The effects of metallic implants on electroporation therapies: feasibility of irreversible electroporation for brachytherapy salvage. Neal, R. E., Smith, R. L., Kavnoudias, H., Rosenfeldt, F., Ou, R., McLean, C. A., Davalos, R. V., & Thomson, K. R. Cardiovasc Intervent Radiol, 36(6):1638-1645, 2013. 1432-086x Neal, Robert E 2nd Smith, Ryan L Kavnoudias, Helen Rosenfeldt, Franklin Ou, Ruchong Mclean, Catriona A Davalos, Rafael V Thomson, Kenneth R Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. United States 2013/08/15 Cardiovasc Intervent Radiol. 2013 Dec;36(6):1638-1645. doi: 10.1007/s00270-013-0704-1. Epub 2013 Aug 14.
doi  abstract   bibtex   
PURPOSE: Electroporation-based therapies deliver brief electric pulses into a targeted volume to destabilize cellular membranes. Nonthermal irreversible electroporation (IRE) provides focal ablation with effects dependent on the electric field distribution, which changes in heterogeneous environments. It should be determined if highly conductive metallic implants in targeted regions, such as radiotherapy brachytherapy seeds in prostate tissue, will alter treatment outcomes. Theoretical and experimental models determine the impact of prostate brachytherapy seeds on IRE treatments. MATERIALS AND METHODS: This study delivered IRE pulses in nonanimal, as well as in ex vivo and in vivo tissue, with and in the absence of expired radiotherapy seeds. Electrical current was measured and lesion dimensions were examined macroscopically and with magnetic resonance imaging. Finite-element treatment simulations predicted the effects of brachytherapy seeds in the targeted region on electrical current, electric field, and temperature distributions. RESULTS: There was no significant difference in electrical behavior in tissue containing a grid of expired radiotherapy seeds relative to those without seeds for nonanimal, ex vivo, and in vivo experiments (all p > 0.1). Numerical simulations predict no significant alteration of electric field or thermal effects (all p > 0.1). Histology showed cellular necrosis in the region near the electrodes and seeds within the ablation region; however, there were no seeds beyond the ablation margins. CONCLUSION: This study suggests that electroporation therapies can be implemented in regions containing small metallic implants without significant changes to electrical and thermal effects relative to use in tissue without the implants. This supports the ability to use IRE as a salvage therapy option for brachytherapy.
@article{RN200,
   author = {Neal, R. E., 2nd and Smith, R. L. and Kavnoudias, H. and Rosenfeldt, F. and Ou, R. and McLean, C. A. and Davalos, R. V. and Thomson, K. R.},
   title = {The effects of metallic implants on electroporation therapies: feasibility of irreversible electroporation for brachytherapy salvage},
   journal = {Cardiovasc Intervent Radiol},
   volume = {36},
   number = {6},
   pages = {1638-1645},
   note = {1432-086x
Neal, Robert E 2nd
Smith, Ryan L
Kavnoudias, Helen
Rosenfeldt, Franklin
Ou, Ruchong
Mclean, Catriona A
Davalos, Rafael V
Thomson, Kenneth R
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
United States
2013/08/15
Cardiovasc Intervent Radiol. 2013 Dec;36(6):1638-1645. doi: 10.1007/s00270-013-0704-1. Epub 2013 Aug 14.},
   abstract = {PURPOSE: Electroporation-based therapies deliver brief electric pulses into a targeted volume to destabilize cellular membranes. Nonthermal irreversible electroporation (IRE) provides focal ablation with effects dependent on the electric field distribution, which changes in heterogeneous environments. It should be determined if highly conductive metallic implants in targeted regions, such as radiotherapy brachytherapy seeds in prostate tissue, will alter treatment outcomes. Theoretical and experimental models determine the impact of prostate brachytherapy seeds on IRE treatments. MATERIALS AND METHODS: This study delivered IRE pulses in nonanimal, as well as in ex vivo and in vivo tissue, with and in the absence of expired radiotherapy seeds. Electrical current was measured and lesion dimensions were examined macroscopically and with magnetic resonance imaging. Finite-element treatment simulations predicted the effects of brachytherapy seeds in the targeted region on electrical current, electric field, and temperature distributions. RESULTS: There was no significant difference in electrical behavior in tissue containing a grid of expired radiotherapy seeds relative to those without seeds for nonanimal, ex vivo, and in vivo experiments (all p > 0.1). Numerical simulations predict no significant alteration of electric field or thermal effects (all p > 0.1). Histology showed cellular necrosis in the region near the electrodes and seeds within the ablation region; however, there were no seeds beyond the ablation margins. CONCLUSION: This study suggests that electroporation therapies can be implemented in regions containing small metallic implants without significant changes to electrical and thermal effects relative to use in tissue without the implants. This supports the ability to use IRE as a salvage therapy option for brachytherapy.},
   keywords = {Animals
Brachytherapy/*methods
Catheter Ablation/methods
Dogs
Electric Conductivity
Electrochemotherapy/*methods
Electroporation/*methods
Feasibility Studies
Male
*Metals
Models, Biological
Models, Theoretical
*Prostate
Salvage Therapy/*methods
Solanum tuberosum},
   ISSN = {0174-1551},
   DOI = {10.1007/s00270-013-0704-1},
   year = {2013},
   type = {Journal Article}
}

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