Spectrum of imaging and characteristics for liver tumors treated with irreversible electroporation

Abstract

Therapeutic irreversible\relectroporation (IRE) is a relatively new technique for targeted tumor ablation. Needle electrodes are placed into or around the targeted region to deliver a\rseries of brief electric pulses that disrupt cell membrane integrity, killing cells in a non-thermal manner that does not\raffect the extracellular matrix or sensitive structures such as major\rvasculature and bile ducts; making IRE an advantageous\rtechnique, especially for tumors that are unresectable or ineligible for\rthermal ablation. Here, we\rpresent on the imaging findings from IRE liver tumor treatments from ultrasound, computed tomography,\rmagnetic resonance, and positron emission tomography. Imaging aids planning and implementing treatments by\rvisualizing the targeted volume and guiding electrode placement. Immediate changes\rto the affected IRE region may be observed to verify complete ablation of the\rtumor with margin during the procedure, and permits follow-up evaluation of\rclinical outcome. In particular, we present tumor treatments in regions adjacent to sensitive structures that contraindicate thermal therapies.