Vollherbst Dominik, Bertheau Robert C, Fritz Stefan, Mogler Carolin, Kauczor Hans-Ulrich, Ryschich Eduard, Radeleff Boris A, Pereira Philippe L, Sommer Christof M
Clinic for Diagnostic and Interventional Radiology, Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany; Clinic for Radiology, Minimally-Invasive Therapies and Nuclear Medicine, Cancer Center Heilbronn-Franken, SLK Kliniken Heilbronn, Heilbronn, Germany.
Clinic for Diagnostic and Interventional Radiology, Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany.
J Vasc Interv Radiol. 2016 Jun;27(6):913-921.e2. doi: 10.1016/j.jvir.2016.02.001. Epub 2016 Apr 18.
To evaluate the effects of combined use of transarterial chemoembolization and irreversible electroporation (IRE) for focal tissue ablation in an acute porcine liver model.
Two established interventional techniques were combined: IRE with zones of irreversible and reversible electroporation and chemoembolization with microspheres, iodized oil, and doxorubicin. IRE was performed before chemoembolization in two pigs (pigs 1 and 2; IRE/chemoembolization group), chemoembolization was performed before IRE in two pigs (pigs 3 and 4; chemoembolization/IRE group), and only IRE was performed in two pigs (pigs 5 and 6). Five study groups were defined: IRE/chemoembolization (pigs 1 and 2), chemoembolization/IRE (pigs 3 and 4), IRE only (pigs 5 and 6), chemoembolization only (tissue outside the IRE zones in pigs 1-4), and control (untreated liver tissue outside the IRE zones in pigs 5 and 6). Animals were euthanized 2 hours after intervention. Size and shape of IRE zones on contrast-enhanced computed tomography, cell death on light microscopy, and doxorubicin tissue concentrations on chromatography and fluorescence microscopy were analyzed.
Size and shape of IRE zones were not significantly different (eg, P = .067 for volume). A histologic marker for irreversible cell death was positive in IRE/chemoembolization, chemoembolization/IRE, and IRE groups only in the macroscopically visible IRE zones. Doxorubicin tissue concentrations were not significantly different (P = .873). However, in the reversible electroporation (RE) zones, broad areas with intense intranuclear doxorubicin accumulation were observed in IRE/chemoembolization but not in chemoembolization/IRE and chemoembolization groups.
IRE before chemoembolization enhances the intranuclear accumulation of doxorubicin in the RE zone.
在急性猪肝模型中评估经动脉化疗栓塞术与不可逆电穿孔（IRE）联合用于局灶性组织消融的效果。
将两种成熟的介入技术相结合：具有不可逆和可逆电穿孔区域的IRE以及使用微球、碘化油和阿霉素的化疗栓塞术。在两只猪（猪1和猪2；IRE/化疗栓塞组）中，IRE在化疗栓塞术前进行；在两只猪（猪3和猪4；化疗栓塞/IRE组）中，化疗栓塞在IRE术前进行；在两只猪（猪5和猪6）中仅进行IRE。定义了五个研究组：IRE/化疗栓塞（猪1和猪2）、化疗栓塞/IRE（猪3和猪4）、仅IRE（猪5和猪6）、仅化疗栓塞（猪1 - 4中IRE区域外的组织）以及对照组（猪5和猪6中IRE区域外的未处理肝组织）。干预后两小时对动物实施安乐死。分析对比增强计算机断层扫描上IRE区域的大小和形状、光镜下的细胞死亡情况以及色谱法和荧光显微镜下阿霉素的组织浓度。
IRE区域的大小和形状无显著差异（例如，体积方面P = 0.067）。仅在宏观可见的IRE区域中，IRE/化疗栓塞组、化疗栓塞/IRE组和IRE组中不可逆细胞死亡的组织学标志物呈阳性。阿霉素组织浓度无显著差异（P = 0.873）。然而，在可逆电穿孔（RE）区域，IRE/化疗栓塞组中观察到广泛区域有强烈的核内阿霉素积聚，而化疗栓塞/IRE组和化疗栓塞组中未观察到。
化疗栓塞术前进行IRE可增强RE区域内核内阿霉素的积聚。
