title: Local control of perivascular malignant liver lesions using percutaneous irreversible electroporation: initial experiences.
abstract: OBJECTIVE
  This study was designed to assess efficacy and safety in the treatment of perivascular malignant liver lesions using percutaneous, computed tomography (CT)-guided irreversible electroporation (IRE).
  
  
  METHODS
  Fourteen patients (mean age 58 ± 11 years) with 18 malignant liver lesions were consecutively enrolled in this study. IRE was performed in patients not eligible for surgery and lesions abutting large vessels or bile ducts. Follow-up exams were performed using multislice-CT (MS-CT) or MRI.
  
  
  RESULTS
  Medium lesion diameter was 20 ± 5 mm. Ten of 14 (71 %) were successfully treated with no local recurrence to date (mean follow-up 388 ± 160 days). One case left initial tumor control unclear and additional RFA was performed 4 weeks after IRE. Complications occurred in 4 of 14 (29 %) cases. In one case, intervention was terminated and abdominal bleeding required laparotomy. In two cases, a postinterventional hematothorax required intervention. In another case, abdominal bleeding could be managed conservatively. No complications related to the bile ducts occurred.
  
  
  CONCLUSIONS
  Percutaneous IRE seems to be effective in perivascular lesions but is associated with a higher complication rate compared with thermoablative techniques.
authors.affiliation: Department of Radiology, University Hospital Erlangen, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054, Erlangen, Germany, Achim.Eller@uk-erlangen.de.
authors.forename: Achim
authors.initials: A
authors.lastname: Eller
authors.forename: Axel
authors.initials: A
authors.lastname: Schmid
authors.forename: Joachim
authors.initials: J
authors.lastname: Schmidt
authors.forename: Matthias
authors.initials: M
authors.lastname: May
authors.forename: Michael
authors.initials: M
authors.lastname: Brand
authors.forename: Marc
authors.initials: M
authors.lastname: Saake
authors.forename: Michael
authors.initials: M
authors.lastname: Uder
authors.forename: Michael
authors.initials: M
authors.lastname: Lell
mesh_terms: D000328:Adult; D000368:Aged; D018274:Electroporation / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome