Type:
Educational Exhibit
Keywords:
Interventional non-vascular, Ultrasound, Ablation procedures, Neoplasia
Authors:
G. Martinelli1, S. Méndez Alonso1, J. Escartín López2; 1Majadahonda/ES, 2Majadahonda, Madrid/ES
DOI:
10.1594/ecr2018/C-1486
Background
Minimally invasive percutaneous tumor ablation is an established treatment option for focal solid tumors in the liver,
kidney,
bone and lung,
with ever-expanding indication for focal tumors in additional locations.
Irreversibe electroporation (IRE) is a non thermal technique of tissue ablation that allows the destruction of tumor cells using a series of short high-voltage electric pulses that induce cellular apoptosis through the formacion of nanopores in the cell membrane.
Efficacy of current thermal ablation techniques,
such as radiofrecuency and microwave,
decrease for large tumors (3-5cm) due to limitations in achieving uniform heating at tumor periphery and the counteracting heat-reducing effect of perfusion-mediated tissue cooling,
which limits thermal-based coagulation.
Irreversible electroporation is being studied as an alternative ablative technology that can potencially adress several of these limitacion.
Because the main therapeutic principle of IRE is not thermal,
the heat-sink effect of flow is no longer a limitacion.
Moreover with this method the extracelular matrix of treated tissues is largely preserved,
as are the surrounding blood vessels and bile ducts,
avoiding fibrotic changes. Fig. 1 Fig. 2
All of these specific properties make IRE an attractive alternative treatment in solid tumors lesions adjacent to critical vascular structure when the other ablative techniques are contraindicated.