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The Effects of Metallic Implants on Electroporation Therapies: Feasibility of Irreversible Electroporation for Brachytherapy Salvage

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Abstract

Purpose

Electroporation-based therapies deliver brief electric pulses into a targeted volume to destabilize cellular membranes. Nonthermal irreversible electroporation (IRE) provides focal ablation with effects dependent on the electric field distribution, which changes in heterogeneous environments. It should be determined if highly conductive metallic implants in targeted regions, such as radiotherapy brachytherapy seeds in prostate tissue, will alter treatment outcomes. Theoretical and experimental models determine the impact of prostate brachytherapy seeds on IRE treatments.

Materials and Methods

This study delivered IRE pulses in nonanimal, as well as in ex vivo and in vivo tissue, with and in the absence of expired radiotherapy seeds. Electrical current was measured and lesion dimensions were examined macroscopically and with magnetic resonance imaging. Finite-element treatment simulations predicted the effects of brachytherapy seeds in the targeted region on electrical current, electric field, and temperature distributions.

Results

There was no significant difference in electrical behavior in tissue containing a grid of expired radiotherapy seeds relative to those without seeds for nonanimal, ex vivo, and in vivo experiments (all p > 0.1). Numerical simulations predict no significant alteration of electric field or thermal effects (all p > 0.1). Histology showed cellular necrosis in the region near the electrodes and seeds within the ablation region; however, there were no seeds beyond the ablation margins.

Conclusion

This study suggests that electroporation therapies can be implemented in regions containing small metallic implants without significant changes to electrical and thermal effects relative to use in tissue without the implants. This supports the ability to use IRE as a salvage therapy option for brachytherapy.

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References

  1. Al-Sakere B, Andre F, Bernat C et al (2007) Tumor ablation with irreversible electroporation. PLoS One 2(11):e1135

    Article  PubMed  Google Scholar 

  2. Appelbaum L, Ben-David E, Sosna J, Nissenbaum Y, Goldberg SN (2012) US findings after irreversible electroporation ablation: radiologic-pathologic correlation. Radiology 262(1):117–125

    Article  PubMed  Google Scholar 

  3. Ball C, Thomson KR, Kavnoudias H (2010) Irreversible electroporation: a new challenge in “out of operating theater” anesthesia. Anesth Analg 110(5):1305–1309

    Article  PubMed  Google Scholar 

  4. Boukaram C, Hannoun-Levi J-M (2010) Management of prostate cancer recurrence after definitive radiation therapy. Cancer Treat Rev 36(2):91–100

    Article  PubMed  Google Scholar 

  5. Carrara N (2007) Dielectric properties of body tissues. Italian National Research Council, Institute for Applied Physics, Florence

    Google Scholar 

  6. Davalos R, Mir L, Rubinsky B (2005) Tissue ablation with irreversible electroporation. Ann Biomed Eng 33(2):223–231

    Article  PubMed  CAS  Google Scholar 

  7. Edd JF, Horowitz L, Davalos RV, Mir LM, Rubinsky B (2006) In vivo results of a new focal tissue ablation technique: irreversible electroporation. IEEE Trans Biomed Eng 53(5):1409–1415

    Article  PubMed  Google Scholar 

  8. Finley D, Belldegrun A (2011) Salvage cryotherapy for radiation-recurrent prostate cancer: outcomes and complications. Curr Urol Rep 12(3):209–215

    Article  PubMed  Google Scholar 

  9. Foster KR, Schwan HP (1989) Dielectric properties of tissues and biological materials: a critical review. Crit Rev Biomed Eng 17(1):25–104

    PubMed  CAS  Google Scholar 

  10. Gabriel S, Lau RW, Gabriel C (1996) The dielectric properties of biological tissues: II. Measurements in the frequency range 10 Hz to 20 GHz. Phys Med Biol 41(11):2251–2269

    Article  PubMed  CAS  Google Scholar 

  11. Garcia PA, Pancotto T, Rossmeisl JH Jr et al (2011) Non-thermal irreversible electroporation (N-TIRE) and adjuvant fractionated radiotherapeutic multimodal therapy for intracranial malignant glioma in a canine patient. Technol Cancer Res Treat 10(1):73–83

    PubMed  CAS  Google Scholar 

  12. Garcia PA, Rossmeisl JH Jr, Neal RE 2nd, Ellis TL, Davalos RV (2011) A parametric study delineating irreversible electroporation from thermal damage based on a minimally invasive intracranial procedure. Biomed Eng Online 10(1):34

    Article  PubMed  Google Scholar 

  13. Hjouj M, Rubinsky B (2010) Magnetic resonance imaging characteristics of nonthermal irreversible electroporation in vegetable tissue. J Membr Biol 236(1):137–146

    Article  PubMed  CAS  Google Scholar 

  14. Ivorra A, Mir LM, Rubinsky B (2009) Electric field redistribution due to conductivity changes during tissue electroporation: experiments with a simple vegetal model. Springer, Berlin, pp 59–62

    Google Scholar 

  15. Ivorra A, Rubinsky B (2007) In vivo electrical impedance measurements during and after electroporation of rat liver. Bioelectrochemistry 70(2):287–295 Epub 2006 Oct 2021

    Article  PubMed  CAS  Google Scholar 

  16. Kimura M, Mouraviev V, Tsivian M, Mayes JM, Satoh T, Polascik TJ (2010) Current salvage methods for recurrent prostate cancer after failure of primary radiotherapy. BJU Int 105(2):191–201

    Article  PubMed  CAS  Google Scholar 

  17. Miklavcic D, Semrov D, Mekid H, Mir LM (2000) A validated model of in vivo electric field distribution in tissues for electrochemotherapy and for DNA electrotransfer for gene therapy. Biochim Biophys Acta 1523(1):73–83

    Article  PubMed  CAS  Google Scholar 

  18. Mir LM, Orlowski S, Belehradek JJ, Teissie J, Rols MP (1995) Biomedical applications of electric pulses with special emphasis on antitumor electrochemotherapy. Bioelectrochem Bioenerg 38:203–207

    Article  CAS  Google Scholar 

  19. Narayanan G, Froud T, Lo K, Barbery KJ, Perez-Rojas E, Yrizarry J (2012) Pain analysis in patients with hepatocellular carcinoma: irreversible electroporation versus radiofrequency ablation-initial observations. Cardiovasc Intervent Radiol 30:30

    Google Scholar 

  20. Neal RE 2nd, Davalos RV (2009) The feasibility of irreversible electroporation for the treatment of breast cancer and other heterogeneous systems. Ann Biomed Eng 37(12):2615–2625

    Article  PubMed  Google Scholar 

  21. Neal RE 2nd, Garcia PA, Robertson JL, Davalos RV (2012) Experimental characterization and numerical modeling of tissue electrical conductivity during pulsed electric fields for irreversible electroporation treatment planning. IEEE Trans Biomed Eng 59(4):1076–1085 Epub 2012 Jan 1076

    Article  PubMed  Google Scholar 

  22. Neal RE 2nd, Rossmeisl JH Jr, Garcia PA, Lanz OI, Henao-Guerrero N, Davalos RV (2011) Successful treatment of a large soft tissue sarcoma with irreversible electroporation. J Clin Oncol 29(13):e372–e377

    Article  PubMed  Google Scholar 

  23. Neal RE 2nd, Singh R, Hatcher HC, Kock ND, Torti SV, Davalos RV (2010) Treatment of breast cancer through the application of irreversible electroporation using a novel minimally invasive single needle electrode. Breast Cancer Res Treat 123(1):295–301

    Article  PubMed  Google Scholar 

  24. Neumann E, Schaefer-Ridder M, Wang Y, Hofschneider PH (1982) Gene transfer into mouse lyoma cells by electroporation in high electric fields. EMBO J 1(7):841–845

    PubMed  CAS  Google Scholar 

  25. Onik G, Mikus P, Rubinsky B (2007) Irreversible electroporation: implications for prostate ablation. Technol Cancer Res Treat 6(4):295–300

    PubMed  Google Scholar 

  26. Potters L, Morgenstern C, Calugaru E et al (2008) 12-year outcomes following permanent prostate brachytherapy in patients with clinically localized prostate cancer. J Urol 179(5):S20–S24

    Article  PubMed  Google Scholar 

  27. Rabin Y, Stahovich TF (2003) Cryoheater as a means of cryosurgery control. Phys Med Biol 48(5):619–632

    Article  PubMed  Google Scholar 

  28. Neal RE II, Cheung W, Kavnoudias H, Thomson KR (2012) Spectrum of imaging and characteristics for liver tumors treated with irreversible electroporation. J Biomed Sci Eng 5(12A):813–818

    Article  Google Scholar 

  29. Thomson KR, Cheung W, Ellis SJ et al (2011) Investigation of the safety of irreversible electroporation in humans. J Vasc Interv Radiol 22(5):611–621

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work is supported by the Flack Trustees, NSF CAREER Award CBET-1055913, and the Whitaker International Program. The authors thank Anatoly Dritschilo for advising experimental analysis as well as Victoria Earl and the radiology staff of The Alfred Hospital for assistance.

Conflict of interest

R. E. Neal and R. V. Davalos hold pending patents and are recipients of royalty payments from Angiodynamics, Inc., for unrelated IRE work. R. V. Davalos received consultancy and research grants from Angiodynamics, Inc., for unrelated IRE work. H. Kavnoudias and K.R. Thomson received donated research materials for unrelated IRE work. R. L. Smith, F. Rosenfeldt, R. Ou, C. A. Mclean have no conflicts of interest to declare.

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Authors and Affiliations

  1. Radiology Research Unit, Department of Radiology, The Alfred Hospital, 1st Floor Philip Block, 55 Commercial Road, Melbourne, VIC, 3004, Australia

    Robert E. Neal II, Helen Kavnoudias & Kenneth R. Thomson

  2. William Buckland Radiotherapy Centre, The Alfred Hospital, 55 Commercial Road, Melbourne, VIC, 3004, Australia

    Ryan L. Smith

  3. Department of Surgery, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia

    Franklin Rosenfeldt & Ruchong Ou

  4. Department of Anatomical Pathology, The Alfred Hospital, 55 Commercial Road, Melbourne, VIC, 3004, Australia

    Catriona A. Mclean

  5. School of Biomedical Engineering and Sciences, Virginia Tech, 329 ICTAS Building, Stranger St. (MC 0298), Blacksburg, VA, 24061, USA

    Rafael V. Davalos

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  1. Robert E. Neal II
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  3. Helen Kavnoudias
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Correspondence to Robert E. Neal II.

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Neal, R.E., Smith, R.L., Kavnoudias, H. et al. The Effects of Metallic Implants on Electroporation Therapies: Feasibility of Irreversible Electroporation for Brachytherapy Salvage. Cardiovasc Intervent Radiol 36, 1638–1645 (2013). https://doi.org/10.1007/s00270-013-0704-1

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  • DOI: https://doi.org/10.1007/s00270-013-0704-1

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