Skip to main content
SpringerLink
Log in

CT-guided Irreversible Electroporation in an Acute Porcine Liver Model: Effect of Previous Transarterial Iodized Oil Tissue Marking on Technical Parameters, 3D Computed Tomographic Rendering of the Electroporation Zone, and Histopathology

  • Laboratory Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the effect of previous transarterial iodized oil tissue marking (ITM) on technical parameters, three-dimensional (3D) computed tomographic (CT) rendering of the electroporation zone, and histopathology after CT-guided irreversible electroporation (IRE) in an acute porcine liver model as a potential strategy to improve IRE performance.

Methods

After Ethics Committee approval was obtained, in five landrace pigs, two IREs of the right and left liver (RL and LL) were performed under CT guidance with identical electroporation parameters. Before IRE, transarterial marking of the LL was performed with iodized oil. Nonenhanced and contrast-enhanced CT examinations followed. One hour after IRE, animals were killed and livers collected. Mean resulting voltage and amperage during IRE were assessed. For 3D CT rendering of the electroporation zone, parameters for size and shape were analyzed. Quantitative data were compared by the Mann–Whitney test. Histopathological differences were assessed.

Results

Mean resulting voltage and amperage were 2,545.3 ± 66.0 V and 26.1 ± 1.8 A for RL, and 2,537.3 ± 69.0 V and 27.7 ± 1.8 A for LL without significant differences. Short axis, volume, and sphericity index were 16.5 ± 4.4 mm, 8.6 ± 3.2 cm3, and 1.7 ± 0.3 for RL, and 18.2 ± 3.4 mm, 9.8 ± 3.8 cm3, and 1.7 ± 0.3 for LL without significant differences. For RL and LL, the electroporation zone consisted of severely widened hepatic sinusoids containing erythrocytes and showed homogeneous apoptosis. For LL, iodized oil could be detected in the center and at the rim of the electroporation zone.

Conclusion

There is no adverse effect of previous ITM on technical parameters, 3D CT rendering of the electroporation zone, and histopathology after CT-guided IRE of the liver.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Davalos RV, Mir IL, Rubinsky B (2005) Tissue ablation with irreversible electroporation. Ann Biomed Eng 33:223–231

    Article  CAS  PubMed  Google Scholar 

  2. Kingham TP, Karkar AM, D’Angelica MI et al (2012) Ablation of perivascular hepatic malignant tumors with irreversible electroporation. J Am Coll Surg 215:379–387

    Article  PubMed  Google Scholar 

  3. Lee EW, Wong D, Tafti BA et al (2012) Irreversible electroporation in eradication of rabbit VX2 liver tumor. J Vasc Interv Radiol 23:833–840

    Article  PubMed  Google Scholar 

  4. Lencioni R, Crocetti L, Pina MC, Cioni D (2009) Percutaneous image-guided radiofrequency ablation of liver tumors. Abdom Imaging 34:547–556

    Article  PubMed  Google Scholar 

  5. Livraghi T, Meloni F, Solbiati L, Zanus G (2012) Complications of microwave ablation for liver tumors: results of a multicenter study. Cardiovasc Interv Radiol 35:868–874

    Article  Google Scholar 

  6. Yan S, Xu D, Sun B (2013) Combination of radiofrequency ablation with transarterial chemoembolization for hepatocellular carcinoma: a meta-analysis. Dig Dis Sci 58:2107–2113

    Article  CAS  PubMed  Google Scholar 

  7. Ni JY, Liu SS, Xu LF et al (2013) Transarterial chemoembolization combined with percutaneous radiofrequency ablation versus TACE and PRFA monotherapy in the treatment for hepatocellular carcinoma: a meta-analysis. J Cancer Res Clin Oncol 139:653–659

    Article  CAS  PubMed  Google Scholar 

  8. Peng ZW, Zhang YJ, Liang HH et al (2012) Recurrent hepatocellular carcinoma treated with sequential transcatheter arterial chemoembolization and RF ablation versus RF ablation alone: a prospective randomized trial. Radiology 262:689–700

    Article  PubMed  Google Scholar 

  9. Gandhi S, Iannitti DA, Mayo-Smith WW, Dupuy DE (2006) Technical report: lipiodol-guided computed tomography for radiofrequency ablation of hepatocellular carcinoma. Clin Radiol 61:888–891

    Article  CAS  PubMed  Google Scholar 

  10. Miyayama S, Matsui O, Yamashiro M et al (2007) Iodized oil accumulation in the hypovascular tumor portion of early-stage hepatocellular carcinoma after ultraselective transcatheter arterial chemoembolization. Hepatol Int 1:451–459

    Article  PubMed Central  PubMed  Google Scholar 

  11. Laeseke PF, Lee FT Jr, Sampson LA et al (2009) Microwave ablation versus radiofrequency ablation in the kidney: high-power triaxial antennas create larger ablation zones than similarly sized internally cooled electrodes. J Vasc Interv Radiol 20:1224–1229

    Article  PubMed Central  PubMed  Google Scholar 

  12. Pereira PL, Trubenbach J, Schenk M et al (2004) Radiofrequency ablation: in vivo comparison of four commercially available devices in pig livers. Radiology 232:482–490

    Article  PubMed  Google Scholar 

  13. Sommer CM, Kortes N, Zelzer S et al (2011) Renal artery embolization combined with radiofrequency ablation in a porcine kidney model: effect of small and narrowly calibrated microparticles as embolization material on coagulation diameter, volume, and shape. Cardiovasc Interv Radiol 34:156–165

    Article  CAS  Google Scholar 

  14. Arnold MM, Wallace AC, Kreel L, Li MK (1990) Demonstration of Lipiodol in paraffin sections using a modified silver impregnation technique. Am J Clin Pathol 94:585–589

    CAS  PubMed  Google Scholar 

  15. Lu DS, Raman SS, Vodopich DJ et al (2002) Effect of vessel size on creation of hepatic radiofrequency lesions in pigs: assessment of the “heat sink” effect. Am J Roentgenol 178:47–51

    Article  Google Scholar 

  16. Yu NC, Raman SS, Kim YJ et al (2008) Microwave liver ablation: influence of hepatic vein size on heat-sink effect in a porcine model. J Vasc Interv Radiol 19:1087–1092

    Article  PubMed  Google Scholar 

  17. Chung H, Kudo M, Minami Y, Kawasaki T (2007) Radiofrequency ablation combined with reduction of hepatic blood flow: effect of Lipiodol on coagulation diameter and ablation time in normal pig liver. Hepatogastroenterology 54:701–704

    CAS  PubMed  Google Scholar 

  18. Sommer CM, Kortes N, Mogler C et al (2012) Super-micro-bland particle embolization combined with RF-ablation: angiographic, macroscopic and microscopic features in porcine kidneys. Eur J Radiol 81:1165–1172

    Article  CAS  PubMed  Google Scholar 

  19. Zhao M, Wang JP, Pan CC et al (2012) CT-guided radiofrequency ablation after with transarterial chemoembolization in treating unresectable hepatocellular carcinoma with long overall survival improvement. Eur J Radiol 81:2717–2725

    Article  PubMed  Google Scholar 

  20. Shiraishi R, Yamasaki T, Saeki I et al (2008) Pilot study of combination therapy with transcatheter arterial infusion chemotherapy using iodized oil and percutaneous radiofrequency ablation during occlusion of hepatic blood flow for hepatocellular carcinoma. Am J Clin Oncol 31:311–316

    Article  CAS  PubMed  Google Scholar 

  21. Sugimori K, Nozawa A, Morimoto M et al (2005) Extension of radiofrequency ablation of the liver by transcatheter arterial embolization with iodized oil and gelatin sponge: results in a pig model. J Vasc Interv Radiol 16:849–856

    Article  PubMed  Google Scholar 

  22. Wendler JJ, Pech M, Blaschke S et al (2012) Angiography in the isolated perfused kidney: radiological evaluation of vascular protection in tissue ablation by nonthermal irreversible electroporation. Cardiovasc Interv Radiol 35:383–390

    Article  Google Scholar 

  23. Vollherbst D, Fritz S, Zelzer S et al (2014) Specific CT 3D rendering of the treatment zone after irreversible electroporation (IRE) in a pig liver model: the “Chebyshev Center Concept” to define the maximum treatable tumor size. BMC Med Imaging 14:2

    Article  PubMed Central  PubMed  Google Scholar 

  24. Kan Z, Sato M, Ivancev K et al (1993) Distribution and effect of iodized poppyseed oil in the liver after hepatic artery embolization: experimental study in several animal species. Radiology 186:861–866

    Article  CAS  PubMed  Google Scholar 

  25. Stampfl S, Stampfl U, Rehnitz C et al (2007) Experimental evaluation of early and long-term effects of microparticle embolization in two different mini-pig models. Part II: liver. Cardiovasc Interv Radiol 30:462–468

    Article  CAS  Google Scholar 

  26. Rao PP, Pascale F, Seck A et al (2012) Irinotecan loaded in eluting beads: preclinical assessment in a rabbit VX2 liver tumor model. Cardiovasc Interv Radiol 35:1448–1459

    Article  Google Scholar 

  27. Roche A (2009) Liver chemoembolization: an update. Bull Cancer 96:1111–1116

    PubMed  Google Scholar 

  28. Corovic S, Lackovic I, Sustaric P et al (2013) Modeling of electric field distribution in tissues during electroporation. Biomed Eng Online 12:16

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported technically and financially by AngioDynamics, Queensbury, NY, USA. The authors express their gratitude to Roland Galmbacher and Markus Cattelaens for their support during the experiments.

Conflict of interest

C. M. Sommer and S. Fritz received a financial Grant from AngioDynamics, Queensbury, NY, USA, for this study. D. Vollherbst, S. Zelzer, M. F. Wachter, N. Bellemann, T. Gockner, T. Mokry, A. Schmitz, S. Aulmann, U. Stampfl, P. Pereira, H. U. Kauczor, J. Werner, and B. A. Radeleff declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, 69120, Heidelberg, Germany

    C. M. Sommer, D. Vollherbst, M. F. Wachter, N. Bellemann, T. Gockner, T. Mokry, A. Schmitz, U. Stampfl, H. U. Kauczor & B. A. Radeleff

  2. Department of General Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany

    S. Fritz & J. Werner

  3. Medical and Biological Informatics, German Cancer Research Center (dkfz), Heidelberg, Germany

    S. Zelzer

  4. Department of General Pathology, University Hospital Heidelberg, Heidelberg, Germany

    S. Aulmann

  5. Clinic for Radiology, Minimally-invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Heilbronn, Germany

    P. Pereira

Authors
  1. C. M. Sommer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Fritz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Vollherbst
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Zelzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. F. Wachter
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. N. Bellemann
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. T. Gockner
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. T. Mokry
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. A. Schmitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. S. Aulmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. U. Stampfl
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. P. Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. H. U. Kauczor
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. J. Werner
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. B. A. Radeleff
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. M. Sommer.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sommer, C.M., Fritz, S., Vollherbst, D. et al. CT-guided Irreversible Electroporation in an Acute Porcine Liver Model: Effect of Previous Transarterial Iodized Oil Tissue Marking on Technical Parameters, 3D Computed Tomographic Rendering of the Electroporation Zone, and Histopathology . Cardiovasc Intervent Radiol 38, 191–200 (2015). https://doi.org/10.1007/s00270-014-0910-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-014-0910-5

Keywords

Search

Navigation