| | - Jing Zhang
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine and Regenerative Medicine and Surgical Engineering Research Center of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xue Chen
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine and Regenerative Medicine and Surgical Engineering Research Center of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xiaopeng Yan
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine and Regenerative Medicine and Surgical Engineering Research Center of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Dake Chu
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine and Regenerative Medicine and Surgical Engineering Research Center of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Gastroenterology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Liangshuo Hu
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine and Regenerative Medicine and Surgical Engineering Research Center of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zhongquan Gao
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi’an, China
| | - Zheng Wu
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine and Regenerative Medicine and Surgical Engineering Research Center of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Rongqian Wu
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine and Regenerative Medicine and Surgical Engineering Research Center of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yi Lv
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine and Regenerative Medicine and Surgical Engineering Research Center of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Yang Y, Moser MAJ, Zhang E, Zhang W, Zhang B. Development of a statistical model for cervical cancer cell death with irreversible electroporation in vitro. PLoS One 2018; 13:e0195561. [PMID: 29694357 PMCID: PMC5919048 DOI: 10.1371/journal.pone.0195561] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 03/23/2018] [Indexed: 12/18/2022] Open
Abstract
PURPOSE The aim of this study was to develop a statistical model for cell death by irreversible electroporation (IRE) and to show that the statistic model is more accurate than the electric field threshold model in the literature using cervical cancer cells in vitro. METHODS HeLa cell line was cultured and treated with different IRE protocols in order to obtain data for modeling the statistical relationship between the cell death and pulse-setting parameters. In total, 340 in vitro experiments were performed with a commercial IRE pulse system, including a pulse generator and an electric cuvette. Trypan blue staining technique was used to evaluate cell death after 4 hours of incubation following IRE treatment. Peleg-Fermi model was used in the study to build the statistical relationship using the cell viability data obtained from the in vitro experiments. A finite element model of IRE for the electric field distribution was also built. Comparison of ablation zones between the statistical model and electric threshold model (drawn from the finite element model) was used to show the accuracy of the proposed statistical model in the description of the ablation zone and its applicability in different pulse-setting parameters. RESULTS The statistical models describing the relationships between HeLa cell death and pulse length and the number of pulses, respectively, were built. The values of the curve fitting parameters were obtained using the Peleg-Fermi model for the treatment of cervical cancer with IRE. The difference in the ablation zone between the statistical model and the electric threshold model was also illustrated to show the accuracy of the proposed statistical model in the representation of ablation zone in IRE. CONCLUSIONS This study concluded that: (1) the proposed statistical model accurately described the ablation zone of IRE with cervical cancer cells, and was more accurate compared with the electric field model; (2) the proposed statistical model was able to estimate the value of electric field threshold for the computer simulation of IRE in the treatment of cervical cancer; and (3) the proposed statistical model was able to express the change in ablation zone with the change in pulse-setting parameters.
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Affiliation(s)
- Yongji Yang
- Tumor Ablation Group, Complex and Intelligent Systems Research Center, East China University of Science and Technology, Shanghai, China
| | - Michael A. J. Moser
- Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Edwin Zhang
- Division of Vascular & Interventional Radiology, Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Wenjun Zhang
- Tumor Ablation Group, Complex and Intelligent Systems Research Center, East China University of Science and Technology, Shanghai, China
| | - Bing Zhang
- Biomedical Science and Technology Research Center, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China
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Clinical and pathological outcomes after irreversible electroporation of the pancreas using two parallel plate electrodes: a porcine model. HPB (Oxford) 2017; 19:1058-1065. [PMID: 29029985 DOI: 10.1016/j.hpb.2017.02.443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 02/02/2017] [Accepted: 02/28/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Irreversible electroporation (IRE) by inserting needles around the tumor as treatment for locally advanced pancreatic cancer entails several disadvantages, such as incomplete ablation due to field inhomogeneity, technical difficulties in needle placement and a risk of pancreatic fistula development. This experimental study evaluates outcomes of IRE using paddles in a porcine model. METHODS Six healthy pigs underwent laparotomy and were treated with 2 separate ablations (in head and tail of the pancreas). Follow-up consisted of clinical and laboratory parameters and contrast-enhanced computed tomography (ceCT) imaging. After 2 weeks, pancreatoduodenectomy was performed for histology and the pigs were terminated. RESULTS All animals survived 14 days. None of the animals developed signs of infection or significant abdominal distention. Serum amylase and lipase peaked at day 1 postoperatively in all pigs, but normalized without signs of pancreatitis. On ceCT-imaging the ablation zone was visible as an ill-defined, hypodense lesion. No abscesses, cysts or ascites were seen. Histology showed a homogenous fibrotic lesion in all pigs. CONCLUSION IRE ablation of healthy porcine pancreatic tissue using two plate electrodes is feasible and safe and creates a homogeneous fibrotic lesion. IRE-paddles should be tested on pancreatic adenocarcinoma to determine the effect in cancer tissue.
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Vroomen LGPH, Scheffer HJ, Melenhorst MCAM, van Grieken N, van den Tol MP, Meijerink MR. Irreversible Electroporation to Treat Malignant Tumor Recurrences Within the Pelvic Cavity: A Case Series. Cardiovasc Intervent Radiol 2017; 40:1631-1640. [PMID: 28470395 PMCID: PMC5581368 DOI: 10.1007/s00270-017-1657-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 04/19/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To describe the initial experience with irreversible electroporation (IRE) to treat pelvic tumor recurrences. METHODS A retrospective single-center analysis was performed. Adverse events were recorded using Common Terminology Criteria of Adverse Events (CTCAE) 4.0. Clinical outcome was determined using pain- and general- symptom assessment, including Seddon's peripheral nerve injury (PNI) types. Radiological outcome was evaluated by comparing baseline with three-month 18F-FDG PET-CT follow-up. RESULTS Eight patients (nine tumors [recurrences of primary rectal (n = 4), anal (n = 1), sigmoid (n = 1), cervical (n = 1), and renal cell carcinoma (n = 1)]) underwent percutaneous IRE as salvage therapy. Median longest tumor diameter was 3.7 cm (range 1.2-7.0). One CTCAE grade III adverse event (hemorrhage) and eight CTCAE grade II complications occurred in 6/8 patients: vagino-tumoral fistula (n = 1), lower limb motor loss (n = 3; PNI type II) with partial recovery in one patient, hypotonic bladder (n = 2; PNI types I and II) with complete recovery in one patient, and upper limb motor loss (n = 2; PNI type II) with partial recovery in both patients. No residual tumor tissue was observed at 3-month follow-up. After a median follow-up of 12 months, local progression was observed in 5/9 lesions (4/5 were >3 cm pre-IRE); one lesion was successfully retreated. Debilitating preprocedural pain (n = 3) remained unchanged (n = 1) or improved (n = 2). CONCLUSION IRE may represent a suitable technique to treat pelvic tumor recurrences, although permanent neural function loss can occur. Complete ablation seems realistic for smaller lesions; for larger lesions symptom control should be the focus.
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Affiliation(s)
- L G P H Vroomen
- Department of Radiology and Nuclear Medicine, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - H J Scheffer
- Department of Radiology and Nuclear Medicine, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - M C A M Melenhorst
- Department of Radiology and Nuclear Medicine, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - N van Grieken
- Department of Pathology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - M P van den Tol
- Department of Surgical Oncology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - M R Meijerink
- Department of Radiology and Nuclear Medicine, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
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Vogl TJ, Hagar A, Nour-Eldin NEA, Gruber-Rouh T, Eichler K, Ackermann H, Bechstein WO, Naguib NNN. High-frequency versus low-frequency microwave ablation in malignant liver tumours: evaluation of local tumour control and survival. Int J Hyperthermia 2016; 32:868-875. [DOI: 10.1080/02656736.2016.1212107] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Thomas J. Vogl
- Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt am Main, Germany
| | - Ahmad Hagar
- Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt am Main, Germany
| | - Nour-Eldin A. Nour-Eldin
- Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt am Main, Germany
| | - Tatjana Gruber-Rouh
- Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt am Main, Germany
| | - Katrin Eichler
- Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt am Main, Germany
| | - Hanns Ackermann
- Department of Biomedical Statistics, Frankfurt University Hospital, Frankfurt am Main, Germany
| | - Wolf O. Bechstein
- Department of General Surgery, Frankfurt University Hospital, Frankfurt am Main, Germany
| | - Nagy N. N. Naguib
- Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt am Main, Germany
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Li S, Chen F, Shen L, Zeng Q, Wu P. Percutaneous irreversible electroporation for breast tissue and breast cancer: safety, feasibility, skin effects and radiologic-pathologic correlation in an animal study. J Transl Med 2016; 14:238. [PMID: 27495906 PMCID: PMC4975887 DOI: 10.1186/s12967-016-0993-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 07/28/2016] [Indexed: 01/04/2023] Open
Abstract
Background To study the safety, feasibility and skin effects of irreversible electroporation (IRE) for breast tissue and breast cancer in animal models. Methods Eight pigs were used in this study. IRE was performed on the left breasts of the pigs with different skin–electrode distances, and the right breasts were used as controls. The electrodes were placed 1–8 mm away from the skin, with an electrode spacing of 1.5–2 cm. Imaging and pathological examinations were performed at specific time points for follow-up evaluation. Vital signs, skin damage, breast tissue changes and ablation efficacy were also closely observed. Eight rabbit models with or without VX2 breast tumor implantations were used to further assess the damage caused by and the repair of thin skin after IRE treatment for breast cancer. Contrast-enhanced ultrasound and elastosonography were used to investigate ablation efficacy and safety. Results During IRE, the color of the pig breast skin reversibly changed. When the skin–electrode distance was 3 mm, the breast skin clearly changed, becoming white in the center and purple in the surrounding region during IRE. One small purulent skin lesion was detected several days after IRE. When the skin–electrode distance was 5–8 mm, the breast skin became red during IRE. However, the skin architecture was normal when evaluated using gross pathology and hematoxylin-eosin staining. When the skin–electrode distance was 1 mm, skin atrophy and yellow glabrescence occurred in the rabbit breasts after IRE. When the skin–electrode distance was ≥5 mm, there was no skin damage in the rabbit model regardless of breast cancer implantation. After IRE, complete ablation of the targeted breast tissue or cancer was confirmed, and apoptosis was detected in the target tissue and outermost epidermal layer. In the ablated breasts of the surviving animals, complete mammary regeneration with normal skin and hair was observed. Furthermore, no massive fibrosis or mass formation were detected on ultrasound or through hematoxylin–eosin staining. Conclusions After IRE, the skin architecture was well preserved when the skin–electrode distance was ≥5 mm. Moreover, breast regeneration occurred without mass formation or obvious fibrosis. Electronic supplementary material The online version of this article (doi:10.1186/s12967-016-0993-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sheng Li
- Department of Medical Imaging and Interventional Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China
| | - Fei Chen
- Department of Ultrasonography, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Lujun Shen
- Department of Medical Imaging and Interventional Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China
| | - Qi Zeng
- Department of Medical Imaging and Interventional Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China
| | - Peihong Wu
- Department of Medical Imaging and Interventional Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China.
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14
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Vollherbst D, Bertheau RC, Fritz S, Mogler C, Kauczor HU, Ryschich E, Radeleff BA, Pereira PL, Sommer CM. Electrochemical Effects after Transarterial Chemoembolization in Combination with Percutaneous Irreversible Electroporation: Observations in an Acute Porcine Liver Model. J Vasc Interv Radiol 2016; 27:913-921.e2. [PMID: 27103147 DOI: 10.1016/j.jvir.2016.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 01/30/2016] [Accepted: 02/01/2016] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To evaluate the effects of combined use of transarterial chemoembolization and irreversible electroporation (IRE) for focal tissue ablation in an acute porcine liver model. MATERIALS AND METHODS Two established interventional techniques were combined: IRE with zones of irreversible and reversible electroporation and chemoembolization with microspheres, iodized oil, and doxorubicin. IRE was performed before chemoembolization in two pigs (pigs 1 and 2; IRE/chemoembolization group), chemoembolization was performed before IRE in two pigs (pigs 3 and 4; chemoembolization/IRE group), and only IRE was performed in two pigs (pigs 5 and 6). Five study groups were defined: IRE/chemoembolization (pigs 1 and 2), chemoembolization/IRE (pigs 3 and 4), IRE only (pigs 5 and 6), chemoembolization only (tissue outside the IRE zones in pigs 1-4), and control (untreated liver tissue outside the IRE zones in pigs 5 and 6). Animals were euthanized 2 hours after intervention. Size and shape of IRE zones on contrast-enhanced computed tomography, cell death on light microscopy, and doxorubicin tissue concentrations on chromatography and fluorescence microscopy were analyzed. RESULTS Size and shape of IRE zones were not significantly different (eg, P = .067 for volume). A histologic marker for irreversible cell death was positive in IRE/chemoembolization, chemoembolization/IRE, and IRE groups only in the macroscopically visible IRE zones. Doxorubicin tissue concentrations were not significantly different (P = .873). However, in the reversible electroporation (RE) zones, broad areas with intense intranuclear doxorubicin accumulation were observed in IRE/chemoembolization but not in chemoembolization/IRE and chemoembolization groups. CONCLUSIONS IRE before chemoembolization enhances the intranuclear accumulation of doxorubicin in the RE zone.
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Affiliation(s)
- Dominik Vollherbst
- Clinic for Diagnostic and Interventional Radiology, Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany; Clinic for Radiology, Minimally-Invasive Therapies and Nuclear Medicine, Cancer Center Heilbronn-Franken, SLK Kliniken Heilbronn, Heilbronn, Germany
| | - Robert C Bertheau
- Clinic for Diagnostic and Interventional Radiology, Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan Fritz
- Department of General Visceral and Transplantation Surgery, Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - Carolin Mogler
- Department of General Pathology, Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Clinic for Diagnostic and Interventional Radiology, Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - Eduard Ryschich
- Department of General Visceral and Transplantation Surgery, Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - Boris A Radeleff
- Clinic for Diagnostic and Interventional Radiology, Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - Philippe L Pereira
- Clinic for Radiology, Minimally-Invasive Therapies and Nuclear Medicine, Cancer Center Heilbronn-Franken, SLK Kliniken Heilbronn, Heilbronn, Germany
| | - Christof M Sommer
- Clinic for Diagnostic and Interventional Radiology, Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany; Clinic for Diagnostic and Interventional Radiology, Stuttgart Cancer Center, European Siemens Reference Site for Interventional Oncology and Radiology, Klinikum Stuttgart, Stuttgart, Germany.
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Wong SSM, Hui JWY, Chan AWH, Chu CM, Rowlands DK, Yu SCH. Irreversible Electroporation of the Femoral Neurovascular Bundle: Imaging and Histologic Evaluation in a Swine Model. J Vasc Interv Radiol 2015; 26:1212-1220.e1. [PMID: 26071841 DOI: 10.1016/j.jvir.2015.04.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/25/2015] [Accepted: 04/25/2015] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To evaluate imaging, histologic changes, and safety of irreversible electroporation (IRE) on the femoral neurovascular bundle in a swine model. MATERIALS AND METHODS The study was approved by the institutional animal ethics committee. IRE was performed on the right femoral neurovascular bundle of 9 swine, which were subsequently sacrificed at 24 hours (n = 4, acute group), 7 days (n = 4, subacute group), or 21 days (n = 1, delayed group). Clinical observation, computed tomography (CT), and pathologic examination were carried out. RESULTS After the procedure, 7 of 9 subjects were able to stand and walk, and the remaining 2 subjects could eventually do so within 1 week. The femoral vessels were patent on CT and gross examination. There was microscopic evidence of venous thrombosis in 75% of the subacute group. Except for mild perineural inflammation observed in 1 subject in the subacute group, the femoral nerves were intact on gross and histologic examination. Significant damage to the surrounding muscle and soft tissue was identified on CT and histology, manifesting as necrosis, hematoma, and inflammation. CONCLUSIONS The ablative effect of IRE on muscle and soft tissue manifested as necrosis, hemorrhage, and inflammation. Histologic changes were observed in the perineural tissue and veins in a few subjects. The clinical implication of such changes and safety of clinical use of IRE for lesions encasing the neurovascular bundle in humans are yet to be determined.
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Affiliation(s)
- Simon Sin Man Wong
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong S.A.R., People's Republic of China
| | - Joyce Wai Yi Hui
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong S.A.R., People's Republic of China
| | - Anthony Wing Hung Chan
- Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong S.A.R., People's Republic of China
| | - Cheuk Man Chu
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong S.A.R., People's Republic of China
| | - Dewi Kenneth Rowlands
- The Laboratory Animal Services Centre, The Chinese University of Hong Kong, Shatin, Hong Kong S.A.R., People's Republic of China
| | - Simon Chun Ho Yu
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong S.A.R., People's Republic of China.
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