Daniels Charlotte, Rubinsky Boris
Department of Mechanical Engineering, University of California, Berkeley, Berkeley, CA 94720, USA.
J Biomech Eng. 2009 Jul;131(7):071006. doi: 10.1115/1.3156808.
Nonthermal irreversible electroporation (NTIRE) is a new minimally invasive surgical technique that is part of the emerging field of molecular surgery, which holds the potential to treat diseases with unprecedented accuracy. NTIRE utilizes electrical pulses delivered to a targeted area, producing irreversible damage to the cell membrane. Because NTIRE does not cause thermal damage, the integrity of all other molecules, collagen, and elastin in the targeted area is preserved. Previous theoretical studies have only examined NTIRE in homogeneous tissues; however, biological structures are complex collections of diverse tissues. In order to develop electroporation as a precise treatment in clinical applications, realistic models are necessary. Therefore, the purpose of this study was to refine electroporation as a treatment by examining the effect of NTIRE in heterogeneous tissues of the prostate and breast. This study uses a two-dimensional finite element solution of the Laplace and bioheat equations to examine the effects of heterogeneities on electric field and temperature distribution. Three different heterogeneous structures were taken into account: nerves, blood vessels, and ducts. The results of this study demonstrate that heterogeneities significantly impact both the temperature and electrical field distribution in surrounding tissues, indicating that heterogeneities should not be neglected. The results were promising. While the surrounding tissue experienced a high electrical field, the axon of the nerve, the interior of the blood vessel, and the ducts experienced no electrical field. This indicates that blood vessels, nerves, and lactiferous ducts adjacent to a tumor treated with electroporation will survive, while the cancerous lesion is ablated. This study clearly demonstrates the importance of considering heterogeneity in NTIRE applications.
非热不可逆电穿孔（NTIRE）是一种新型微创手术技术，是新兴的分子外科领域的一部分，有望以前所未有的精度治疗疾病。NTIRE利用传递到目标区域的电脉冲，对细胞膜造成不可逆损伤。由于NTIRE不会造成热损伤，目标区域内所有其他分子、胶原蛋白和弹性蛋白的完整性得以保留。以往的理论研究仅考察了NTIRE在均匀组织中的情况；然而，生物结构是由多种不同组织组成的复杂集合。为了将电穿孔发展成为临床应用中的精确治疗方法，需要建立逼真的模型。因此，本研究的目的是通过考察NTIRE在前列腺和乳腺的异质组织中的效果，优化电穿孔治疗。本研究采用拉普拉斯方程和生物热方程的二维有限元解，考察异质性对电场和温度分布的影响。考虑了三种不同的异质结构：神经、血管和导管。本研究结果表明，异质性对周围组织中的温度和电场分布均有显著影响，这表明异质性不容忽视。结果很有前景。虽然周围组织承受了高电场，但神经轴突、血管内部和导管未承受电场。这表明，接受电穿孔治疗的肿瘤附近的血管、神经和输乳管将存活，而癌性病变则被消融。本研究清楚地证明了在NTIRE应用中考虑异质性的重要性。
