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CardioVascular and Interventional Radiology

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01-11-2020 | Laboratory Investigation

Histotripsy Ablations in a Porcine Liver Model: Feasibility of Respiratory Motion Compensation by Alteration of the Ablation Zone Prescription Shape

Authors: Katherine C. Longo, Annie M. Zlevor, Paul F. Laeseke, John F. Swietlik, Emily A. Knott, Allison C. Rodgers, Lu Mao, Xiaofei Zhang, Zhen Xu, Martin G. Wagner, Sarvesh Periyasamy, Fred T. Lee Jr., Timothy J. Ziemlewicz

Published in: CardioVascular and Interventional Radiology | Issue 11/2020

Abstract

Background

Previous human-scale porcine liver model studies of histotripsy have resulted in ablation zones elongated in the cranial-caudal (CC) dimension due to uninterrupted respiratory motion during the ablation procedure.

Purpose

The purpose of this study is to compensate for elongation of hepatic histotripsy ablation zones in the cranial-caudal (CC) dimension caused by respiratory motion by prescribing ellipsoid-shaped ablations.

Methods

Six female swine underwent 12 hepatic histotripsy ablations using a prototype clinical histotripsy system under general anesthesia. Each animal received two ablation zones prescribed as either an ellipsoid (2.5 cm (AP) × 2.5 cm (ML) × 1.7 cm (CC), prescribed volume = 5.8 cc) or a sphere (2.5 cm all dimensions, prescribed volume 8.2 cc). Ventilatory tidal volume was held constant at 400 cc for all ablations. Post-procedure MRI was followed by sacrifice and gross and microscopic histology.

Results

Ablations on MRI were slightly larger than prescribed in all dimensions. Ellipsoid plan ablations (2.8 × 3.0 × 3.1 cm, volume 13.2 cc, sphericity index 0.987) were closer to prescribed volume than spherical plan ablations (2.9 × 3.1 × 3.7 cm, volume 17.1 cc, sphericity index 0.953). Ellipsoid plan ablations were more spherical than sphere plan ablations, but the difference did not reach statistical significance (p = .0.06). Pathologic analysis confirmed complete necrosis within the center of each ablation zone with no widening of the zone of partial ablation on the superior and inferior as compared to the lateral borders (p = .0.22).

Conclusion

Altering ablation zone prescription shape when performing hepatic histotripsy ablations can partially mitigate respiratory motion effects to achieve the desired ablation shape and volume.

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Title: Histotripsy Ablations in a Porcine Liver Model: Feasibility of Respiratory Motion Compensation by Alteration of the Ablation Zone Prescription Shape
Authors: Katherine C. Longo
Annie M. Zlevor
Paul F. Laeseke
John F. Swietlik
Emily A. Knott
Allison C. Rodgers
Lu Mao
Xiaofei Zhang
Zhen Xu
Martin G. Wagner
Sarvesh Periyasamy
Fred T. Lee Jr.
Timothy J. Ziemlewicz
Publication date: 01-11-2020
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 11/2020
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-020-02582-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Histotripsy Ablations in a Porcine Liver Model: Feasibility of Respiratory Motion Compensation by Alteration of the Ablation Zone Prescription Shape

Abstract

Background

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Purpose

Methods

Results

Conclusion

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