National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine and Regenerative Medicine and Surgical Engineering Research Center of Shaanxi Province, First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , China.
Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , China.
Int J Hyperthermia. 2019;36(1):854-867. doi: 10.1080/02656736.2019.1646928.
Irreversible electroporation (IRE) combined with a catheter-based electrode during endoscopy is a potential alternative treatment method for digestive tract tumors. The aim of this study was to investigate the electrical injury (EI) and thermal injury (TI) to the digestive tract via numerical analyses and to evaluate the role and impact of electrode configurations and pulse settings on the efficacy and outcomes of IRE. A finite element method was used to solve the numerical model. A digestive tract model having 4-mm-thick walls and two catheter-based electrode configuration models were constructed. The distributions of electric fields, temperature, electrical conductivity, tissue injury and limitation on the pulse number required for IRE were calculated and compared. Electrode length is an important geometric parameter for electrodes in the monopolar model (MPM), while electrode spacing affects the outcomes in the bipolar model (BPM). Increasing the pulse voltage reduces the pulse number required for tissue ablation, while increasing the risk of TI. In total, there were 6 NT-IRE protocols, 12 thermal-IRE protocols and 30 TI protocols. All of the NT-IRE protocols were set in BPMs with a voltage of 0.50 kV. With increasing electrode spacing, the minimum pulse number decreased. However, thermal effects were inevitable in the MPM. The electrode configuration and pulse settings are adjusted to achieve NT-IRE synergistically. The BPM is more reliable for achieving NT-IRE in 4-mm-thick digestive wall. Future and studies are needed to support and validate this conclusion.
不可逆电穿孔（IRE）结合内镜下的基于导管的电极是治疗消化道肿瘤的一种潜在替代治疗方法。本研究旨在通过数值分析研究IRE 对消化道的电损伤（EI）和热损伤（TI），并评估电极构型和脉冲设置对 IRE 疗效和结果的作用和影响。使用有限元方法解决数值模型。构建了具有 4mm 厚壁的消化道模型和两种基于导管的电极构型模型。计算并比较了电场、温度、电导率、组织损伤的分布以及 IRE 所需脉冲数的限制。电极长度是单极模型（MPM）中电极的重要几何参数，而电极间距影响双极模型（BPM）的结果。增加脉冲电压会减少组织消融所需的脉冲数，但会增加 TI 的风险。总共有 6 个 NT-IRE 方案、12 个热 IRE 方案和 30 个 TI 方案。所有的 NT-IRE 方案都设置在 BPM 中，电压为 0.50kV。随着电极间距的增加，最小脉冲数减少。然而，在 MPM 中不可避免地会产生热效应。通过调整电极构型和脉冲设置来协同实现 NT-IRE。BPM 更可靠地实现 4mm 厚消化道壁中的 NT-IRE。需要进一步的研究来支持和验证这一结论。
