TY - JOUR
T1 - Irreversible Electroporation of the Pancreas Using Parallel Plate Electrodes in a Porcine Model
T2 - A Feasibility Study
AU - Rombouts, Steffi J E
AU - Nijkamp, Maarten W
AU - van Dijck, Willemijn P M
AU - Brosens, Lodewijk A A
AU - Konings, Maurits
AU - van Hillegersberg, R
AU - Borel Rinkes, Inne H M
AU - Hagendoorn, Jeroen
AU - Wittkampf, Fred H
AU - Molenaar, I Quintus
N1 - Publisher Copyright:
© 2017 Rombouts et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2017
Y1 - 2017
N2 - Background: Irreversible electroporation (IRE) with needle electrodes is being explored as treatment option in locally advanced pancreatic cancer. Several studies have shown promising results with IRE needles, positioned around the tumor to achieve tumor ablation. Disadvantages are the technical difficulties for needle placement, the time needed to achieve tumor ablation, the risk of needle track seeding and most important the possible occurrence of postoperative pancreatic fistula via the needle tracks. The aim of this experimental study was to evaluate the feasibility of a new IRE-technique using two parallel plate electrodes, in a porcine model. Methods: Twelve healthy pigs underwent laparotomy. The pancreas was mobilized to enable positioning of the paddles. A standard monophasic external cardiac defibrillator was used to perform an ablation in 3 separate parts of the pancreas; either a single application of 50 or 100J or a serial application of 4×50J. After 6 hours, pancreatectomy was performed for histology and pigs were terminated. Results: Histology showed necrosis of pancreatic parenchyma with neutrophil influx in 5/12,11/12 and 12/12 of the ablated areas at 50,100, and 4×50J respectively. The electric current density threshold to achieve necrosis was 4.3, 5.1 and 3.4 A/cm
2 respectively. The ablation threshold was significantly lower for the serial compared to the single applications (p = 0.003). The content of the ablated areas differed between the applications: areas treated with a single application of 50 J often contained vital areas without obvious necrosis, whereas half of the sections treated with 100 J showed small islands of normal looking cells surrounded by necrosis, while all sections receiving 4×50 J showed a homogeneous necrotic lesion. Conclusion: Pancreatic tissue can be successfully ablated using two parallel paddles around the tissue. A serial application of 4×50J was most effective in creating a homogeneous necrotic lesion.
AB - Background: Irreversible electroporation (IRE) with needle electrodes is being explored as treatment option in locally advanced pancreatic cancer. Several studies have shown promising results with IRE needles, positioned around the tumor to achieve tumor ablation. Disadvantages are the technical difficulties for needle placement, the time needed to achieve tumor ablation, the risk of needle track seeding and most important the possible occurrence of postoperative pancreatic fistula via the needle tracks. The aim of this experimental study was to evaluate the feasibility of a new IRE-technique using two parallel plate electrodes, in a porcine model. Methods: Twelve healthy pigs underwent laparotomy. The pancreas was mobilized to enable positioning of the paddles. A standard monophasic external cardiac defibrillator was used to perform an ablation in 3 separate parts of the pancreas; either a single application of 50 or 100J or a serial application of 4×50J. After 6 hours, pancreatectomy was performed for histology and pigs were terminated. Results: Histology showed necrosis of pancreatic parenchyma with neutrophil influx in 5/12,11/12 and 12/12 of the ablated areas at 50,100, and 4×50J respectively. The electric current density threshold to achieve necrosis was 4.3, 5.1 and 3.4 A/cm
2 respectively. The ablation threshold was significantly lower for the serial compared to the single applications (p = 0.003). The content of the ablated areas differed between the applications: areas treated with a single application of 50 J often contained vital areas without obvious necrosis, whereas half of the sections treated with 100 J showed small islands of normal looking cells surrounded by necrosis, while all sections receiving 4×50 J showed a homogeneous necrotic lesion. Conclusion: Pancreatic tissue can be successfully ablated using two parallel paddles around the tissue. A serial application of 4×50J was most effective in creating a homogeneous necrotic lesion.
U2 - 10.1371/journal.pone.0169396
DO - 10.1371/journal.pone.0169396
M3 - Article
C2 - 28052102
SN - 1932-6203
VL - 12
JO - PLoS ONE [E]
JF - PLoS ONE [E]
IS - 1
M1 - e0169396
ER -