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内部电极冷却对灌注器官模型中不可逆电穿孔的影响。

Effects of internal electrode cooling on irreversible electroporation using a perfused organ model.

机构信息

a Institute for Critical Technology and Applied Science, Virginia Tech , Blacksburg , VA , USA.

b Angiodynamics , Latham , NY , USA.

出版信息

Int J Hyperthermia. 2018;35(1):44-55. doi: 10.1080/02656736.2018.1473893. Epub 2018 May 28.

Abstract

PURPOSE

This study evaluates the effects of active electrode cooling, via internal fluid circulation, on the irreversible electroporation (IRE) lesion, deployed electric current and temperature changes using a perfused porcine liver model.

MATERIALS AND METHODS

A bipolar electrode delivered IRE electric pulses with or without activation of internal cooling to nine porcine mechanically perfused livers. Pulse schemes included a constant voltage, and a preconditioned delivery combined with an arc-mitigation algorithm. After treatment, organs were dissected, and treatment zones were stained using triphenyl-tetrazolium chloride (TTC) to demonstrate viability.

RESULTS

Thirty-nine treatments were performed with an internally cooled applicator and 21 with a non-cooled applicator. For the constant voltage scenario, the average final electrical current measured was 26.37 and 29.20 A for the cooled and uncooled electrodes respectively ([Formula: see text]). The average final temperature measured was 33.01 and 42.43 °C for the cooled and uncooled electrodes respectively ([Formula: see text]). The average measured ablations (fixed lesion) were 3.88-by-2.08 cm and 3.86-by-2.12 cm for the cooled and uncooled electrode respectively ([Formula: see text], [Formula: see text]). Similarly, the preconditioned/arc-mitigation scenario yielded an average final electrical current measurement of a 41.07 and 47.20 A for the cooled and uncooled electrodes respectively ([Formula: see text]). The average final temperature measured was 34.93 and 44.90 °C for the cooled and uncooled electrodes respectively ([Formula: see text]). The average measured ablations (fixed lesion) were 3.67-by-2.27 cm and 3.58-by-2.09 cm for the cooled and uncooled applicators ([Formula: see text]).

CONCLUSIONS

The internally-cooled bipolar applicator offers advantages that could improve clinical outcomes. Thermally mitigating internal perfusion technology reduced tissue temperatures and electric current while maintaining similar lesion sizes.

摘要

目的

本研究通过内部流体循环评估主动电极冷却对不可逆电穿孔(IRE)损伤的影响,使用灌注猪肝模型评估部署电流和温度变化。

材料与方法

使用双极电极在 9 个机械灌注的猪肝脏中施加 IRE 电脉冲,或在施加电脉冲的同时激活内部冷却。脉冲方案包括恒压和预处理联合电弧缓解算法。治疗后,对器官进行解剖,并使用三苯基四唑氯化物(TTC)染色以显示活力来治疗区。

结果

使用内部冷却器械进行了 39 次治疗,使用非冷却器械进行了 21 次治疗。对于恒压方案,测量到的平均最终电流分别为冷却和未冷却电极的 26.37 和 29.20A([Formula: see text])。测量到的平均最终温度分别为冷却和未冷却电极的 33.01 和 42.43°C([Formula: see text])。测量到的平均消融(固定损伤)分别为冷却和未冷却电极的 3.88-by-2.08cm 和 3.86-by-2.12cm([Formula: see text], [Formula: see text])。同样,预处理/电弧缓解方案产生的冷却和未冷却电极的平均最终电流测量值分别为 41.07 和 47.20A([Formula: see text])。测量到的平均最终温度分别为冷却和未冷却电极的 34.93 和 44.90°C([Formula: see text])。测量到的平均消融(固定损伤)分别为冷却和未冷却应用器的 3.67-by-2.27cm 和 3.58-by-2.09cm([Formula: see text])。

结论

内部冷却双极器械具有优势,可以改善临床结果。热缓解内部灌注技术降低了组织温度和电流,同时保持了相似的损伤大小。

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