High-Frequency Irreversible Electroporation for Intracranial Meningioma: A Feasibility Study in a Spontaneous Canine Tumor Model.
High-Frequency Irreversible Electroporation for Intracranial Meningioma: A Feasibility Study in a Spontaneous Canine Tumor Model.
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DOI：
10.1177/1533033818785285
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发表时间：
2018-01-01
影响因子：
2.8
通讯作者：
Rossmeisl JH
中科院分区：
文献类型：
--
作者：
Latouche EL;Arena CB;Ivey JW;Garcia PA;Pancotto TE;Pavlisko N;Verbridge SS;Davalos RV;Rossmeisl JH
高频不可逆电穿孔是一种非热的组织消融方法，使用0.5至2.0微秒的双极电脉冲的爆发来透化细胞膜并诱导细胞死亡。高频不可逆电穿孔具有用于神经外科的潜在优势，包括在不诱导肌肉收缩的情况下递送脉冲的能力、对恶性细胞的固有选择性以及同时打开消融区域周围的血脑屏障的能力。我们的目的是确定是否可以将具有肿瘤消融能力的高频不可逆电穿孔脉冲传递给患有颅内脑膜瘤的狗。治疗了三只患有颅内脑膜瘤的狗。使用基于磁共振成像的组织分割、体积网格化和有限元建模生成患者特定的治疗计划。在肿瘤活检后，立体定向原位递送高频不可逆电穿孔脉冲，随后进行肿瘤切除和消融的形态学和体积评估。治疗的临床评价包括治疗前和治疗后的临床、实验室和磁共振成像检查以及治疗后2周的不良事件监测。高频不可逆电穿孔脉冲成功地管理在所有患者。未观察到直接归因于高频不可逆电穿孔的不良事件。单个消融导致肿瘤坏死体积范围为0.25 - 1.29 cm3。在一只犬中，观察到不均匀的消融，肿瘤内矿化灶周围仍有存活的肿瘤细胞。总之，高频不可逆电穿孔脉冲可以被递送到脑肿瘤，包括邻近关键脉管系统的区域，并且能够产生临床相关体积的肿瘤消融。矿化可能使肿瘤完全消融的实现复杂化。
High-frequency irreversible electroporation is a nonthermal method of tissue ablation that uses bursts of 0.5- to 2.0-microsecond bipolar electric pulses to permeabilize cell membranes and induce cell death. High-frequency irreversible electroporation has potential advantages for use in neurosurgery, including the ability to deliver pulses without inducing muscle contraction, inherent selectivity against malignant cells, and the capability of simultaneously opening the blood–brain barrier surrounding regions of ablation. Our objective was to determine whether high-frequency irreversible electroporation pulses capable of tumor ablation could be delivered to dogs with intracranial meningiomas. Three dogs with intracranial meningiomas were treated. Patient-specific treatment plans were generated using magnetic resonance imaging-based tissue segmentation, volumetric meshing, and finite element modeling. Following tumor biopsy, high-frequency irreversible electroporation pulses were stereotactically delivered in situ followed by tumor resection and morphologic and volumetric assessments of ablations. Clinical evaluations of treatment included pre- and posttreatment clinical, laboratory, and magnetic resonance imaging examinations and adverse event monitoring for 2 weeks posttreatment. High-frequency irreversible electroporation pulses were administered successfully in all patients. No adverse events directly attributable to high-frequency irreversible electroporation were observed. Individual ablations resulted in volumes of tumor necrosis ranging from 0.25 to 1.29 cm3. In one dog, nonuniform ablations were observed, with viable tumor cells remaining around foci of intratumoral mineralization. In conclusion, high-frequency irreversible electroporation pulses can be delivered to brain tumors, including areas adjacent to critical vasculature, and are capable of producing clinically relevant volumes of tumor ablation. Mineralization may complicate achievement of complete tumor ablation.
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影响因子：
4.1
作者：
Rogers L;Barani I;Chamberlain M;Kaley TJ;McDermott M;Raizer J;Schiff D;Weber DC;Wen PY;Vogelbaum MA
通讯作者：
Vogelbaum MA
影响因子：
2.8
作者：
Garcia, P. A.;Pancotto, T.;Davalos, R. V.
通讯作者：
Davalos, R. V.
影响因子：
3.9
作者：
Arena CB;Sano MB;Rossmeisl JH Jr;Caldwell JL;Garcia PA;Rylander MN;Davalos RV
通讯作者：
Davalos RV
影响因子：
4.6
作者：
Arena, Christopher B.;Sano, Michael B.;Davalos, Rafael V.
通讯作者：
Davalos, Rafael V.
DOI：
10.1016/j.jamcollsurg.2013.10.013
发表时间：
2014-02-01
影响因子：
5.2
作者：
Dunki-Jacobs, Erik M.;Philips, Prejesh;Martin, Robert C. G., II
通讯作者：
Martin, Robert C. G., II