Nonthermal Irreversible Electroporation as a Focal Ablation Treatment for Brain Cancer

  • Paulo A. Garcia
  • John H. RossmeislJr.
  • Thomas L. Ellis
  • Rafael V. Davalos
Chapter
Part of the Tumors of the Central Nervous System book series (TCNS, volume 12)

Abstract

Irreversible Electroporation (IRE) is a new focal tissue ablation technique that has shown great promise as a treatment for a variety of soft-tissue neoplasms. The therapy uses pulsed electric fields to destabilize cell membranes and achieve tissue death in a non-thermal manner. The procedure is minimally invasive and is performed through small electrodes inserted into the tissue with treatment duration of about 1 min. In this chapter we describe the first systematic in vivo studies of IRE in canine brain tissue. We confirmed that the procedure can be applied safely in the brain and was well tolerated clinically in normal dogs. The necrotic lesions created with IRE were sub-millimeter in resolution, sharply delineated from normal brain, and spared the major blood vessels. In addition, our preliminary results in a rodent study indicate that IRE transiently disrupts the BBB adjacent to the ablated area in a voltage-dependent manner with implications for enhanced delivery of cytotoxic agents to regions with infiltrative tumor cells. Finally, we present representative case examples demonstrating therapeutic planning aspects, clinical applications, and results of IRE ablation of spontaneous malignant intracranial gliomas in canine patients. Our group has demonstrated that IRE ablation can be performed safely, and is effective at reducing the tumor volume and associated intracranial hypertension, and allows for improvement in tumor-associated neurologic dysfunction. Our work illustrates the potential benefits of IRE for in vivo ablation of neoplastic brain tissue, especially when traditional methods of cytoreductive surgery are not possible or ideal.

Keywords

Malignant Glioma Pulse Electric Field Electric Field Distribution Major Blood Vessel Irreversible Electroporation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The work highlighted in this chapter was supported by the Coulter Foundation, the Golfer’s Against Cancer, and by the CBET-0933335 and CAREER CBET-1055913 awards from the National Science Foundation (NSF) in the United States of America. The authors would also like to thank AngioDynamics® Inc. for loan of their equipment and for technical support of these studies.

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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Paulo A. Garcia
    • 1
  • John H. RossmeislJr.
    • 2
  • Thomas L. Ellis
    • 3
  • Rafael V. Davalos
    • 4
  1. 1.School of Biomedical Engineering and SciencesVirginia Tech – Wake Forest UniversityBlacksburgUSA
  2. 2.Department of Small Animal Clinical SciencesVirginia-Maryland Regional College of Veterinary MedicineBlacksburgUSA
  3. 3.Department of NeurosurgeryWake Forest University School of MedicineWinston-SalemUSA
  4. 4.School of Biomedical Engineering and SciencesVirginia Tech – Wake Forest UniversityeBlacksburgUSA

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