title: Anatomically Realistic Simulations of Liver Ablation by Irreversible Electroporation: Impact of Blood Vessels on Ablation Volumes and Undertreatment.
abstract: Irreversible electroporation is a novel tissue ablation technique which entails delivering intense electrical pulses to target tissue, hence producing fatal defects in the cell membrane. The present study numerically analyzes the potential impact of liver blood vessels on ablation by irreversible electroporation because of their influence on the electric field distribution. An anatomically realistic computer model of the liver and its vasculature within an abdominal section was employed, and blood vessels down to 0.4 mm in diameter were considered. In this model, the electric field distribution was simulated in a large series of scenarios (N = 576) corresponding to plausible percutaneous irreversible electroporation treatments by needle electrode pairs. These modeled treatments were relatively superficial (maximum penetration depth of the electrode within the liver = 26 mm) and it was ensured that the electrodes did not penetrate the vessels nor were in contact with them. In terms of total ablation volume, the maximum deviation caused by the presence of the vessels was 6%, which could be considered negligible compared to the impact by other sources of uncertainty. Sublethal field magnitudes were noticed around vessels covering volumes of up to 228 mm3. If in this model the blood was substituted by a liquid with a low electrical conductivity (0.1 S/m), the maximum volume covered by sublethal field magnitudes was 3.7 mm3and almost no sublethal regions were observable. We conclude that undertreatment around blood vessels may occur in current liver ablation procedures by irreversible electroporation. Infusion of isotonic low conductivity liquids into the liver vasculature could prevent this risk.
authors.affiliation: 1 Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Radwan
authors.initials: R
authors.lastname: Qasrawi
authors.affiliation: 2 Ecole Centrale de Lyon, University of Pompeu Fabra, Écully, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Silve
authors.affiliation: 3 Department of Surgery, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Burdío
authors.affiliation: 4 Al-Quds University, Jerusalem, Palestine.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Abdeen
authors.affiliation: 1 Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain.|5 Serra Húnter Fellowship, Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Ivorra
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D003198:Computer Simulation; D004553:Electric Conductivity; D004566:Electrodes; D018274:Electroporation / Q000379:methods*; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000601:surgery*; D008297:Male
keywords: blood vessels; conductivity; irreversible electroporation; liver; numerical modeling