Conductivity Rise During Irreversible Electroporation: True Permeabilization or Heat?
Cardiovasc Intervent Radiol
; 41(8): 1257-1266, 2018 Aug.
Article
em En
| MEDLINE
| ID: mdl-29687261
ABSTRACT
PURPOSE:
Irreversible electroporation (IRE) induces apoptosis with high-voltage electric pulses. Although the working mechanism is non-thermal, development of secondary Joule heating occurs. This study investigated whether the observed conductivity rise during IRE is caused by increased cellular permeabilization or heat development.METHODS:
IRE was performed in a gelatin tissue phantom, in potato tubers, and in 30 patients with unresectable colorectal liver metastases (CRLM). Continuous versus sequential pulsing protocols (10-90 vs. 10-30-30-30) were assessed. Temperature was measured using fiber-optic probes. After temperature had returned to baseline, 100 additional pulses were delivered. The primary technique efficacy of the treated CRLM was compared to the periprocedural current rise. Seven patients received ten additional pulses after a 10-min cool-down period.RESULTS:
Temperature and current rise was higher for the continuous pulsing protocol (medians, gel 13.05 vs. 9.55 °C and 9 amperes (A) vs. 7A; potato 12.70 vs. 10.53 °C and 6.0A vs. 6.5A). After cooling-down, current returned to baseline in the gel phantom and near baseline values (Δ2A with continuous- and Δ5A with sequential pulsing) in the potato tubers. The current declined after cooling-down in all seven patients with CRLM, although baseline values were not reached. There was a positive correlation between current rise and primary technique efficacy (p = 0.02); however, the previously reported current increase threshold of 12-15A was reached in 13%.CONCLUSION:
The observed conductivity rise during IRE is caused by both cellular permeabilization and heat development. Although a correlation between current rise and efficacy exists, the current increase threshold seems unfeasible for CRLM.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Tipos_de_cancer
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Outros_tipos
Base de dados:
MEDLINE
Assunto principal:
Eletroporação
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Temperatura Alta
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Neoplasias Hepáticas
Tipo de estudo:
Observational_studies
Limite:
Female
/
Humans
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Male
Idioma:
En
Revista:
Cardiovasc Intervent Radiol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Holanda