An overview of the irreversible electroporation for the treatment of liver metastases: When to use it
Tumour ablation is an established therapy for local treatment of liver metastases and hepatocellular carcinoma. Most commonly two different kind of thermic ablation, radiofrequency ablation and microwave ablation, are used in clinical practice. The aim of both is to induce thermic damage to the mali...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.943176/full |
| _version_ | 1811337814979117056 |
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| author | Maria Paola Belfiore Marco De Chiara Alfonso Reginelli Alfredo Clemente Fabrizio Urraro Roberto Grassi Giuseppe Belfiore Salvatore Cappabianca |
| author_facet | Maria Paola Belfiore Marco De Chiara Alfonso Reginelli Alfredo Clemente Fabrizio Urraro Roberto Grassi Giuseppe Belfiore Salvatore Cappabianca |
| author_sort | Maria Paola Belfiore |
| collection | DOAJ |
| description | Tumour ablation is an established therapy for local treatment of liver metastases and hepatocellular carcinoma. Most commonly two different kind of thermic ablation, radiofrequency ablation and microwave ablation, are used in clinical practice. The aim of both is to induce thermic damage to the malignant cells in order to obtain coagulative necrosis of the neoplastic lesions. Our main concerns about these procedures are the collateral thermic damage to adjacent structures and heat-sink effect. Irreversible electroporation (IRE) is a recently developed, non-thermal ablation procedure which works applying short pulses of direct current that generate an electric field in the lesion area. The electric field increase the transmembrane potential, changing its permeability to ions.Irreversible electroporation does not generate heat, giving the chance to avoid the heat-sink effect and opening the path to a better treatment of all the lesions located in close proximity to big vessels and bile ducts. Electric fields produced by the IRE may affect endothelial cells and cholangiocytes but they spare the collagen matrix, preserving re-epithelization process as well as the function of the damaged structures. Purpose of the authors is to identify the different scenarios where CT-guided percutaneous IRE of the liver should be preferred to other ablative techniques and why. |
| first_indexed | 2024-04-13T18:01:22Z |
| format | Article |
| id | doaj.art-11f6ea2e6557475a8517888870cc589a |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-13T18:01:22Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-11f6ea2e6557475a8517888870cc589a2022-12-22T02:36:14ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.943176943176An overview of the irreversible electroporation for the treatment of liver metastases: When to use itMaria Paola Belfiore0Marco De Chiara1Alfonso Reginelli2Alfredo Clemente3Fabrizio Urraro4Roberto Grassi5Giuseppe Belfiore6Salvatore Cappabianca7Division of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, ItalyDivision of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, ItalyDivision of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, ItalyDivision of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, ItalyDivision of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, ItalyDivision of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, ItalyDepartment of Diagnostic Imaging, Nursing home L.Cobellis, Vallo della Lucania Salerno, ItalyDivision of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, ItalyTumour ablation is an established therapy for local treatment of liver metastases and hepatocellular carcinoma. Most commonly two different kind of thermic ablation, radiofrequency ablation and microwave ablation, are used in clinical practice. The aim of both is to induce thermic damage to the malignant cells in order to obtain coagulative necrosis of the neoplastic lesions. Our main concerns about these procedures are the collateral thermic damage to adjacent structures and heat-sink effect. Irreversible electroporation (IRE) is a recently developed, non-thermal ablation procedure which works applying short pulses of direct current that generate an electric field in the lesion area. The electric field increase the transmembrane potential, changing its permeability to ions.Irreversible electroporation does not generate heat, giving the chance to avoid the heat-sink effect and opening the path to a better treatment of all the lesions located in close proximity to big vessels and bile ducts. Electric fields produced by the IRE may affect endothelial cells and cholangiocytes but they spare the collagen matrix, preserving re-epithelization process as well as the function of the damaged structures. Purpose of the authors is to identify the different scenarios where CT-guided percutaneous IRE of the liver should be preferred to other ablative techniques and why.https://www.frontiersin.org/articles/10.3389/fonc.2022.943176/fullirreversible electroporationireCT guidedliver metastasesinterventional radiology |
| spellingShingle | Maria Paola Belfiore Marco De Chiara Alfonso Reginelli Alfredo Clemente Fabrizio Urraro Roberto Grassi Giuseppe Belfiore Salvatore Cappabianca An overview of the irreversible electroporation for the treatment of liver metastases: When to use it Frontiers in Oncology irreversible electroporation ire CT guided liver metastases interventional radiology |
| title | An overview of the irreversible electroporation for the treatment of liver metastases: When to use it |
| title_full | An overview of the irreversible electroporation for the treatment of liver metastases: When to use it |
| title_fullStr | An overview of the irreversible electroporation for the treatment of liver metastases: When to use it |
| title_full_unstemmed | An overview of the irreversible electroporation for the treatment of liver metastases: When to use it |
| title_short | An overview of the irreversible electroporation for the treatment of liver metastases: When to use it |
| title_sort | overview of the irreversible electroporation for the treatment of liver metastases when to use it |
| topic | irreversible electroporation ire CT guided liver metastases interventional radiology |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.943176/full |
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