title: Contrast Enhancement Patterns after Irreversible Electroporation: Experimental Study of CT Perfusion Correlated to Histopathology in Normal Porcine Liver.
abstract: OBJECTIVE
  To analyze ablated tissue zones after irreversible electroporation (IRE) of porcine liver using computed tomography (CT) perfusion imaging with histopathologic correlation.
  
  
  METHODS
  Under ultrasound and CT guidance, 10 IRE ablations were performed percutaneously in three Yorkshire pigs using a single bipolar electrode. CT perfusion imaging was performed in all pigs immediately after ablation and on day 2. Pathologic sections were prepared for correlation with histopathology (hematoxylin-eosin and terminal deoxynucleotidyl transferase dUTP nick end labeling stains, 5-mm-thick slices). The short diameter of different enhancing zones on CT was correlated with the gross specimen.
  
  
  RESULTS
  CT perfusion images showed three differently enhancing zones: zone 1, inner nonenhancing zone; zone 2, middle well-defined progressive internal enhancement zone; and zone 3, outer ill-defined arterial enhancement zone with rapid washout. On histopathology, zone 1 showed a strong correlation with a pale zone, and zone 2 correlated with a red zone, together accounting for the extent of cell death. Zone 3 was outside of the ablation zone and contained inflammatory cells. Each enhancing zone had different perfusion parameters.
  
  
  CONCLUSIONS
  CT perfusion imaging in the acute setting effectively demonstrates histopathologic tissue zones after IRE ablation. Zone 2 is unique to IRE not seen in thermal ablation, characterized by progressive intra-zonal enhancement, and its outer boundary defines the extent of cell death.
authors.affiliation: Departments of Radiological Sciences and Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095; Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Chung
authors.affiliation: Departments of Radiological Sciences and Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095.
authors.forename: Kyunghyun
authors.initials: K
authors.lastname: Sung
authors.affiliation: Departments of Radiological Sciences and Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095.
authors.forename: Ferdnand C
authors.initials: FC
authors.lastname: Osuagwu
authors.affiliation: Departments of Radiological Sciences and Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095.
authors.forename: Holden H
authors.initials: HH
authors.lastname: Wu
authors.affiliation: Departments of Radiological Sciences and Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095.
authors.forename: Charles
authors.initials: C
authors.lastname: Lassman
authors.affiliation: Departments of Radiological Sciences and Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095. Electronic address: DLu@mednet.ucla.edu.
authors.forename: David S K
authors.initials: DS
authors.lastname: Lu
mesh_terms: D055011:Ablation Techniques / Q000379:methods; D000818:Animals; D003287:Contrast Media; D018274:Electroporation / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D023421:Models, Animal; D011856:Radiographic Image Enhancement; D015641:Radiography, Interventional; D013552:Swine; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media