University Hospital RWTH Aachen, Clinic for Diagnostic and Interventional Radiology, Aachen, Germany.
Philips Research, Eindhoven, the Netherlands.
Technol Cancer Res Treat. 2024 Jan-Dec;23:15330338241288342. doi: 10.1177/15330338241288342.
Irreversible Electroporation (IRE) is a non-thermal minimally invasive cancer therapy used in the treatment of liver tumors. However, the therapy entails an electrical current flux which can be high enough to cause a noticeable temperature increase. Therefore, the analysis of the heat distribution is important: during any IRE treatment, the target area is intended to be treated with non-thermal effects, where existing thermal effects should not damage nearby sensitive structures. This article aims to compare the established two parallel needles electrode setup, used by FDA-approved electroporation delivering devices, to a single needle, multiple electrode prototype design.
Levels and distributions of the temperature at different distances from the applicators during an IRE liver treatment were investigated. The prototype results were collated with already published in-vivo data. All electrode configurations were analyzed numerically in COMSOL Multiphysics for different pulse protocols.
The extension of coagulation necrosis predicted by the model matched available in-vivo data. While the maximum average temperature during pulsation was higher for the prototype (74 °C) than for the two-needle IRE setup (57 °C), the thickness of the coagulation necrosis around the conductive electrodes was in the same range for both configurations. However, the location differed completely: the necrosis engendered by the prototype was located inside the tumor, while the two-needle IRE setup created necrosis outside the tumor, potentially closer to sensitive structures.
The results highlighted the importance of heat distribution analysis for the design of new IRE needles as well as for IRE treatment planning. Proper analysis ensures that the non-thermal effects are maximized while minimizing any potential thermal damage to surrounding sensitive structures.
不可逆电穿孔(IRE)是一种非热微创癌症治疗方法,用于治疗肝脏肿瘤。然而,该疗法需要足够高的电流通量,以引起明显的温度升高。因此,分析热分布非常重要:在任何 IRE 治疗过程中,目标区域都应采用非热效应进行治疗,其中现有的热效应不应损害附近的敏感结构。本文旨在比较已通过 FDA 批准的电穿孔输送设备使用的两个平行针电极设置与单针、多电极原型设计。
在 IRE 肝脏治疗过程中,研究了不同距离处温度的水平和分布。将原型结果与已发表的体内数据进行了比较。对所有电极配置都在 COMSOL Multiphysics 中进行了数值分析,以研究不同的脉冲协议。
模型预测的凝固性坏死扩展与可获得的体内数据相匹配。虽然原型(74°C)在脉冲期间的平均最高温度高于两针 IRE 装置(57°C),但两种配置的导电电极周围的凝固性坏死厚度相同。然而,位置完全不同:原型引起的坏死位于肿瘤内部,而两针 IRE 装置在肿瘤外部产生坏死,可能更接近敏感结构。
结果强调了热分布分析对于新 IRE 针的设计以及 IRE 治疗计划的重要性。适当的分析确保最大化非热效应,同时最小化周围敏感结构的潜在热损伤。