Irreversible electroporation as a novel method for soft tissue ablation: Review and challenges in clinical practice

Abstract

Irreversible electroporation has been evaluated as a novel method for ablation of various soft tissues for the last fifteen years. This method presents an alternative to the established thermal ablation methods due to its predominantly non-thermal mechanism of cell kill. It is currently mostly used for treating patients in whom the application of thermal ablation is contraindicat-ed due to risk of thermal damage to sensitive nearby structures, or when the presence of heat sinks reduces ablation efficacy. The main medical application of irreversible electroporation has until recently been ablation of deep seated tumours, e.g. in the liver, prostate and kidney, however, in the last few years its potential for the treatment of various arrhythmias has sparked great interest. Since irreversible electroporation is still a relatively new method, there is a lack of standardized treatment protocols and planning procedures for use in clinical setting. Numerical modelling has proven to be an indispensable tool in investigating and designing electropora-tion-based treatments and preparing patient-specific treatment plans. In this paper the most recent developments in clinical use of irreversible electroporation ablation are summarized and its major advantages as well as challenges and possible drawbacks in introducing this novel ab-lation method into clinical routine are highlighted.