Top

Published in:

01-07-2015 | Original Article

Irreversible electroporation for nonthermal tumor ablation in patients with hepatocellular carcinoma: initial clinical experience in Japan

Authors: Katsutoshi Sugimoto, Fuminori Moriyasu, Yoshiyuki Kobayashi, Kazuhiro Saito, Hirohito Takeuchi, Saori Ogawa, Mayumi Ando, Takatomo Sano, Toshifumi Mori, Yoshihiro Furuichi, Ikuo Nakamura

Published in: Japanese Journal of Radiology | Issue 7/2015

Abstract

Purpose

This clinical study was conducted to evaluate the safety and short-term outcomes of irreversible electroporation (IRE) for the treatment of patients with hepatocellular carcinoma (HCC) in Japan.

Materials and methods

The study was designed in a prospective setting. Five patients (3 men and 2 women; mean age, 66.6 ± 5.8 years) with 6 HCCs were enrolled and treated using percutaneous ultrasound (US)-guided IRE. Safety was assessed based on adverse events and laboratory values. Local control was assessed using contrast-enhanced US with a perflubutane microbubble contrast agent, contrast-enhanced multiphase CT, and gadoxetic acid-enhanced MRI (EOB-MRI) at designated points.

Results

The tumors ranged in diameter from 11 to 28 mm (mean diameter, 17.5 ± 6.3 mm). Five of the 6 tumors (83 %) were successfully treated, with no local recurrence to date (mean follow-up 244 ± 55 days). In 1 lesion located in liver segment 1, residual tumor was diagnosed at 7 days after intervention by follow-up EOB-MRI. No serious complications related to the IRE procedure were observed.

Conclusion

The results of this study suggest that image-guided percutaneous IRE can achieve satisfactory local disease control, particularly for small HCCs, and is well tolerated by patients.

Davalos RV, Mir IL, Rubinsky B. Tissue ablation with irreversible electroporation. Ann Biomed Eng. 2005;33:223–31.PubMedCrossRef

Lee EW, Loh CT, Kee ST. Imaging guided percutaneous irreversible electroporation: ultrasound and immunohistological correlation. Technol Cancer Res Treat. 2007;6:287–94.PubMedCrossRef

Martin RC, Philips P, Ellis S, Hayes D, Bagla S. Irreversible electroporation of unresectable soft tissue tumors with vascular invasion: effective palliation. BMC Cancer. 2014;14:540.PubMedCentralPubMedCrossRef

Cheung W, Kavnoudias H, Roberts S, Szkandera B, Kemp W, Thomson KR. Irreversible electroporation for unresectable hepatocellular carcinoma: initial experience and review of safety and outcomes. Technol Cancer Res Treat. 2013;12:233–41.PubMed

Martin RC 2nd, McFarland K, Ellis S, Velanovich V. Irreversible electroporation in locally advanced pancreatic cancer: potential improved overall survival. Ann Surg Oncol. 2013;20:S443–9.PubMedCrossRef

Thomson KR, Cheung W, Ellis SJ, Federman D, Kavnoudias H, Loader-Oliver D, et al. Investigation of the safety of irreversible electroporation in humans. J Vasc Interv Radiol. 2011;22:611–21.PubMedCrossRef

Valerio M, Dickinson L, Ali A, Ramachandran N, Donaldson I, Freeman A, et al. A prospective development study investigating focal irreversible electroporation in men with localised prostate cancer: Nanoknife Electroporation Ablation Trial (NEAT). Contemp Clin Trials. 2014;39:57–65.PubMedCentralPubMedCrossRef

Kudo M, Izumi N, Kokudo N, Matsui O, Sakamoto M, Nakashima O, et al. HCC Expert Panel of Japan Society of Hepatology. Management of hepatocellular carcinoma in Japan: consensus-based clinical practice guidelines proposed by the Japan Society of Hepatology (JSH) 2010 updated version. Dig Dis. 2011;29:339–64.PubMedCrossRef

International Working Party. Terminology of nodular hepatocellular lesions. Hepatology. 1995;22:983–93.CrossRef

10.

Cardella JF, Kundu S, Miller DL, Millward SF, Sacks D. Society of Interventional Radiology. Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol. 2009;20:S189–91.PubMedCrossRef

11.

Sugimoto K, Moriyasu F, Kobayashi Y, Imai Y. Assessment of irreversible electroporation ablation zone using Kupffer-phase contrast-enhanced ultrasound (CEUS) images with Sonazoid. J Med Ultrason. 2014;41:531–2.CrossRef

12.

Sugimoto K, Moriyasu F, Kobayashi Y, Kasuya K, Nagakawa Y, Tsuchida A, et al. Assessment of various types of US findings after irreversible electroporation in porcine liver: comparison with radiofrequency ablation. J Vasc Interv Radiol. 2015;26:279–87.PubMedCrossRef

13.

Guo Y, Zhang Y, Nijm GM, Sahakian AV, Yang GY, Omary RA, et al. Irreversible electroporation in the liver: contrast-enhanced inversion-recovery MR imaging approaches to differentiate reversibly electroporated penumbra from irreversibly electroporated ablation zones. Radiology. 2011;258:461–8.PubMedCentralPubMedCrossRef

14.

Qin Z, Jiang J, Long G, Lindgren B, Bischof JC. Irreversible electroporation: an in vivo study with dorsal skin fold chamber. Ann Biomed Eng. 2013;41:619–29.PubMedCrossRef

15.

Moriyasu F, Itoh K. Efficacy of perflubutane microbubble-enhanced ultrasound in the characterization and detection of focal liver lesions: phase 3 multicenter clinical trial. AJR Am J Roentgenol. 2009;193:86–95.PubMedCrossRef

16.

Sugimoto K, Moriyasu F, Shiraishi J, Saito K, Taira J, Saguchi T, et al. Assessment of arterial hypervascularity of hepatocellular carcinoma: comparison of contrast-enhanced US and gadoxetate disodium-enhanced MR imaging. Eur Radiol. 2012;22:1205–13.PubMedCrossRef

17.

Wilson SR, Burns PN. Microbubble-enhanced US in body imaging: what role? Radiology. 2010;257:24–39.PubMedCrossRef

18.

Rhim H, Lee MH, Kim YS, Choi D, Lee WJ, Lim HK. Planning sonography to assess the feasibility of percutaneous radiofrequency ablation of hepatocellular carcinomas. AJR Am J Roentgenol. 2008;190:1324–30.PubMedCrossRef

19.

Kunishi Y, Numata K, Morimoto M, Okada M, Kaneko T, Maeda S, et al. Efficacy of fusion imaging combining sonography and hepatobiliary phase MRI with Gd-EOB-DTPA to detect small hepatocellular carcinoma. AJR Am J Roentgenol. 2012;198:106–14.PubMedCrossRef

20.

Kingham TP, Karkar AM, D’Angelica MI, Allen PJ, Dematteo RP, Getrajdman GI, et al. Ablation of perivascular hepatic malignant tumors with irreversible electroporation. J Am Coll Surg. 2012;215:379–87.PubMedCrossRef

Title: Irreversible electroporation for nonthermal tumor ablation in patients with hepatocellular carcinoma: initial clinical experience in Japan
Authors: Katsutoshi Sugimoto
Fuminori Moriyasu
Yoshiyuki Kobayashi
Kazuhiro Saito
Hirohito Takeuchi
Saori Ogawa
Mayumi Ando
Takatomo Sano
Toshifumi Mori
Yoshihiro Furuichi
Ikuo Nakamura
Publication date: 01-07-2015
Publisher: Springer Japan
Published in: Japanese Journal of Radiology / Issue 7/2015
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-015-0442-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Irreversible electroporation for nonthermal tumor ablation in patients with hepatocellular carcinoma: initial clinical experience in Japan

Abstract

Purpose

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 7/2015

Effect of transcatheter arterial embolization with a mixture of n-butyl cyanoacrylate, lipiodol, and ethanol on the vascular wall: macroscopic and microscopic studies

Differences between glioblastomas and primary central nervous system lymphomas in 1H-magnetic resonance spectroscopy

Comparison of myocardial F-18 FDG uptake between overnight and non-overnight fasting in non-diabetic healthy subjects

Mediastinal paraganglioma

Primary intraosseous meningioma in the calvaria: morphological feature changes on magnetic resonance images over several years

Fluoroscopically guided large balloon dilatation for treating congenital esophageal stenosis in children