Irreversible electroporation current role in percutaneous tumor ablation
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1 Irreversible electroporation current role in percutaneous tumor ablation Focus session: Interventional oncology and embolisation therapies Liver (part I) Prof. Ph. Wiggermann - Institut für Röntgendiagnostik und Nuklearmedizin
2 Irreversible electroporation (IRE)
3 IRE: non thermal ablation technique
4 IRE: What's the difference + -
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6
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8 CRCLM
9 HCC
10 HCC
11 HCC
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14 Irreversible electroporation current role in percutaneous tumor ablation Surgical resection lack of data (no phase III trials) Not an alternative for thermal ablation intervention time/ efficacy Niche modality for specific indications in case of CI thermal ablation perivascular peribiliary proximity to vital structures
15 Time (min) IRE Procedure time until start of ablation CIRE SIRE Sterile Preparation Planning Trajectories Electrode Placement Beyer LP et al. (2016) Stereotactically-navigated percutaneous Irreversible Electroporation (IRE) compared to conventional IRE: a prospective trial. PeerJ 4:e2277
16 Lead Author Center Yea r Type of Study Response Assessment Number of Patients Number of Treatments Number of Lesions Tumor Types Tumor Size Range(Median) Cannon University of Louisville 2012 Multi Institutional Registry Imaging Follow Up CRC;14 HCC; 10 Other 11-50(Mean 25) Cheung Alfred Hospital, Australia 2013 Retrospective Imaging Follow Up 11 Not specified 18 HCC 10-61(Mean 24) Hosein University of Miami 2014 Retrospective Imaging Follow Up CRC 12-70(Mean 27) Scheffer VU University Medical Center, Netherlands 2014 Prospective Surgical Resection CRC 8-53(Median 24) Cheng Univ of Washingto n 2015 Retrospective Explant of Livers 6 6 HCC 6-26(Mean 22) Sugimoto Tokyo Medical University 2015 Prospective Imaging Follow Up HCC 11-28(Mean18) Langan Memorial Sloan Kettering 2017 Retrospective Imaging Follow Up 40 Not specified 77 CRC(74%) 5-60(Median 13) Niessen University Hospital Regensburg 2017 Retrospective Imaging Follow Up HCC 36; mets (Mean 19) Sutter Univ of ParisSeine- SaintDenis 2017 Retrospective Imaging Follow Up HCC 6-90(Median 24) Fruhling Uppsala University, Sweden 2017 Prospective Imaging Follow Up 30 Not specified CRC; 8 HCC 8 Other 8-40(Median 24) adapted from Cohen EI et al. Expert Rev Med Devices Feb;15(2):
17 IRE Efficacy: HCC not Amenable to Thermal Ablation Techniques IRE: CA was 77.3% after one procedure, 89.3% after two procedures, and 92% after three procedures IRE: PFS 6- and 12-mon - 87% and 70% TACE: CR (7month) of up to 31% within the Milan criteria Niessen, C. et al. Sci. Rep. 7, 43687; (2017). Sutter O. et al. Radiology Sep;284(3):
18 IRE Liver: Evidence sparse data single center retrospective inhomogeneous patient groups mainly safety and short term efficacy - no RCT BMJ Open 2017;7:e Efficacy of Irreversible Electroporation (IRE) for Central Colorectal Liver Metastases COLDFIRE-I and COLDFIRE-2 10 pat ablate and resect (1,5 h) 40 pat - single arm - the local control rate is good and improving rel. high number of early distant recurrence.. CIRSE 2017 M. Meijerink
19 FUTURE Pre treatment Arterial Phase Pre treatment Venous phase Seminoma Hasio et al. Journal of Medical Ultrasound Volume 25, Issue 4, December 2017, Pages Electroporation Based Drug Delivery and Its Applications - Scientific Figure on ResearchGate. Available from: [accessed 21 Jan, 2019]
20 Questions?
21 Irreversible electroporation current role in percutaneous tumor ablation Focus session: Interventional oncology and embolisation therapies Liver (part I) Prof. Ph. Wiggermann - Institut für Röntgendiagnostik und Nuklearmedizin
Disclosure. Speaker name: Prof. Maciej Pech I have the following potential conflicts of interest to report:
Disclosure Speaker name: Prof. Maciej Pech I have the following potential conflicts of interest to report: Consulting Employment in industry Stockholder of a healthcare company Owner of a healthcare company
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