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优化单插入电极阵列,以使用高频不可逆电穿孔技术创建临床相关的消融。

Optimization of a single insertion electrode array for the creation of clinically relevant ablations using high-frequency irreversible electroporation.

机构信息

UNC-NCSU Joint Department of Biomedical Engineering, USA.

Luna Innovations Inc, USA.

出版信息

Comput Biol Med. 2018 Apr 1;95:107-117. doi: 10.1016/j.compbiomed.2018.02.009. Epub 2018 Feb 17.

DOI:10.1016/j.compbiomed.2018.02.009
PMID:29486332
Abstract

High-frequency irreversible electroporation (H-FIRE) is an emerging ablation modality, delivering rapid bursts of bipolar microsecond-duration electrical pulses to non-thermally ablate tissue including tumors. With advantages over current electroporation techniques including mitigation of muscle stimulation and reduced susceptibility to heterogeneous tissue properties, H-FIRE may produce more uniform and predictable ablations and can potentially be delivered with a single applicator device. However, the resulting ablations tend to be smaller than those provided with equivalent energy monopolar pulse protocols. Here, we develop numerical simulations that demonstrate the potential for clinically relevant ablations with H-FIRE delivered via a single insertion technique comprised of an expandable array and a distally placed grounding pad. Based on existing in vivo data and new in vitro results, delivery of H-FIRE with a clinical IRE single electrode probe (1 cm long) is predicted to produce a 2.2 cm ablation while an optimized eight tine array produces a 3.2 cm ablation when the same H-FIRE bursts are delivered (5000 V). We demonstrate that alternative pulse protocols can be used to increase ablation volumes with this optimized array and these results indicate that in vivo investigation of a single insertion array and grounding pad are warranted.

摘要

高频不可逆电穿孔(H-FIRE)是一种新兴的消融方式,它通过快速传递双极微秒时长的电脉冲来非热消融组织,包括肿瘤。与目前的电穿孔技术相比,H-FIRE 具有减轻肌肉刺激和降低对异质组织特性的敏感性等优势,它可以产生更均匀和可预测的消融效果,并且可能仅使用单个施源器设备来实现。然而,与等效能量的单极脉冲方案相比,H-FIRE 产生的消融体积通常较小。在这里,我们开发了数值模拟,展示了通过由可扩展阵列和远端接地垫组成的单一插入技术来实现临床相关消融的潜力。基于现有的体内数据和新的体外结果,预测使用临床 IRE 单电极探头(长 1cm)进行 H-FIRE 传递将产生 2.2cm 的消融,而当传递相同的 H-FIRE 脉冲时,优化的 8 齿阵列将产生 3.2cm 的消融(5000V)。我们证明,可替代的脉冲方案可用于增加优化阵列的消融体积,这些结果表明有必要对单个插入阵列和接地垫进行体内研究。

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