Nonthermal irreversible electroporation for intracranial surgical applications. Laboratory investigation.
OBJECTIVE
Nonthermal irreversible electroporation (NTIRE) is a novel, minimally invasive technique to treat cancer, which is unique because of its nonthermal mechanism of tumor ablation. This paper evaluates the safety of an NTIRE procedure to lesion normal canine brain tissue.


METHODS
The NTIRE procedure involved placing electrodes into a targeted area of brain in 3 dogs and delivering a series of short and intense electric pulses. The voltages of the pulses applied were varied between dogs. Another dog was used as a sham control. One additional dog was treated at an extreme voltage to determine the upper safety limits of the procedure. Ultrasonography was used at the time of the procedure to determine if the lesions could be visualized intraoperatively. The volumes of ablated tissue were then estimated on postprocedure MR imaging. Histological brain sections were then analyzed to evaluate the lesions produced.


RESULTS
The animals tolerated the procedure with no apparent complications except for the animal that was treated at the upper voltage limit. The lesion volume appeared to decrease with decreasing voltage of applied pulses. Histological examination revealed cell death within the treated volume with a submillimeter transition zone between necrotic and normal brain.


CONCLUSIONS
The authors' results reveal that NTIRE at selected voltages can be safely administered in normal canine brain and that the volume of ablated tissue correlates with the voltage of the applied pulses. This preliminary study is the first step toward using NTIRE as a brain cancer treatment.
Ellis
Thomas L
TL
Department of Neurosurgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Garcia
Paulo A
PA
Rossmeisl
John H
JH
Henao-Guerrero
Natalia
N
Robertson
John
J
Davalos
Rafael V
RV
D000465:Algorithms; D000818:Animals; D001921:Brain / Q000601:surgery*; D001932:Brain Neoplasms; D016923:Cell Death; D002462:Cell Membrane / Q000502:physiology / Q000648:ultrastructure; D004285:Dogs; D004558:Electric Stimulation; D004567:Electrodes, Implanted; D018274:Electroporation / Q000379:methods*; D008279:Magnetic Resonance Imaging; D009336:Necrosis; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D010865:Pilot Projects