Bipolar Microsecond Pulses and Insulated Needle Electrodes for Reducing Muscle Contractions During Irreversible Electroporation

Objective: To minimize the effect of muscle contractions during irreversible electroporation (IRE), this paper attempts to research the ablation effect and muscle contractions by applying high-frequency IRE (H-FIRE) ablation to liver tissue in vivo. Methods: An insulated needle electrode was produced by painting an insulating coating on the outer surface of the needle electrode tip. A series of experiments were conducted using insulated needle electrodes and traditional needle electrodes to apply H-FIRE pulses and traditional monopolar IRE pulses to rabbit liver tissues. The finite element model of the rabbit liver tissue was established to determine the lethal thresholds of H-FIRE in liver tissues. Muscle contractions were measured by an accelerometer. Results: With increased constitutive pulse width and pulse voltage, the ablation area and muscle contraction strength are also increased, which can be used to optimize the ablation parameters of H-FIRE. Under the same pulse parameters, the ablation areas are similar for the two types of electrodes, and the ablation region has a clear boundary. H-FIRE and insulated needle electrodes can mitigate the extent of muscle contractions. The lethal thresholds of H-FIRE in rabbit liver tissues were determined. Conclusion: This paper describes the relationships between the ablation area, muscle contractions, and pulse parameters; the designed insulated needle electrodes can be used in IRE for reducing muscle contraction. Significance: The study provides guidance for treatment planning and reducing muscle contractions in the clinical application of H-FIRE.

[1]  B. Benway.  Irreversible Electroporation of Renal Cell Carcinoma: A First-in-Man Phase I Clinical Study: Pech M, Janitzky A, Wendler JJ, et al (Univ of Magdeburg, Germany) Cardiovasc Intervent Radiol 34:132-138, 2011§ , 2011 .

[2]  G. Narayanan,et al.  Pain Analysis in Patients with Hepatocellular Carcinoma: Irreversible Electroporation versus Radiofrequency Ablation—Initial Observations , 2013, CardioVascular and Interventional Radiology.

[3]  Helen Kavnoudias,et al.  Investigation of the safety of irreversible electroporation in humans. , 2011, Journal of vascular and interventional radiology : JVIR.

[4]  Damijan Miklavčič,et al.  Electroporation-based technologies for medicine: principles, applications, and challenges. , 2014, Annual review of biomedical engineering.

[5]  D. D. de Bruin,et al.  The safety and efficacy of irreversible electroporation for the ablation of prostate cancer: a multicentre prospective human in vivo pilot study protocol , 2014, BMJ Open.

[6]  C. Yao,et al.  Differences in the Effects of Duty Cycle and Interval on Cell Response Induced by High-Frequency Pulses Under Different Pulse Durations , 2016, IEEE Transactions on Plasma Science.

[7]  D Miklavcic,et al.  A validated model of in vivo electric field distribution in tissues for electrochemotherapy and for DNA electrotransfer for gene therapy. , 2000, Biochimica et biophysica acta.

[8]  Matthew R. DeWitt,et al.  Bursts of Bipolar Microsecond Pulses Inhibit Tumor Growth , 2015, Scientific Reports.

[9]  J. Leor,et al.  Optimization of Irreversible Electroporation Protocols for In-vivo Myocardial Decellularization , 2016, PloS one.

[10]  Boris Rubinsky,et al.  In vivo results of a new focal tissue ablation technique: irreversible electroporation , 2006, IEEE Transactions on Biomedical Engineering.

[11]  Recent Advances in Tissue Minimally Invasive Ablation with Irreversible Electroporation , 2014 .

[12]  Markus Porsch,et al.  Urinary Tract Effects After Multifocal Nonthermal Irreversible Electroporation of the Kidney: Acute and Chronic Monitoring by Magnetic Resonance Imaging, Intravenous Urography and Urinary Cytology , 2012, CardioVascular and Interventional Radiology.

[13]  K. Mabuchi,et al.  Parylene flexible neural probes integrated with microfluidic channels. , 2005, Lab on a chip.

[14]  H. Ahmed,et al.  INITIAL ASSESSMENT OF SAFETY AND CLINICAL FEASIBILITY OF IRREVERSIBLE ELECTROPORATION IN THE FOCAL TREATMENT OF PROSTATE CANCER , 2014, Prostate Cancer and Prostatic Disease.

[15]  Vic Velanovich,et al.  Irreversible Electroporation in Locally Advanced Pancreatic Cancer: Potential Improved Overall Survival , 2013, Annals of Surgical Oncology.

[16]  Markus Porsch,et al.  Angiography in the Isolated Perfused Kidney: Radiological Evaluation of Vascular Protection in Tissue Ablation by Nonthermal Irreversible Electroporation , 2012, CardioVascular and Interventional Radiology.

[17]  Eduardo L. Latouche,et al.  Targeted cellular ablation based on the morphology of malignant cells , 2015, Scientific Reports.

[18]  B. Rubinsky,et al.  Tissue Ablation with Irreversible Electroporation , 2005, Annals of Biomedical Engineering.

[19]  Robert C. G. Martin,et al.  Safety and early efficacy of irreversible electroporation for hepatic tumors in proximity to vital structures , 2013, Journal of surgical oncology.

[20]  Robert C. G. Martin,et al.  Evaluation of resistance as a measure of successful tumor ablation during irreversible electroporation of the pancreas. , 2014, Journal of the American College of Surgeons.

[21]  Stuart K. Roberts,et al.  Irreversible Electroporation for Unresectable Hepatocellular Carcinoma: Initial Experience and Review of Safety and Outcomes , 2013, Technology in Cancer Research and Treatment.

[22]  Jens Ricke,et al.  Irreversible Electroporation of Renal Cell Carcinoma: A First-in-Man Phase I Clinical Study , 2011, CardioVascular and Interventional Radiology.

[23]  Rafael V. Davalos,et al.  Intracranial Nonthermal Irreversible Electroporation: In Vivo Analysis , 2010, The Journal of Membrane Biology.

[24]  Thomas L Ellis,et al.  Safety and feasibility of the NanoKnife system for irreversible electroporation ablative treatment of canine spontaneous intracranial gliomas. , 2015, Journal of neurosurgery.

[25]  Matthew R. DeWitt,et al.  Induction of rapid, reproducible hepatic ablations using next-generation, high frequency irreversible electroporation (H-FIRE) in vivo. , 2016, HPB : the official journal of the International Hepato Pancreato Biliary Association.

[26]  Damijan Miklavcic,et al.  The effect of high frequency electric pulses on muscle contractions and antitumor efficiency in vivo for a potential use in clinical electrochemotherapy. , 2005, Bioelectrochemistry.

[27]  Damijan Miklavčič,et al.  Time course of transmembrane voltage induced by time-varying electric fields—a method for theoretical analysis and its application , 1998 .

[28]  R. Davalos,et al.  Nonthermal Irreversible Electroporation as a Focal Ablation Treatment for Brain Cancer , 2014 .

[29]  M. Ronchetti,et al.  Irreversible Electroporation Systems for Clinical Use , 2010 .

[30]  Jennifer M Hunter,et al.  Monitoring of neuromuscular block , 2006 .

[31]  Paulo A. Garcia,et al.  Towards the creation of decellularized organ constructs using irreversible electroporation and active mechanical perfusion , 2010, Biomedical engineering online.

[32]  Robert C. G. Martin,et al.  Intra - operative Anesthesia Management in Patients Undergoing Surgical Irreversible Electroporation of the Pancreas, Liver, Kidney, and Retroperitoneal Tumors , 2015, Anesthesiology and pain medicine.

[33]  Zhao Li,et al.  The Effects of Irreversible Electroporation (IRE) on Nerves , 2011, PloS one.

[34]  R. Pethig,et al.  Dielectric properties of body tissues. , 1987, Clinical physics and physiological measurement : an official journal of the Hospital Physicists' Association, Deutsche Gesellschaft fur Medizinische Physik and the European Federation of Organisations for Medical Physics.

[35]  Boris Rubinsky,et al.  Experimental Studies on Non-thermal Irreversible Electroporation in Tissue , 2010 .

[36]  Vic Velanovich,et al.  Irreversible electroporation therapy in the management of locally advanced pancreatic adenocarcinoma. , 2012, Journal of the American College of Surgeons.

[37]  Helen Kavnoudias,et al.  In vivo characterization and numerical simulation of prostate properties for non‐thermal irreversible electroporation ablation , 2014, The Prostate.

[38]  Boris Rubinsky,et al.  Temperature considerations during irreversible electroporation , 2008 .

[39]  T. L. Ellis,et al.  Non-Thermal Irreversible Electroporation (N-TIRE) and Adjuvant Fractionated Radiotherapeutic Multimodal Therapy for Intracranial Malignant Glioma in a Canine Patient , 2011, Technology in cancer research & treatment.

[40]  Karin Nielsen,et al.  Irreversible electroporation for nonthermal tumor ablation in the clinical setting: a systematic review of safety and efficacy. , 2014, Journal of vascular and interventional radiology : JVIR.

[41]  Chenguo Yao,et al.  Experimental studies on Killing and inhibiting effects of steep pulsed electric field (SPEF) to target cancer cell and solid tumor , 2004, IEEE Transactions on Plasma Science.

[42]  Daniel C. Sweeney,et al.  Mitigation of impedance changes due to electroporation therapy using bursts of high-frequency bipolar pulses , 2015, Biomedical engineering online.

[43]  Boris Rubinsky,et al.  Irreversible electroporation near the heart: ventricular arrhythmias can be prevented with ECG synchronization. , 2011, AJR. American journal of roentgenology.

[44]  Martin L. Yarmush,et al.  Nonthermal Irreversible Electroporation: Fundamentals, Applications, and Challenges , 2013, IEEE Transactions on Biomedical Engineering.

[45]  S. Solomon,et al.  Percutaneous ablation of peribiliary tumors with irreversible electroporation. , 2014, Journal of vascular and interventional radiology : JVIR.

[46]  Boris Rubinsky,et al.  Irreversible Electroporation: Implications for Prostate Ablation , 2007, Technology in cancer research & treatment.

[47]  Ronak Talati,et al.  Irreversible electroporation of lung neoplasm: A case series , 2012, Medical science monitor : international medical journal of experimental and clinical research.

[48]  Samuel K. Park,et al.  Irreversible electroporation: evaluation of nonthermal and thermal ablative capabilities in the porcine kidney. , 2013, Urology.

[49]  Boris Rubinsky,et al.  Towards Electroporation Based Treatment Planning considering Electric Field Induced Muscle Contractions , 2012, Technology in cancer research & treatment.

[50]  Paulo A. Garcia,et al.  High-frequency irreversible electroporation (H-FIRE) for non-thermal ablation without muscle contraction , 2011, Biomedical engineering online.

[51]  Boris Rubinsky,et al.  Non Thermal Irreversible Electroporation: Novel Technology for Vascular Smooth Muscle Cells Ablation , 2009, PloS one.

[52]  Boris Rubinsky,et al.  Irreversible Electroporation in Medicine , 2007, Technology in cancer research & treatment.

[53]  Damijan Miklavcic,et al.  Treatment planning of electroporation-based medical interventions: electrochemotherapy, gene electrotransfer and irreversible electroporation , 2012, Physics in medicine and biology.