Retrospective Study for Validation and Improvement of Numerical Treatment Planning of Irreversible Electroporation Ablation for Treatment of Liver Tumors
- Resource Type
- Periodical
- Authors
- Cindric, H.; Mariappan, P.; Beyer, L.; Wiggermann, P.; Moche, M.; Miklavcic, D.; Kos, B.
- Source
- IEEE Transactions on Biomedical Engineering IEEE Trans. Biomed. Eng. Biomedical Engineering, IEEE Transactions on. 68(12):3513-3524 Dec, 2021
- Subject
- Bioengineering
Computing and Processing
Components, Circuits, Devices and Systems
Communication, Networking and Broadcast Technologies
Tumors
Electrodes
Mathematical model
Electric fields
Medical treatment
Electroporation
Magnetic resonance imaging
Irreversible electroporation (IRE)
liver tumors
numerical modelling
treatment planning
tumor ablation
- Language
- ISSN
- 0018-9294
1558-2531
Objective: The aims of this study were to determine the electric field threshold that best fits the local response to irreversible electroporation (IRE) ablation of hepatic tumors as seen in follow-up MRI; to numerically evaluate the heat generating effect of IRE; and to demonstrate the utility of treatment planning to improve procedures in the future. Methods: 18 cases of hepatic tumors treated with IRE ablation were numerically reconstructed and treatment outcome was computed with a numerical treatment planning framework. Simulated ablation volumes were compared to ablation volumes segmented from 6-week follow-up MRI. Two cases with a high thermal component were selected for numerical optimization. Results: The best fit between segmented and simulated ablation zones was obtained at 900 V/cm threshold with the average absolute error of 5.6 ± 1.5 mm. Considerable heating was observed in 7/18 cases, where >50% of tumor volume experienced heating likely to cause thermal damage. In the selected two cases, thermal damage was eliminated with adjustment of applied voltages. Conclusion: Lesions visible on MRI 6 weeks post IRE represent areas that experienced an electric field of 900 V/cm or higher. This threshold is higher than previously reported for IRE of hepatic tumors. It is likely the 6-week follow-up period was too long and the ablation zone has already shrunk considerably, resulting in overestimation of the threshold. Significance : We developed a sophisticated method for validation of the numerical treatment planning framework. A future prospective study can be effectively designed based on the findings of this study.