Irreversible Electroporation of Hepatic and Pancreatic Malignancies: Radiologic-Pathologic Correlation

• Published in: Techniques in vascular and interventional radiology 2015-09, Vol.18 (3), p.176-182
• Main Authors: Gonzalez-Beicos, Aldo, MD, Venkat, Shree, MD, Songrug, Tanakorn, MD, Poveda, Julio, MD, Garcia-Buitrago, Monica, Poozhikunnath Mohan, Prasoon, MD, Narayanan, Govindarajan, MD
• Format: Article
• Language: English
• Subjects: Ablation Techniques - adverse effects; Ablation Techniques - instrumentation; Aged; Biopsy; Cell Death; Databases, Factual; Electroporation - instrumentation; Electroporation - methods; Equipment Design; Female; Hematology, Oncology and Palliative Medicine; Hepatectomy; hepatic malignancy; Humans; Immunohistochemistry; irreversible electroporation; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Male; Middle Aged; Pancreatectomy; pancreatic malignancy; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Positron-Emission Tomography; Postoperative Complications - etiology; Predictive Value of Tests; Radiology; Retrospective Studies; Risk Factors; Surgery, Computer-Assisted - adverse effects; Surgery, Computer-Assisted - instrumentation; Surgery, Computer-Assisted - methods; Tomography, X-Ray Computed; Treatment Outcome; Tumor Burden
• ISSN: 1089-2516; 1557-9808
• DOI: 10.1053/j.tvir.2015.06.009

Irreversible electroporation (IRE) is a novel therapy that has shown to be a feasible and promising alternative to conventional ablative techniques when treating tumors near vital structures or blood vessels. The clinical efficacy of IRE has been evaluated using established imaging criteria. This study evaluates the histologic and imaging response of hepatic and pancreatic malignancies that were surgically resected after IRE. In total, 12 lesions ablated with IRE were included, including 3 pancreatic carcinomas, 5 primary tumors of the liver, and 4 metastatic tumors of the liver. The rate of complete response to IRE was 25% based on the histologic evaluation of the resected tumors. Although treatment-related vessel wall changes were noted in several cases in histologic findings, there was no evidence of vascular luminal narrowing or obliteration in any of the specimens. The imaging response to IRE before surgical resection usually resulted in underestimation of disease burden when compared with the histologic response seen on the resected specimens.