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Review
. 2014 Jun;31(2):111-7.
doi: 10.1055/s-0034-1373785.

The state of irreversible electroporation in interventional oncology

Mikhail Silk  1 , David Tahour  1 , Govindarajan Srimathveeravalli  1 , Stephen B Solomon  1 , Raymond H Thornton  1
Affiliations
Review

The state of irreversible electroporation in interventional oncology

Mikhail Silk et al. Semin Intervent Radiol. 2014 Jun.

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: ablation; interventional oncology; interventional radiology; irreversible electroporation; kidney; liver; lung; pancreas.

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Figures

Figure 1
Figure 1
Nanoknife ablation device and needle electrodes. (A) Nanoknife device by AngioDynamics (Latham, NY). (B) Placement of two monopolar electrodes and a blue plastic spacer used to keep the needles parallel.
Figure 2
Figure 2
Irreversible electroporation ablation of normal swine liver. Gross pathologic (A) and histopathologic (B) images show complete tissue necrosis adjacent to a large blood vessel (asterisk).
Figure 3
Figure 3
Irreversible electroporation of swine lung showing CT imaging (A) during treatment, (B) immediately after (yellow circle around ablation defect), (C) 1 week after treatment (yellow circle around ablation defect), and (D) 3 weeks after treatment demonstrating resolution of the ablation defect.
Figure 4
Figure 4
CT imaging of a 48-year-old woman with metastatic colon cancer to the liver. (A) Pretreatment tumor imaging (yellow bar shows major axis of tumor). (B) Treatment CT image after placement of two monopolar electrodes in the liver. (C) Immediate postprocedure imaging demonstrating hypodense ablation zone (yellow bar shows major axis of ablation zone). (D) One-month postablation imaging showing an involution of the ablation cavity (yellow bar shows major axis of ablation zone). (E) Four-month postablation imaging showing continued involution of the ablation cavity (yellow bar shows major axis of ablation zone). CT, computed tomography.
Figure 5
Figure 5
Ultrasound images during IRE of a 76-year-old man with metastatic colon cancer to the liver. (A) Targeted tumor dimensions. (B) Image obtained half way through the treatment. The area treated by IRE becomes hyperechoic compared with surrounding liver tissue. IRE, irreversible electroporation.
See this image and copyright information in PMC

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