title: Percutaneous irreversible electroporation lung ablation: preliminary results in a porcine model.
abstract: OBJECTIVE
  Irreversible electroporation (IRE) uses direct electrical pulses to create permanent "pores" in cell membranes to cause cell death. In contrast to conventional modalities, IRE has a nonthermal mechanism of action. Our objective was to study the histopathological and imaging features of IRE in normal swine lung.
  
  
  METHODS
  Eleven female swine were studied for hyperacute (8 h), acute (24 h), subacute (96 h), and chronic (3 week) effects of IRE ablation in lung. Paired unipolar IRE applicators were placed under computed tomography (CT) guidance. Some applicators were deliberately positioned near bronchovascular structures. IRE pulse delivery was synchronized with the cardiac rhythm only when ablation was performed within 2 cm of the heart. Contrast-enhanced CT scan was performed immediately before and after IRE and at 1 and 3 weeks after IRE ablation. Representative tissue was stained with hematoxylin and eosin for histopathology.
  
  
  RESULTS
  Twenty-five ablations were created: ten hyperacute, four acute, and three subacute ablations showed alveolar edema and necrosis with necrosis of bronchial, bronchiolar, and vascular epithelium. Bronchovascular architecture was maintained. Chronic ablations showed bronchiolitis obliterans and alveolar interstitial fibrosis. Immediate post-procedure CT images showed linear or patchy density along the applicator tract. At 1 week, there was consolidation that resolved partially or completely by 3 weeks. Pneumothorax requiring chest tube developed in two animals; no significant cardiac arrhythmias were noted.
  
  
  CONCLUSIONS
  Our preliminary porcine study demonstrates the nonthermal and extracellular matrix sparing mechanism of action of IRE. IRE is a potential alternative to thermal ablative modalities.
authors: Interventional Radiology and Image-Guided Therapies, Memorial Sloan Kettering Cancer Center, New York, NY 10021, USA.
authors: Ajita
authors: A
authors: Deodhar
authors: Sébastien
authors: S
authors: Monette
authors: Gordon W
authors: GW
authors: Single
authors: William C
authors: WC
authors: Hamilton
authors: Raymond H
authors: RH
authors: Thornton
authors: Constantinos T
authors: CT
authors: Sofocleous
authors: Majid
authors: M
authors: Maybody
authors: Stephen B
authors: SB
authors: Solomon
mesh_terms: D000818:Animals; D003287:Contrast Media; D018274:Electroporation / Q000379:methods*; D005260:Female; D008168:Lung / Q000000981:diagnostic imaging / Q000601:surgery*; D015641:Radiography, Interventional; D013552:Swine; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media