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Title: Planning Irreversible Electroporation in the Porcine Kidney: Are Numerical Simulations Reliable for Predicting Empiric Ablation Outcomes?

PurposeNumerical 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.MethodsThe 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.ResultsAblation 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.ConclusionBoth 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.
Authors:
; ;  [1] ;  [2] ;  [3] ; ; ;  [1] ;  [4] ;  [1]
  1. Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States)
  2. The Rockefeller University, Research Animal Resource Center, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College (United States)
  3. The Rockefeller University, Laboratory of Comparative Pathology, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College (United States)
  4. Memorial Sloan-Kettering Cancer Center, Urology Service, Department of Surgery (United States)
Publication Date:
OSTI Identifier:
22470098
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 38; Journal Issue: 1; Conference: IROS 2015: Interventional Radiological Olbert Symposium, Berlin (Germany), 15-17 Jan 2015; Other Information: Copyright (c) 2015 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABLATION; COMPARATIVE EVALUATIONS; COMPUTERIZED SIMULATION; COMPUTERIZED TOMOGRAPHY; ELECTRODES; HISTOLOGY; KIDNEYS; PLANNING; RELIABILITY; SWINE