Numerical workflow of irreversible electroporation for deep-seated tumor

Abstract

The paper provides a numerical workflow, based on the "real-life" clinical workflow of irreversible electroporation (IRE) performed for the treatment of deep-seated liver tumors. Thanks to a combination of numerical modeling, image registration algorithm and clinical data, our numerical workflow enables to provide the distribution of the electric field as effectively delivered by the clinical IRE procedure. As a proof of concept, we show on a specific clinical case of IRE ablation of liver tumor that clinical data could be advantageously combined to numerical simulations in a near future , in order to give to the interventional radiologists information on the effective IRE ablation. We also corroborate the simulated treated region with the post-treatment MRI performed 3 days after the treatment.

Numerical modelling challenges for clinical electroporation ablation technique of liver tumors

“…For this purpose, numerical simulations are performed from the real clinical data: the medical images which give the position of the organ and the tumor, the real position of the needles, and the current graphs of test pulses for tissues conductivity calibration. These data are the input parameters (see the numerical workflow detailed in Gallinato et al [20]).…”

“…Then we present the most used numerical model of tissue electroporation we investigate numerical the sensitivity to needle location and to conductivity value. Section 5 proposes a strategy which has been presented in [20]. In conclusion, we draw some clinically relevant perspectives to increase the impact of the numerical modeling on the clinical practice of EBTs.…”

“…It is somehow the minimal clinical procedure, which can be performed in most of interventional radiology operative room equipped with new generation of angiographic suit including 3D cone beam CT acquisition capacity [48]. The clinical workflow is split into 3 steps as described in [20]. The image exhibits a scar tissue left from a previous RF ablation.…”

“…An efficient and accurate computation of the electrical intensity which flows through one needle -say E + -is required to calibrate the tissues conductivity from initial test pulses and their recorded intensities (IRE current graphs) [20]. It is defined as…”

“…Indeed, a small inclination of the needle due to anatomic constraint modifies substantially the isosurfaces of the electric field, and thus the electroporation ablation zone. In [20], we propose a numerical workflow to provide a numerical evaluation of the clinical electroporation ablation as performed by the interventional radiologist during the procedure.…”