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Irreversible electroporation

Margaret M Fleming, Anna I Holbrook, Mary S Newell
OBJECTIVE: The purpose of this article is to delineate the potential techniques for percutaneous ablation of breast cancer, discuss the advantages and disadvantages of each technique, and provide results from recent studies on these technologies. The techniques discussed are cryotherapy, laser irradiation, microwave irradiation, radiofrequency ablation, high-intensity focused ultrasound ablation, and irreversible electroporation. CONCLUSION: Although percutaneous ablation techniques have some promising potential for less-invasive treatment of breast cancer, larger multicenter trials are needed to confirm their efficacy, especially in comparison with the reference standard of lumpectomy...
October 20, 2016: AJR. American Journal of Roentgenology
H A Marsman, M G Besselink
- The incidence of pancreatic cancer is increasing due to the ageing population among other things, while 5-year survival has improved in the past two decades from 3 to 7%.- In case of biliary obstruction due to pancreatic cancer, biliary drainage before surgery or ablative therapy using a covered metal stent instead of plastic reduces the rate of complications.- In patients with metastasized pancreatic cancer a combination of folinic acid, fluorouracil, irinotecan and oxaliplatin (FOLFIRINOX) results in improved survival...
2016: Nederlands Tijdschrift Voor Geneeskunde
L Bond, B Schulz, T VanMeter, R C G Martin
INTRODUCTION: Irreversible electroporation (IRE) uses multiple needles and a series of electrical pulses to create pores in cell membranes and cause cell apoptosis. One of the demands of IRE is the precise needle spacing required. Two-dimensional intraoperative ultrasound (2-D iUS) is currently used to measure inter-needle distances but requires significant expertise. This study evaluates the potential of three-dimensional (3-D) image guidance for placing IRE needles and calculating needle spacing...
September 29, 2016: European Journal of Surgical Oncology
Patryk Kambakamba, John M Bonvini, Michael Glenck, Liliana Castrezana López, Thomas Pfammatter, Pierre-Alain Clavien, Michelle L DeOliveira
BACKGROUND: Irreversible electroporation is increasingly used for treatment of solid tumors, but safety data remain scarce. This study aimed to describe intraoperative adverse events associated with irreversible electroporation in patients undergoing solid tumor ablation. METHODS: We analyzed demographic and intraoperative data for patients (n = 43) undergoing irreversible electroporation for hepato-pancreato-biliary and retroperitoneal malignancies (2012 to 2015)...
October 2016: American Journal of Surgery
Massimo Valerio, Louise Dickinson, Afia Ali, Navin Ramachadran, Ian Donaldson, Neil Mccartan, Alex Freeman, Hashim U Ahmed, Mark Emberton
PURPOSE: Irreversible electroporation (IRE) has attractive attributes for focal ablation, namely non-thermal effect, precise demarcation of treatment, and tissue-selectivity. We report on a prospective development study investigating focal IRE. MATERIALS AND METHODS: 20 men with the following characteristics were recruited: anterior MR-visible index lesion concordant with transperineal targeted and template prostate mapping biopsy, absence of clinically significant disease elsewhere (UCL definition 2), and PSA </= 15 ng/ml...
September 30, 2016: Journal of Urology
Ishan Goswami, Sheryl Coutermarsh-Ott, Ryan G Morrison, Irving C Allen, Rafael V Davalos, Scott S Verbridge, Lissett R Bickford
Low-level electric fields have been demonstrated to induce spatial re-distribution of cell membrane receptors when applied for minutes or hours. However, there is limited literature on the influence on cell signaling with short transient high-amplitude pulses typically used in irreversible electroporation (IRE) for cancer treatment. Moreover, literature on signaling pertaining to immune cell trafficking after IRE is conflicting. We hypothesized that pulse parameters (field strength and exposure time) influence cell signaling and subsequently impact immune-cell trafficking...
September 25, 2016: Bioelectrochemistry
S Gajjar, R Yechieli, A H Wolfson, G Narayanan, J Merchan, L Portelance
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Marlon Perera, Nishanth Krishnananthan, Uri Lindner, Nathan Lawrentschuk
Globally, the increased uptake of serum PSA level screening led to an increase in the number of diagnoses of low-risk and intermediate-risk prostate cancer. Traditionally, these patients have been considered for either active surveillance programmes or radical whole-gland therapies, such as prostatectomy or radiotherapy. Focal therapy is an emerging treatment option that involves the focal ablation of prostate cancer with preservation of surrounding healthy tissue. This approach might result in reduced morbidity when compared with whole-gland therapies...
September 27, 2016: Nature Reviews. Urology
Casey E Underhill, Nathaniel J Walsh, Brian P Bateson, Caleb Mentzer, Edward J Kruse
No abstract text is available yet for this article.
September 2016: American Surgeon
Suyashree Bhonsle, Mohammad Bonakdar, Robert E Neal, Charles Aardema, John L Robertson, Jonathon Howarth, Helen Kavnoudias, Kenneth R Thomson, S Nahum Goldberg, Rafael V Davalos
PURPOSE: To develop and validate a perfused organ model for characterizing ablations for irreversible electroporation (IRE)-based therapies. MATERIALS AND METHODS: Eight excised porcine livers were mechanically perfused with a modified phosphate-buffered saline solution to maintain viability during IRE ablation. IRE pulses were delivered using 2 monopolar electrodes over a range of parameters, including voltage (1,875-3,000 V), pulse length (70-100 µsec), number of pulses (50-600), electrode exposure (1...
September 20, 2016: Journal of Vascular and Interventional Radiology: JVIR
Laurien G P H Vroomen, Hester J Scheffer, Marleen C A M Melenhorst, Marcus C de Jong, Janneke E van den Bergh, Cornelis van Kuijk, Foke van Delft, Geert Kazemier, Martijn R Meijerink
OBJECTIVES: To assess specific imaging characteristics after irreversible electroporation (IRE) for locally advanced pancreatic carcinoma (LAPC) with contrast-enhanced (ce)MRI and ceCT, and to explore the correlation of these characteristics with the development of recurrence. METHODS: Qualitative and quantitative analyses of imaging data were performed on 25 patients treated with percutaneous IRE for LAPC. Imaging characteristics of the ablation zone on ceCT and ceMRI were assessed over a 6-month follow-up period...
September 22, 2016: European Radiology
Michail Papamichail, Amir Ali, Michail Pizanias, Praveen Peddu, John Karani, Nigel Heaton
BACKGROUNDS/AIMS: Resection or enucleation is currently the treatment of choice for small pancreatic neuroendocrine tumors (NETs). Irreversible electroporation is a novel ablative method that is used for locally advanced pancreatic adenocarcinoma, but little data exists for its use for pancreatic NETs. We report an early experience of IRE for early pancreatic NETs. METHODS: Between April 2014 and March 2015, 3 patients with small (<2 cm) pancreatic NETs were treated with percutaneous IRE...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Hester J Scheffer, Laurien G P H Vroomen, Marcus C de Jong, Marleen C A M Melenhorst, Babs M Zonderhuis, Freek Daams, Jantien A Vogel, Marc G H Besselink, Cornelis van Kuijk, Jill Witvliet, Marian A E de van der Schueren, Tanja D de Gruijl, Anita G M Stam, Petrousjka M P van den Tol, Foke van Delft, Geert Kazemier, Martijn R Meijerink
Purpose To (a) investigate the safety of percutaneous irreversible electroporation (IRE) for locally advanced pancreatic cancer and (b) evaluate the quality of life (QOL), pain perception, and efficacy in terms of time to local progression, event-free survival, and overall survival (OS). Materials and Methods The study was approved by the local review board (NL42888.029.13). All patients provided written informed consent for study participation, the ablation procedure, and data usage. Between January 2014 and June 2015, 25 patients with histologically proved locally advanced pancreatic cancer 5 cm or smaller (13 women, 12 men; median age, 61 years; age range, 41-78 years) were prospectively included to undergo percutaneous computed tomographic-guided IRE...
September 6, 2016: Radiology
Lukas P Beyer, Benedikt Pregler, Christoph Nießen, Andreas Schicho, Michael Haimerl, Ernst Michael Jung, Christian Stroszczynski, Philipp Wiggermann
Purpose. The purpose of this study was to compare CT-navigated stereotactic IRE (SIRE) needle placement to non-navigated conventional IRE (CIRE) for percutaneous ablation of liver malignancies. Materials and Methods. A prospective trial including a total of 20 patients was conducted with 10 patients in each arm of the study. IRE procedures were guided using either CT fluoroscopy (CIRE) or a stereotactic planning and navigation system (SIRE). Primary endpoint was procedure time. Secondary endpoints were accuracy of needle placement, technical success rate, complication rate and dose-length product (DLP)...
2016: PeerJ
Massimo Valerio, Yannick Cerantola, Scott E Eggener, Herbert Lepor, Thomas J Polascik, Arnauld Villers, Mark Emberton
CONTEXT: Focal therapy of prostate cancer has been proposed as an alternative to whole-gland treatments. OBJECTIVE: To summarize the evidence regarding sources of energy employed in focal therapy. EVIDENCE ACQUISITION: Embase and Medline (PubMed) were searched from 1996 to October 31, 2015 following the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Ongoing trials were selected from electronic registries. The stage of assessment of each source of energy was determined using the Idea, Development, Exploration, Assessment, Long-term study recommendations...
August 29, 2016: European Urology
Imran A Siddiqui, Eduardo L Latouche, Matthew R DeWitt, Jacob H Swet, Russell C Kirks, Erin H Baker, David A Iannitti, Dionisios Vrochides, Rafael V Davalos, Iain H McKillop
INTRODUCTION: Irreversible electroporation (IRE) offers an alternative to thermal tissue ablation in situ. High-frequency IRE (H-FIRE), employing ultra-short bipolar electrical pulses, may overcome limitations associated with existing IRE technology to create rapid, reproducible liver ablations in vivo. METHODS: IRE electrodes (1.5 cm spacing) were inserted into the hepatic parenchyma of swine (n = 3) under surgical anesthesia. In the absence of paralytics or cardiac synchronization five independent H-FIRE ablations were performed per liver using 100, 200, or 300 pulses (2250 V, 2-5-2 μs configuration)...
September 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
David Stillström, Henrik Nilsson, Michaela Jesse, Matthias Peterhans, Eduard Jonas, Jacob Freedman
BACKGROUND: Palliative irreversible electroporation of pancreatic adenocarcinomas is rapidly gaining in interest since a large proportion of these patients cannot be radically resected. METHODS: This is a description of a minimally invasive approach to irreversible electroporation of pancreatic tumors using computer-assisted navigation, laparoscopy and laparoscopic ultrasound to correctly guide electrodes into the tissue. RESULTS: The procedure is presented...
August 29, 2016: Surgical Endoscopy
Athanasios Petrou, Demetrios Moris, Patrick Paul Tabet, Brian David Wensley Richards, Georgios Kourounis
Pancreatic ductal adenocarcinoma is a lethal and late presenting malignancy with dismal survival rates. An estimated total of 330,000 people died from this malignancy in 2012. Although there have been improvements in diagnostic and treatment methods, the survival of late stage pancreatic cancer has not shown significant improvement in the past 4 decades. Multiple treatment approaches are available including chemotherapy, radiotherapy, and immunotherapy, but to this day surgical resection remains the only curative treatment option...
May 2016: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Robert C G Martin, Alan North Durham, Marc G Besselink, David Iannitti, Matthew J Weiss, Christopher L Wolfgang, Kai-Wen Huang
Irreversible Electroporation (IRE) is used to treat locally advanced cancers, commonly of the pancreas, liver, kidney, and other soft tissues. Precise eligibility for IRE should be established in each individual patient by a multidisciplinary team based on comprehensive clinical, imaging, and laboratory assessment. Standardization of IRE technique and protocols is expected to improve safety, lead to reproducible outcomes, and facilitate further research into IRE. The present article provides a set of technical recommendations for the use of IRE in the treatment of locally advanced pancreatic cancer...
August 21, 2016: Journal of Surgical Oncology
Man-Xia Lin, Ming Kuang, Ming Xu, Bo-Wen Zhuang, Wen-Shuo Tian, Jie-Yi Ye, Xiao-Hua Xie, Xiao-Yan Xie
The objective of this study was to describe the performance of ultrasound (US) and contrast-enhanced ultrasound (CEUS) within 2 h after irreversible electroporation (IRE) ablation of porcine liver. Six IRE ablations were performed on porcine liver in vivo; ultrasound assessments were performed within 2 h after IRE ablation. On US images, the ablation zone appeared as a hypo-echoic area within 10 min after the ablation, and then the echo of the ablation zone gradually increased. On CEUS images, the ablation zone appeared as a non-enhanced area within 10 min after ablation and then was gradually centripetally filled by microbubbles...
November 2016: Ultrasound in Medicine & Biology
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