Toward a clinical real time tissue ablation technology: combining electroporation and electrolysis (E2)

Author:

Guenther Enric123ORCID,Klein Nina134,Mikus Paul1,Botea Florin56,Pautov Mihail56,Lugnani Franco7ORCID,Macchioro Matteo7,Popescu Irinel56,Stehling Michael K.123,Rubinsky Boris12

Affiliation:

1. Biophysics, Inter Science GmbH, Gisikon, Lucerne, Switzerland

2. Department of Bioengineering and Department of Mechanical Engineering, University of California, Berkeley, Berkeley, CA, USA

3. Institut fur Bildgebende Diagnostik, Offenbach, Germany

4. Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain

5. Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania

6. Center of Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania

7. Hippocrates D.O.O. Divaĉa, Malaga, Spain

Abstract

Background Percutaneous image-guided tissue ablation (IGA) plays a growing role in the clinical management of solid malignancies. Electroporation is used for IGA in several modalities: irreversible electroporation (IRE), and reversible electroporation with chemotoxic drugs, called electrochemotherapy (ECT). It was shown that the combination of electrolysis and electroporation—E2—affords tissue ablation with greater efficiency, that is, lower voltages, lower energy and shorter procedure times than IRE and without the need for chemotoxic additives as in ECT. Methods A new E2 waveform was designed that delivers optimal doses of electroporation and electrolysis in a single waveform. A series of experiments were performed in the liver of pigs to evaluate E2 in the context of clinical applications. The goal was to find initial parameter boundaries in terms of electrical field, pulse duration and charge as well as tissue behavior to enable real time tissue ablation of clinically relevant volumes. Results Histological results show that a single several hundred millisecond long E2 waveform can ablate large volume of tissue at relatively low voltages while preserving the integrity of large blood vessels and lumen structures in the ablation zone without the use of chemotoxic drugs or paralyzing drugs during anesthesia. This could translate clinically into much shorter treatment times and ease of use compared to other techniques that are currently applied.

Publisher

PeerJ

Subject

General Agricultural and Biological Sciences,General Biochemistry, Genetics and Molecular Biology,General Medicine,General Neuroscience

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