Web-based tool for visualization of electric field distribution in deep-seated body structures and planning of electroporation-based treatments

Abstract

BackgroundTreatments based on electroporation are a new and promising approach to treating tumors, especially non-resectable ones. The success of the treatment is, however, heavily dependent on coverage of the entire tumor volume with a sufficiently high electric field. Ensuring complete coverage in the case of deep-seated tumors is not trivial and can in best way be ensured by patient-specific treatment planning. The basis of the treatment planning process consists of two complex tasks: medical image segmentation, and numerical modeling and optimization.MethodsIn addition to previously developed segmentation algorithms for several tissues (human liver, hepatic vessels, bone tissue and canine brain) and the algorithms for numerical modeling and optimization of treatment parameters, we developed a web-based tool to facilitate the translation of the algorithms and their application in the clinic. The developed web-based tool automatically builds a 3D model of the target tissue from the medical images uploaded by the user and then uses this 3D model to optimize treatment parameters. The tool enables the user to validate the results of the automatic segmentation and make corrections if necessary before delivering the final treatment plan.ResultsEvaluation of the tool was performed by five independent experts from four different institutions. During the evaluation, we gathered data concerning user experience and measured performance times for different components of the tool. Both user reports and performance times show significant reduction in treatment-planning complexity and time-consumption from 1-2 days to a few hours.ConclusionsThe presented web-based tool is intended to facilitate the treatment planning process and reduce the time needed for it. It is crucial for facilitating expansion of electroporation-based treatments in the clinic and ensuring reliable treatment for the patients. The additional value of the tool is the possibility of easy upgrade and integration of modules with new functionalities as they are developed.

Predictive therapeutic planning for irreversible electroporation treatment of spontaneous malignant glioma

“…The computational models were used to define the electrode configuration and electric pulse parameters for the intraoperative IRE treatments with the goal of maximizing tumor coverage while minimizing damage to the surrounding healthy tissue . Figure presents results that replicate the intraoperative electrode configuration, surgical placement, and electrical parameters employed during the IRE treatments (Table ).…”

Electrochemotherapy as treatment option for hepatocellular carcinoma, a prospective pilot study

“…The intraoperative ultrasound was used to identify lesions and aid the positioning of the electrodes into and around the tumor. The long needle electrodes were positioned according to the pretreatment plan prepared for each patient and specific tumor individually using previously developed procedures [30,31]. Plans were developed based on computed tomography and/or magnetic resonance scans taken less than 30 days prior to treatment.…”

Quantification of cell membrane permeability induced by monopolar and high-frequency bipolar bursts of electrical pulses

“…A notable recent improvement in IRE has been termed high-frequency IRE (HF-IRE) and replaces the long monopolar pulsing schemes traditionally used in IRE (80 × 100 µs-long pulses delivered at 1 Hz) with bursts of short bipolar pulses [20]. These bursts of short pulses partially mitigate intra-operative impedance changes [51] and virtually eliminate muscle contractions [52,53,54,20] during the treatment to potentially improve both current treatment planning algorithms [20,55] and the procedural safety for the patient due to the reduced need for neuroparalytic drugs typically required to inhibit muscle contraction. For the same reason, bursts of short pulses could also be advantageous in ECT and GET, which have historically utilized pulse widths of hundreds of microseconds to milliseconds to permeabilize the cell membrane.…”