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Ishan Goswami, Justin B Perry, Mitchell E Allen, David A Brown, Michael R von Spakovsky, Scott S Verbridge
Pulsed electric fields with microsecond pulse width (μsPEFs) are used clinically; namely, irreversible electroporation/Nanoknife is used for soft tissue tumor ablation. The μsPEF pulse parameters used in irreversible electroporation (0.5-1 kV/cm, 80-100 pulses, ∼100 μs each, 1 Hz frequency) may cause an internal field to develop within the cell because of the disruption of the outer cell membrane and subsequent penetration of the electric field. An internal field may disrupt voltage-sensitive mitochondria, although the research literature has been relatively unclear regarding whether such disruptions occur with μsPEFs...
June 19, 2018: Biophysical Journal
Joseph H Cioffi, Derek J Estes, Vaia Florou, Bach Ardalan
A 32-year-old female with stage IV colorectal cancer and metastasis to the liver experienced cardiotoxic reactions after treatment with 5-fluorouracil and its oral prodrug capecitabine even at two-thirds the recommended dose. After careful considerations, the decision was made to attempt capecitabine retrial at a further suboptimal dose with combination chemotherapy where she no longer experienced cardiac events. As a result, the liver tumour shrank and rectal mass stabilised, tumour markers dropped and she underwent surgical resection of both masses...
November 27, 2017: BMJ Case Reports
T M Wah
This review article aims to provide an overview of image-guided ablation of renal cell carcinoma (RCC) since it was first introduced in 1998. This will cover the background and rationale behind its development; an overview of the evidence for current thermal technology, such as heat-based, e.g., radiofrequency ablation (RFA), microwave ablation (MWA), and cold-based energies, e.g., cryoablation used; and summarise the published evidence regarding its treatment efficacy and oncological outcome. In addition, it aims to provide an insight into the potential role of the new non-thermal ablative technology, e...
August 2017: Clinical Radiology
Georgios Kourounis, Patrick Paul Tabet, Demetrios Moris, Alexandros Papalambros, Evangelos Felekouras, Fanourios Georgiades, George Astras, Athanasios Petrou
PURPOSE: We aimed to provide an overview of current understanding on the potential use of irreversible electroporation (IRE) in the field of hepatobiliary surgery with a focus on current results in hepatic and pancreatic cancers, its limitations, and its current directions. METHODS: Through a review of the literature we have gathered the key articles and trials that are shaping our understanding of the current status of IRE and its prospective uses, and organized them in an easily understandable format showcasing the most up to date results...
January 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
C Niessen, S Thumann, L Beyer, B Pregler, J Kramer, S Lang, A Teufel, E M Jung, C Stroszczynski, P Wiggermann
Aim of this retrospective analysis was to evaluate the survival times after percutaneous irreversible electroporation (IRE) in inoperable liver tumors not amenable to thermal ablation. 71 patients (14 females, 57 males, median age 63.5 ± 10.8 years) with 103 liver tumors were treated in 83 interventions using IRE (NanoKnife® system). The median tumor short-axis diameter was 1.9 cm (minimum 0.4 cm, maximum 4.5 cm). 35 patients had primary liver tumors and 36 patients had liver metastases. The Kaplan-Meier method was employed to calculate the survival rates, and the different groups were compared using multivariate log-rank and Wilcoxon tests...
March 7, 2017: Scientific Reports
Noah E Canvasser, Igor Sorokin, Aaron H Lay, Monica S C Morgan, Asim Ozayar, Clayton Trimmer, Jeffrey A Cadeddu
PURPOSE: To report on the first short-term oncologic outcomes of percutaneous irreversible electroporation for small renal masses. METHODS: Patients with cT1a renal masses treated with irreversible electroporation from April 2013 through December 2016 were reviewed. Small, low complexity tumors were generally selected for irreversible electroporation using the NanoKnife® System (Angiodynamics, Latham, NY, USA). Surveillance imaging was performed post-operatively, and survival analysis was completed using the Kaplan-Meier method...
October 2017: World Journal of Urology
P V Glybochko, Yu G Alyaev, A V Amosov, D V Enikeev, D V Chinenov, G E Krupinov, Ya N Chernov, A S Tivtikyan
Modern medicine tends to use minimally invasive treatments. Selected patients with prostate cancer may be treated using irreversible electroporation that involves the application of a NanoKnife device. The procedure directs short electrical pulses that open microscopic pores in the cells in the treatment area and effectively destroy cancer cells. This literature review outlines the history of irreversible electroporation, its use in surgery for treating cancers of the pancreas, liver, lung, kidney and brain...
December 2016: Urologii︠a︡
T Franz, J von Hardenberg, A Blana, H Cash, D Baumunk, G Salomon, B Hadaschik, T Henkel, J Herrmann, F Kahmann, K-U Köhrmann, J Köllermann, S Kruck, U-B Liehr, S Machtens, I Peters, J P Radtke, A Roosen, H-P Schlemmer, L Sentker, J J Wendler, U Witzsch, J-U Stolzenburg, M Schostak, R Ganzer
BACKGROUND: Several systems for MRI/TRUS fusion-guided biopsy of the prostate are commercially available. Many studies have shown superiority of fusion systems for tumor detection and diagnostic quality compared to random biopsy. The benefit of fusion systems in focal therapy of prostate cancer (PC) is less clear. OBJECTIVES: Critical considerations of fusion systems for planning and monitoring of focal therapy of PC were investigated. MATERIALS AND METHODS: A systematic literature review of available fusion systems for the period 2013-5/2016 was performed...
February 2017: Der Urologe. Ausg. A
Massimo Valerio, Louise Dickinson, Afia Ali, Navin Ramachadran, Ian Donaldson, Neil Mccartan, Alex Freeman, Hashim U Ahmed, Mark Emberton
PURPOSE: Irreversible electroporation has attractive attributes for focal ablation, namely nonthermal effect, precise demarcation of treatment and tissue selectivity. We report a prospective development study investigating focal irreversible electroporation. MATERIALS AND METHODS: A total of 20 men with certain characteristics were recruited for study, including a visible index lesion on anterior magnetic resonance imaging that was concordant with transperineal targeted and template prostate mapping biopsy, absent clinically significant disease noted elsewhere (University College London definition 2) and prostate specific antigen 15 ng/ml or less...
March 2017: Journal of Urology
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
Johann J Wendler, Katharina Fischbach, Jens Ricke, Julian Jürgens, Frank Fischbach, Jens Köllermann, Markus Porsch, Daniel Baumunk, Martin Schostak, Uwe-Bernd Liehr, Maciej Pech
BACKGROUND: Irreversible electroporation (IRE) as newer ablation modality has been introduced and its clinical niche is under investigation. At present just one IRE system has been approved for clinical use and is currently commercially available (NanoKnife® system). In 2014, the International Working Group on Image-Guided Tumor Ablation updated the recommendation about standardization of terms and reporting criteria for image-guided tumor ablation. The IRE method is not covered in detail...
2016: Polish Journal of Radiology
Wanfeng Shang, Haojian Lu, Wenfeng Wan, Toshio Fukuda, Yajing Shen
Cell cutting is a significant task in biology study, but the highly productive non-embedded cell cutting is still a big challenge for current techniques. This paper proposes a vision-based nano robotic system and then realizes automatic non-embedded cell cutting with this system. First, the nano robotic system is developed and integrated with a nanoknife inside an environmental scanning electron microscopy (ESEM). Then, the positions of the nanoknife and the single cell are recognized, and the distance between them is calculated dynamically based on image processing...
March 4, 2016: Scientific Reports
L Lambert, J Horejs, Z Krska, D Hoskovec, L Petruzelka, T Krechler, P Kriz, J Briza
The aim of this study was to evaluate the safety of irreversible electroporation (IRE) and the outcome of patients undergoing IRE of locally advanced pancreatic cancer (PC). Twenty-one patients with unresectable PC underwent open (n=19) or percutaneous (n=2) IRE of the tumor using the Nanoknife system with two electrodes that were repositioned several times to affect the whole mass. The size of the tumor was 39±10mm with a range from 21 to 65mm. Five patients underwent neoadjuvant chemotherapy and seven patients were treated with chemotherapy after IRE...
2016: Neoplasma
Johann Jakob Wendler, Jens Ricke, Maciej Pech, Frank Fischbach, Julian Jürgens, Sandra Siedentopf, Albert Roessner, Markus Porsch, Daniel Baumunk, Martin Schostak, Jens Köllermann, Uwe-Bernd Liehr
INTRODUCTION: It is postulated that focal IRE affords complete ablation of soft-tissue tumours while protecting the healthy peritumoral tissue. Therefore, IRE may be an interesting option for minimally invasive, kidney-tissue-sparing, non-thermal ablation of renal tumours. AIM: With this current pilot study ("IRENE trial"), we present the first detailed histopathological data of IRE of human RCC followed by delayed tumour resection. The aim of this interim analysis of the first three patients was to investigate the ablation efficiency of percutaneous image-guided focal IRE in RCC, to assess whether a complete ablation of T1a RCC and tissue preservation with the NanoKnife system is possible and to decide whether the ablation parameters need to be altered...
February 2016: Cardiovascular and Interventional Radiology
John H Rossmeisl, Paulo A Garcia, Theresa E Pancotto, John L Robertson, Natalia Henao-Guerrero, Robert E Neal, Thomas L Ellis, Rafael V Davalos
OBJECT: Irreversible electroporation (IRE) is a novel nonthermal ablation technique that has been used for the treatment of solid cancers. However, it has not been evaluated for use in brain tumors. Here, the authors report on the safety and feasibility of using the NanoKnife IRE system for the treatment of spontaneous intracranial gliomas in dogs. METHODS: Client-owned dogs with a telencephalic glioma shown on MRI were eligible. Dog-specific treatment plans were generated by using MRI-based tissue segmentation, volumetric meshing, and finite element modeling...
October 2015: Journal of Neurosurgery
J J Wendler, R Ganzer, B Hadaschik, A Blana, T Henkel, K U Köhrmann, S Machtens, A Roosen, G Salomon, L Sentker, U Witzsch, H P Schlemmer, D Baumunk, J Köllermann, M Schostak, U B Liehr
BACKGROUND: Irreversible electroporation (IRE), a new tissue ablation procedure available since 2007, could meet the requirements for ideal focal therapy (FT) with its postulated features, especially the absence of a thermal ablative effect. Thus far, there is no adequate tumor-entity-specific proof of its effectiveness, and its clinical application has hitherto been confined to very small patient cohorts. This also holds true for prostate cancer (PCA). Nevertheless, it is now being increasingly applied outside clinical trials-to a certain extent due to active advertising in the lay press...
June 2015: Der Urologe. Ausg. A
J J Wendler, M Porsch, S Nitschke, J Köllermann, S Siedentopf, M Pech, F Fischbach, J Ricke, M Schostak, U B Liehr
INTRODUCTION: Focal ablation therapy is playing an increasing role in oncology and may reduce the toxicity of current surgical treatments while achieving adequate oncological benefit. Irreversible electroporation (IRE) has been proposed to be tissue-selective with potential advantages compared with current thermal-ablation technologies or radiotherapy. The aim of this pilot trial is to determine the effectiveness and feasibility of focal percutaneous IRE in patients with localised renal cell cancer as a uro-oncological tumour model...
July 2015: Contemporary Clinical Trials
Salvatore Paiella, Giovanni Butturini, Isabella Frigerio, Roberto Salvia, Giulia Armatura, Matilde Bacchion, Martina Fontana, Mirko D'Onofrio, Enrico Martone, Claudio Bassi
PURPOSE: To evaluate the safety of the NanoKnife Low Energy Direct Current (LEDC) System (Irreversible Electroporation, IRE) in order to treat patients with unresectable pancreatic adenocarcinoma. METHODS: Prospective, nonrandomized, single-center clinical evaluation of ten patients with a cytohystological diagnosis of unresectable locally advanced pancreatic cancer (LAPC) that was no further responsive to standard treatments. The primary outcome was the rate of procedure-related abdominal complications...
2015: Digestive Surgery
Jens Ricke, Julian H W Jürgens, Frederic Deschamps, Lambros Tselikas, Katja Uhde, Ortrud Kosiek, Thierry De Baere
PURPOSE: To assess safety and efficacy of irreversible electroporation (IRE) of lung malignancies. MATERIALS AND METHODS: Patients with primary and secondary lung malignancies and preserved lung function were included in this prospective single arm trial. Primary and secondary endpoints were safety and efficacy. Recruitment goal was 36 subjects in 2 centers. Patients underwent IRE under general anesthesia with probe placement performed in Fluoroscopy-CT. The IRE system employed was NanoKnife® (Angiodynamics)...
April 2015: Cardiovascular and Interventional Radiology
Govindarajan Narayanan, Shivank Bhatia, Ana Echenique, Rekha Suthar, Katuzka Barbery, Jose Yrizarry
PURPOSE: The purpose of the study was to evaluate the effect of Irreversible Electroporation (IRE) on vessel patency in close proximity to the ablation zone. MATERIALS AND METHODS: Between January 2010 and November 2013, 101 patients underwent percutaneous IRE procedures using the NanoKnife for primary and metastatic tumors in different organs. Age ranged from 24 to 83 years. A total of 129 lesions were treated. [liver (100), pancreas (18), kidney (3), pelvis (1), aorto-caval lymph nodes (2), adrenal (2), lung (1), retroperitoneal (1), surgical bed of a prior Whipple procedure (1)]...
December 2014: Cardiovascular and Interventional Radiology
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