Urinary Tract Effects After Multifocal Nonthermal Irreversible Electroporation of the Kidney: Acute and Chronic Monitoring by Magnetic Resonance Imaging, Intravenous Urography and Urinary Cytology

Abstract

This first urographical, urine-cytological, and MRI evaluation after porcine kidney NTIRE shows multifocal parenchyma destruction while protecting the involved urine-collecting system with regenerated urothelial tissue. NTIRE could be used as a targeted ablation method of centrally located renal masses.

Electroporation-Based Technologies for Medicine: Principles, Applications, and Challenges

“…Indeed, studies have shown that the ablated volumes detected by T1-weighted (T1W), transverse relaxation time (T2), T2-weighted (T2W), fluid attenuated inversion recovery (FLAIR), and diffusion-weighted magnetic resonance imaging (DW-MRI), for the apparent water diffusion coefficient (ADC), are similar to the volumes detected by histological observations. Additionally, T1-Thrive5-3D-GE urogram scans, together with intravenous urography, were used to validate the functionality of NTIRE-ablated swine kidney (161). The usefulness of a particular MRI sequence depends on the type of ablated tissue.…”

Feasibility of Catheter-Directed Intraluminal Irreversible Electroporation of Porcine Ureter and Acute Outcomes in Response to Increasing Energy Delivery

“…Irreversible electroporation (IRE) has been evaluated in multiple preclinical studies (1–6) for focal ablation of renal parenchyma adjacent to the renal pelvis and the ureter in large animal models. Results from these studies indicate that IRE may be safe for the focal ablation of tissue near such heat-sensitive structures (1–2).…”

A prospective Phase 2a pilot study investigating focal percutaneous irreversible electroporation (IRE) ablation by NanoKnife in patients with localised renal cell carcinoma (RCC) with delayed interval tumour resection (IRENE trial)

“…The oncotherapeutic security of the patient is guaranteed by the inclusion of standard, guideline-compliant tumour resection. IRE is a procedure with potentially attractive characteristics and may be ideal for delivering focal therapy in the kidney, especially as it has been shown to have tissue-selectivity in animal studies that have demonstrated a homogeneous ablation of renal tissue with preservation of larger vessels and the urine-collecting system [6,11,12,14,15].…”

“…Previous investigations on renal IRE were exclusively experimental or safety-oriented [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. A complete histological analysis is still required to assess the completeness of tumour ablation and the nephron-sparing potential of IRE in RCC.…”