Planning irreversible electroporation in the porcine kidney: Are numerical simulations reliable for predicting empiric ablation outcomes? Journal Article

Authors: Wimmer, T.; Srimathveeravalli, G.; Gutta, N.; Ezell, P. C.; Monette, S.; Maybody, M.; Erinjeri, J. P.; Durack, J. C.; Coleman, J. A.; Solomon, S. B.
Article Title: Planning irreversible electroporation in the porcine kidney: Are numerical simulations reliable for predicting empiric ablation outcomes?
Abstract: Purpose: Numerical simulations are used for treatment planning in clinical applications of irreversible electroporation (IRE) to determine ablation size and shape. To assess the reliability of simulations for treatment planning, we compared simulation results with empiric outcomes of renal IRE using computed tomography (CT) and histology in an animal model. Methods: The ablation size and shape for six different IRE parameter sets (70–90 pulses, 2,000–2,700 V, 70–100 µs) for monopolar and bipolar electrodes was simulated using a numerical model. Employing these treatment parameters, 35 CT-guided IRE ablations were created in both kidneys of six pigs and followed up with CT immediately and after 24 h. Histopathology was analyzed from postablation day 1. Results: Ablation zones on CT measured 81 ± 18 % (day 0, p ≤ 0.05) and 115 ± 18 % (day 1, p ≤ 0.09) of the simulated size for monopolar electrodes, and 190 ± 33 % (day 0, p ≤ 0.001) and 234 ± 12 % (day 1, p ≤ 0.0001) for bipolar electrodes. Histopathology indicated smaller ablation zones than simulated (71 ± 41 %, p ≤ 0.047) and measured on CT (47 ± 16 %, p ≤ 0.005) with complete ablation of kidney parenchyma within the central zone and incomplete ablation in the periphery. Conclusion: Both numerical simulations for planning renal IRE and CT measurements may overestimate the size of ablation compared to histology, and ablation effects may be incomplete in the periphery. © 2014, Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
Keywords: controlled study; histopathology; nonhuman; treatment planning; comparative study; follow up; animal tissue; computer assisted tomography; animal experiment; simulation; contrast enhancement; reliability; ablation therapy; kidney parenchyma; computed tomography scanner; ablation; irreversible electroporation; electric field; experimental pig; experimental ir; priority journal; article; irreversible electroporation device; needle electrode; non-vascular interventions; kidney/renal; irreversible electroporation (ire)
Journal Title: CardioVascular and Interventional Radiology
Volume: 38
Issue: 1
ISSN: 0174-1551
Publisher: Springer  
Date Published: 2015-02-01
Start Page: 182
End Page: 190
Language: English
DOI: 10.1007/s00270-014-0905-2
PROVIDER: scopus
PUBMED: 24831827
PMCID: PMC5497497
Notes: Export Date: 2 July 2015 -- Source: Scopus
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MSK Authors
  1. Jonathan Coleman
    192 Coleman
  2. Majid Maybody
    72 Maybody
  3. Stephen Solomon
    270 Solomon
  4. Sebastien Monette
    77 Monette
  5. Paula Cherie Ezell
    19 Ezell
  6. Narendra Babu Gutta
    7 Gutta
  7. Jeremy Charles Durack
    85 Durack
  8. Thomas Wimmer
    6 Wimmer