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使用非热不可逆电穿孔产生球形消融:使用单电极和接地垫的实验室研究

Production of Spherical Ablations Using Nonthermal Irreversible Electroporation: A Laboratory Investigation Using a Single Electrode and Grounding Pad.

作者信息

Sano Michael B, Fan Richard E, Hwang Gloria L, Sonn Geoffrey A, Xing Lei

机构信息

Department of Radiation Oncology and Division of Radiation Physics, Stanford University Medical Center, 875 Blake Wilbur Dr., Stanford, CA 94305.

Department of Urology, Stanford University Medical Center, 875 Blake Wilbur Dr., Stanford, CA 94305.

出版信息

J Vasc Interv Radiol. 2016 Sep;27(9):1432-1440.e3. doi: 10.1016/j.jvir.2016.05.032. Epub 2016 Jul 29.

Abstract

PURPOSE

To mathematically model and test ex vivo a modified technique of irreversible electroporation (IRE) to produce large spherical ablations by using a single probe.

MATERIALS AND METHODS

Computed simulations were performed by using varying voltages, electrode exposure lengths, and tissue types. A vegetable (potato) tissue model was then used to compare ablations created by conventional and high-frequency IRE protocols by using 2 probe configurations: a single probe with two collinear electrodes (2EP) or a single electrode configured with a grounding pad (P+GP). The new P+GP electrode configuration was evaluated in ex vivo liver tissue.

RESULTS

The P+GP configuration produced more spherical ablation volumes than the 2EP configuration in computed simulations and tissue models. In prostate tissue, computed simulations predicted ablation volumes at 3,000 V of 1.6 cm(3) for the P+GP configurations, compared with 0.94 cm(3) for the 2EP configuration; in liver tissue, the predicted ablation volumes were 4.7 times larger than those in the prostate. Vegetable model studies verify that the P+GP configuration produces larger and more spherical ablations than those produced by the 2EP. High-frequency IRE treatment of ex vivo liver with the P+GP configuration created a 2.84 × 2.21-cm ablation zone.

CONCLUSIONS

Computer modeling showed that P+GP configuration for IRE procedures yields ablations that are larger than the 2EP configuration, creating substantial ablation zones with a single electrode placement. When tested in tissue models and an ex vivo liver model, the P+GP configuration created ablation zones that appear to be of clinically relevant size and shape.

摘要

目的

通过数学建模并在体外测试一种改良的不可逆电穿孔(IRE)技术,该技术使用单个探针产生大的球形消融灶。

材料与方法

使用不同的电压、电极暴露长度和组织类型进行计算机模拟。然后使用蔬菜(土豆)组织模型,通过两种探针配置比较传统IRE方案和高频IRE方案产生的消融灶:带有两个共线电极的单个探针(2EP)或配置有接地垫的单个电极(P+GP)。在离体肝组织中评估新的P+GP电极配置。

结果

在计算机模拟和组织模型中,P+GP配置产生的球形消融灶体积比2EP配置更多。在前列腺组织中,计算机模拟预测,对于P+GP配置,在3000V时消融灶体积为1.6cm³,而2EP配置为0.94cm³;在肝组织中,预测的消融灶体积比前列腺组织中的大4.7倍。蔬菜模型研究证实,P+GP配置产生的消融灶比2EP产生的更大且更接近球形。使用P+GP配置对离体肝进行高频IRE治疗产生了一个2.84×2.21cm的消融区。

结论

计算机建模表明,IRE程序的P+GP配置产生的消融灶比2EP配置更大,通过单次电极放置可创建实质性的消融区。在组织模型和离体肝模型中进行测试时,P+GP配置创建的消融区似乎具有临床相关的大小和形状。

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