Retrospective Study for Validation and Improvement of Numerical Treatment Planning of Irreversible Electroporation Ablation for Treatment of Liver Tumors

Cindrič, Helena; Mariappan, Panchatcharam; Beyer, Lukas Philipp; Wiggermann, Philipp; Moche, Michael; Miklavčič, Damijan; Kos, Bor

doi:10.1109/tbme.2021.3075772

Cited by 17 publications

(11 citation statements)

References 60 publications

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“…COMSOL Multiphysics was used for computation of electric field and temperature distribution during the procedures. The computation process is described in detail in 19 , 34 – 36 . Briefly, the model consists of solving the partial differential equation for electric potential distribution in steady state form.…”

Section: Methodsmentioning

confidence: 99%

“…The change in electrical conductivity due to electroporation of each modelled structure is approximated in COMSOL as a smoothed step function, with the following parameters: base electrical conductivity (σ 0 ), factor of conductivity increase, center (E C ) and size (E W ) of the transition zone. The parameters of the electrodes and all tissues except for the septa were taken from previous works 19 , 27 , 36 , and are listed in Supplementary Table S1 . The electrical conductivity of the interlobular septa is unknown, therefore, we performed a parametric study, using the heterogeneous model, where we varied all four parameters of the conductivity function.…”

Section: Methodsmentioning

confidence: 99%

“…In a recent translational animal model study 33 , we examined whether ECT with bleomycin causes clinically significant damage to normal liver tissue with respect to large blood vessels and bile ducts. In our present study, we numerically reconstructed four of the experiments performed in that study 33 , and computed the electric field distribution in tissue with our previously developed treatment planning framework 19 , 34 – 36 . The aim of this study was to compare the computed electric field distribution with the histopathological changes observed in tissue after treatment, and to evaluate how the liver structures affect the electric field distribution.…”

Section: Introductionmentioning

confidence: 99%

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Numerical mesoscale tissue model of electrochemotherapy in liver based on histological findings

Cindrič

Gašljević

Edhemović

et al. 2022

Sci Rep

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Electrochemotherapy (ECT) and irreversible electroporation (IRE) are being investigated for treatment of hepatic tumours. The liver is a highly heterogeneous organ, permeated with a network of macro- and microvasculature, biliary tracts and connective tissue. The success of ECT and IRE depends on sufficient electric field established in whole target tissue; therefore, tissue heterogeneity may affect the treatment outcome. In this study, we investigate electroporation in the liver using a numerical mesoscale tissue model. We numerically reconstructed four ECT experiments in healthy porcine liver and computed the electric field distribution using our treatment planning framework. We compared the computed results with histopathological changes identified on microscopic images after treatment. The mean electric field threshold that best fitted the zone of coagulation necrosis was 1225 V/cm, while the mean threshold that best fitted the zone of partially damaged liver parenchyma attributed to IRE was 805 V/cm. We evaluated how the liver macro- and microstructures affect the electric field distribution. Our results show that the liver microstructure does not significantly affect the electric field distribution on the level needed for treatment planning. However, major hepatic vessels and portal spaces significantly affect the electric field distribution, and should be considered when planning treatments.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Numerical mesoscale tissue model of electrochemotherapy in liver based on histological findings

Cindrič

Gašljević

Edhemović

et al. 2022

Sci Rep

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“…This simplification is commonly used in literature before 3,14,22 and the resultant ablation is considered to match the experimental results of a pulsed protocol. 23,24 The electric potential distribution, V, is the critical unknown in the modeling of electroporation. This variable is determined by solving the partial differential equation (PDE) for static electric currents, given in Equation (1).…”

Section: Electric Potential Modelmentioning

confidence: 99%

Global sensitivity study for irreversible electroporation: Towards treatment planning under uncertainty

et al. 2023

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Background: Electroporation-based cancer treatments are minimally invasive, nonthermal interventional techniques that leverage cell permeabilization to ablate the target tumor. However, the amount of permeabilization is susceptible to the numerous uncertainties during treatment, such as patient-specific variations in the tissue, type of the tumor, and the resolution of imaging equipment. These uncertainties can reduce the extent of ablation in the tissue, thereby affecting the effectiveness of the treatment. Purpose: The aim of this work is to understand the effect of these treatment uncertainties on the treatment outcome for irreversible electroporation (IRE) in the case of colorectal liver metastasis (CRLM). Understanding the nature and extent of these effects can help us identify the influential treatment parameters and build better models for predicting the treatment outcome. Methods: This is an in silico study using a static computational model with a custom applicator design, spherical tissue, and tumor geometry. A nonlinear electrical conductivity, dependent on the local electric field, is considered. Morris analysis is used to identify the influential treatment parameters on the treatment outcome. Seven treatment parameters pertaining to the relative tumor location with respect to the applicator, the tumor growth pattern, and the electrical conductivity of tissue are analyzed. The treatment outcome is measured in terms of the relative tumor ablation with respect to the target ablation volume and total ablation volume. Results: The Morris analysis was performed with 800 model evaluations, sampled from the seven dimensional input parameter space. Electrical properties of the tissue, especially the electrical conductivity of the tumor before ablation, were found to be the most influential parameter for relative tumor ablation and total ablation volume. This parameter was found to be about 4-15 times more influential than the least influential parameter, depending on the tumor size. The tumor border configuration was identified as the least important parameter for treatment effectiveness. The most desired treatment outcome is obtained by a combination of high healthy liver conductivity and low tumor conductivity. This information can be used to tackle worst-case scenarios in treatment planning. Finally, when the safety margins used in the clinical applications are accounted for, the effects of uncertainties in the treatment parameters reduce drastically. Conclusions:The results of this work can be used to create an efficient surrogate estimator for uncertainty quantification in the treatmentThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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“…Innovative probe designs that include heat-dissipating technology such as phase-change materials or active cooling [ 25 , 26 ], as well as pulse paradigm changes that enable tissue perfusion to distribute heat between successive pulses [ 27 , 28 ], have demonstrated an ability to reduce thermal damage. However, the advantages of these techniques must be weighed against the increased time, cost, and effort required by modified probes [ 20 , 29 , 30 ]. While previous studies have utilized computational modeling for prospective and retrospective estimations of temperature rises during treatment, no studies have been conducted to implement real-time temperature monitoring without requiring the insertion of additional sensor devices.…”

Section: Introductionmentioning

confidence: 99%

Real-Time Temperature Rise Estimation during Irreversible Electroporation Treatment through State-Space Modeling

et al. 2022

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To evaluate the feasibility of real-time temperature monitoring during an electroporation-based therapy procedure, a data-driven state-space model was developed. Agar phantoms mimicking low conductivity (LC) and high conductivity (HC) tissues were tested under the influences of high (HV) and low (LV) applied voltages. Real-time changes in impedance, measured by Fourier Analysis SpecTroscopy (FAST) along with the known tissue conductivity and applied voltages, were used to train the model. A theoretical finite element model was used for external validation of the model, producing model fits of 95.8, 88.4, 90.7, and 93.7% at 4 mm and 93.2, 58.9, 90.0, and 90.1% at 10 mm for the HV-HC, LV-LC, HV-LC, and LV-HC groups, respectively. The proposed model suggests that real-time temperature monitoring may be achieved with good accuracy through the use of real-time impedance monitoring.

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Retrospective Study for Validation and Improvement of Numerical Treatment Planning of Irreversible Electroporation Ablation for Treatment of Liver Tumors

Cited by 17 publications

References 60 publications

Numerical mesoscale tissue model of electrochemotherapy in liver based on histological findings

Numerical mesoscale tissue model of electrochemotherapy in liver based on histological findings

Global sensitivity study for irreversible electroporation: Towards treatment planning under uncertainty

Real-Time Temperature Rise Estimation during Irreversible Electroporation Treatment through State-Space Modeling

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