IRE made easy: introducing the robotic grid system for multiple parallel needle insertion in irreversible electroporation treatment.

PURPOSE: Accurate needle placement is crucial for successful tumor treatment using the irreversible electroporation (IRE) method. Multiple needles are inserted around the tumor, ideally in parallel, to achieve uniform electric field distribution. This paper presents a robot utilizing a grid system to enable multiple needles insertion while maintaining parallelism between them. METHODS: The robotic system has two degrees of freedom, which allow for the adjustment of the grid system to accommodate targeting lesions in various positions. The robot's performance was evaluated by testing its accuracy across various configurations and target depth locations, as well as its ability to maintain the needle parallelism. RESULTS: The robot has dimensions of ϕ 134 mm and a height of 46 mm, with a total weight of 295 g. The system accuracy test showed that the robot can precisely target points across different target depths and needle orientations, with an average error of 2.71 ± 0.68 mm. Moreover, multiple insertions at different grid locations reveal needle orientation deviations typically below 1 ∘ . CONCLUSION: This study presented the design and validation of a robotic grid system. The robot is capable of maintaining insertion accuracy and needle parallelism during multiple needle insertions at various robot configurations. The robot showed promising results with limited needle deviation, making it suitable for IRE procedures.

Investigating the effect of electrode orientation on irreversible electroporation with experiment and simulation.

PURPOSE: In recent years, irreversible electroporation (IRE) has been developed to specifically destroy undesirable tissues as an alternative to surgical resection. In this treatment, placing multiple electrodes in parallel is required to create a uniform electric field distribution. The process of maintaining parallel electrodes is challenging, and the effect of the electrodes' orientation accuracy has not been investigated quantitatively. This study investigates the impact of the electrode orientation along with various electrode and pulse parameters on the outcomes of IRE. METHODS: The electrode configurations that were considered were parallel, forward, and sideward orientation. A numerical model was developed to study the effect of electrode orientation on the electric field distribution, which was validated experimentally on potato tubers as it has similar properties to biological tissue. In addition, a conductivity test was performed to evaluate the conductivity and electroporation threshold of the potatoes. RESULTS: The developed numerical model was validated by comparing the electroporated volumes between potatoes from the experiment and simulation, which achieved a mean dice score of [Formula: see text]. The potato has an electrical conductivity of 0.044-0.454 S/m with an electroporation threshold of 375 V/cm. ANOVA test showed that the difference in the electroporated regions obtained between a parallel orientation and a 5[Formula: see text] forward and sideward orientation was not significant. CONCLUSION: This study showed that the developed numerical models were validated and able to predict the outcome of IRE on potatoes. In addition, a 5[Formula: see text] tolerance on the electrode orientation can be defined to obtain a similar response to the parallel orientation.

Toward reliable automatic liver and tumor segmentation using convolutional neural network based on 2.5D models.

PURPOSE: We investigated the parameter configuration in the automatic liver and tumor segmentation using a convolutional neural network based on 2.5D model. The implementation of 2.5D model shows promising results since it allows the network to have a deeper and wider network architecture while still accommodates the 3D information. However, there has been no detailed investigation of the parameter configurations on this type of network model. METHODS: Some parameters, such as the number of stacked layers, image contrast, and the number of network layers, were studied and implemented on neural networks based on 2.5D model. Networks are trained and tested by utilizing the dataset from liver and tumor segmentation challenge (LiTS). The network performance was further evaluated by comparing the network segmentation with manual segmentation from nine technical physicians and an experienced radiologist. RESULTS: Slice arrangement testing shows that multiple stacked layers have better performance than a single-layer network. However, the dice scores start decreasing when the number of stacked layers is more than three layers. Adding higher number of layers would cause overfitting on the training set. In contrast enhancement test, implementing contrast enhancement method did not show a statistically significant different to the network performance. While in the network layer test, adding more layers to the network architecture does not always correspond to the increasing dice score result of the network. CONCLUSIONS: This paper compares the performance of the network based on 2.5D model using different parameter configurations. The result obtained shows the effect of each parameter and allow the selection of the best configuration in order to improve the network performance in the application of automatic liver and tumor segmentation.

Development of a thermal model for irreversible electroporation: an approach to estimate and optimize the IRE protocols.

PURPOSE: Irreversible electroporation (IRE) is an emerging technique that has drawn attention in the field of cancer treatment. IRE uses non-thermal electric pulses to induce death of cancerous cells. However, recent studies have shown that the application of this technique may result in heating of the tissue. There is still room for improving its efficiency and defining better treatment protocols. This study investigates the optimal IRE protocols that avoiding the thermal damage during the IRE treatment. METHODS: Electrode and pulse parameter are investigated. Finite element models are created to evaluate the ablation area and the temperature changes in the tissue. The model is validated experimentally in bovine liver tissue, while the parameters were optimized using response surface method (RSM). RESULTS: From analysis of variance, the parameter of electrode distance and input voltage has significant effect to the temperature rise in the IRE treatment of bovine liver (P = 0.020 and P = 0.003 respectively). Meanwhile, only the input voltage significantly affects the ablation area (P < 0.001). The optimal result from RSM showed that for maximum ablation area 250.82mm2 with no thermal damage, the IRE protocol consisted of an active electrode length of 10 mm, a distance between electrodes of 10 mm, and the delivery of 50 pulses of 41.21 µs and 3000 V. CONCLUSIONS: The approach presented in this study allows the optimization of the IRE protocols. An optimal IRE protocol that maximizes the ablation area was successfully calculated which can be applied with no risk of thermal damage to the tissue.