title: Irreversible electroporation for the ablation of pancreatic malignancies: A patient-specific methodology.
abstract: OBJECTIVE
  Irreversible Electroporation (IRE) is a focal ablation technique highly attractive to surgical oncologists due to its non-thermal nature that allows for eradication of unresectable tumors in a minimally invasive procedure. In this study, our group sought to address the challenge of predicting the ablation volume with IRE for pancreatic procedures.
  
  
  METHODS
  In compliance with HIPAA and hospital IRB approval, we established a pre-treatment planning methodology for IRE procedures in pancreas, which optimized treatment protocols for individual cases of locally advanced pancreatic cancer (LAPC). A new method for confirming treatment plans through intraoperative monitoring of tissue resistance was also proved feasible in three patients.
  
  
  RESULTS
  Results from computational models showed good correlation with experimental data available in the literature. By implementing the proposed resistance measurement system 210 ± 26.1 (mean ± standard deviation) fewer pulses were delivered per electrode-pair.
  
  
  CONCLUSIONS
  The proposed physics-based pre-treatment plan through finite element analysis and system for actively monitoring resistance changes can be paired to significantly reduce ablation times and risk of thermal effects during IRE procedures for LAPC.
authors.affiliation: Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia.
authors.forename: Eduardo L
authors.initials: EL
authors.lastname: Latouche
authors.affiliation: Radiation Oncology, Stanford University School of Medicine, Stanford, California.|UNC/NCSU Joint Department of Biomedical Engineering, Chapel Hill, North Carolina.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Sano
authors.affiliation: Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia.
authors.forename: Melvin F
authors.initials: MF
authors.lastname: Lorenzo
authors.affiliation: Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia.
authors.forename: Rafael V
authors.initials: RV
authors.lastname: Davalos
authors.affiliation: Surgery, Division of Surgical Oncology, University of Louisville, Louisville, Kentucky.
authors.forename: Robert C G
authors.initials: RCG
authors.lastname: Martin
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000368:Aged; D018274:Electroporation / Q000379:methods*; D020342:Finite Element Analysis; D006801:Humans; D008297:Male; D008953:Models, Anatomic; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D057285:Precision Medicine / Q000379:methods
keywords: IRE; finite element analysis; impedance; pancreatic adenocarcinoma; real-time feedback; treatment planning