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Planning Irreversible Electroporation in the Porcine Kidney: Are Numerical Simulations Reliable for Predicting Empiric Ablation Outcomes?

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Abstract

Purpose

Numerical simulations are used for treatment planning in clinical applications of irreversible electroporation (IRE) to determine ablation size and shape. To assess the reliability of simulations for treatment planning, we compared simulation results with empiric outcomes of renal IRE using computed tomography (CT) and histology in an animal model.

Methods

The ablation size and shape for six different IRE parameter sets (70–90 pulses, 2,000–2,700 V, 70–100 µs) for monopolar and bipolar electrodes was simulated using a numerical model. Employing these treatment parameters, 35 CT-guided IRE ablations were created in both kidneys of six pigs and followed up with CT immediately and after 24 h. Histopathology was analyzed from postablation day 1.

Results

Ablation zones on CT measured 81 ± 18 % (day 0, p ≤ 0.05) and 115 ± 18 % (day 1, p ≤ 0.09) of the simulated size for monopolar electrodes, and 190 ± 33 % (day 0, p ≤ 0.001) and 234 ± 12 % (day 1, p ≤ 0.0001) for bipolar electrodes. Histopathology indicated smaller ablation zones than simulated (71 ± 41 %, p ≤ 0.047) and measured on CT (47 ± 16 %, p ≤ 0.005) with complete ablation of kidney parenchyma within the central zone and incomplete ablation in the periphery.

Conclusion

Both numerical simulations for planning renal IRE and CT measurements may overestimate the size of ablation compared to histology, and ablation effects may be incomplete in the periphery.

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Acknowledgments

The institution of S. B. Solomon received an unrestricted grant and equipment from AngioDynamics Inc. Stephen B. Solomon is a consultant for Covidien and received a grant from GE Healthcare.

Conflict of interest

Thomas Wimmer, Govindarajan Srimathveeravalli, Narendra Gutta, Paula C. Ezell, Sebastien Monette, Majid Maybody, Joseph P. Erinjery, Jeremy C. Durack, and Jonathan A. Coleman declare that they have no conflict of interest.

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Authors and Affiliations

  1. Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Thomas Wimmer, Govindarajan Srimathveeravalli, Narendra Gutta, Majid Maybody, Joseph P. Erinjery, Jeremy C. Durack & Stephen B. Solomon

  2. Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036, Graz, Austria

    Thomas Wimmer

  3. Research Animal Resource Center, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, The Rockefeller University, New York, NY, USA

    Paula C. Ezell

  4. Laboratory of Comparative Pathology, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, The Rockefeller University, New York, NY, USA

    Sebastien Monette

  5. Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Jonathan A. Coleman

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  1. Thomas Wimmer
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  2. Govindarajan Srimathveeravalli
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  10. Stephen B. Solomon
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Correspondence to Thomas Wimmer.

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Wimmer, T., Srimathveeravalli, G., Gutta, N. et al. Planning Irreversible Electroporation in the Porcine Kidney: Are Numerical Simulations Reliable for Predicting Empiric Ablation Outcomes?. Cardiovasc Intervent Radiol 38, 182–190 (2015). https://doi.org/10.1007/s00270-014-0905-2

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  • DOI: https://doi.org/10.1007/s00270-014-0905-2

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