title: Irreversible electroporation for focal ablation at the porta hepatis.
abstract: Patients with chemotherapy-refractory liver metastases who are not candidates for surgery may be treated with focal ablation techniques with established survival benefits. Irreversible electroporation is the newest of these and has the putative advantages of a nonthermal action, preventing damage to adjacent biliary structures and bowel. This report describes the use of irreversible electroporation in a 61-year-old man with a solitary chemoresistant liver metastasis unsuitable for radiofrequency ablation as a result of its proximity to the porta hepatis. At 3 months, tumor size was decreased on computed tomography from 28 × 19 to 20 × 17 mm, representing stable disease according to the response evaluation criteria in solid tumors. This corresponded to a decrease in tumor volume size from 5.25 to 3.16 cm(3). There were no early or late complications. Chemoresistant liver metastases in the proximity of the porta hepatis that are considered to be too high a risk for conventional surgery or thermal ablation may be considered for treatment by the novel ablation technique of irreversible electroporation.
authors.affiliation: Department of Radiology, Imperial College London, London, UK. vk103@ic.ac.uk
authors.forename: Veeru
authors.initials: V
authors.lastname: Kasivisvanathan
authors.forename: Ankur
authors.initials: A
authors.lastname: Thapar
authors.forename: Youssof
authors.initials: Y
authors.lastname: Oskrochi
authors.forename: John
authors.initials: J
authors.lastname: Picard
authors.forename: Edward L S
authors.initials: EL
authors.lastname: Leen
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D003131:Combined Modality Therapy; D003287:Contrast Media; D018274:Electroporation / Q000379:methods*; D005472:Fluorouracil; D006498:Hepatectomy; D006801:Humans; D002955:Leucovorin; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds; D010743:Phospholipids; D013459:Sulfur Hexafluoride; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D009944:Organoplatinum Compounds; D010743:Phospholipids; C420843:contrast agent BR1; D002955:Leucovorin; D005472:Fluorouracil; D013459:Sulfur Hexafluoride