A Comparative Modeling Study of Thermal Mitigation Strategies in Irreversible Electroporation Treatments
A Comparative Modeling Study of Thermal Mitigation Strategies in Irreversible Electroporation Treatments
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DOI：
10.1115/1.4053199
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发表时间：
2022-03-01
影响因子：
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通讯作者：
Davalos, Rafael, V
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文献类型：
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作者：
Aycock, Kenneth N.;Campelo, Sabrina N.;Davalos, Rafael, V
不可逆电穿孔（IRE），也称为非热脉冲场消融（PFA），是一种有吸引力的实体瘤和心脏组织的局部消融方式，因为它能够破坏异常细胞，对底层组织结构的破坏有限。尽管其非热细胞死亡机制，电能的应用导致焦耳加热，如果忽略，可能会导致不希望的热损伤。工程热缓解（TM）技术，包括相变材料（PCM）和主动冷却（AC）已被报告和测试作为一种潜在的手段，以限制热损害。然而，几个变量影响TM性能，包括脉冲范例，电极几何形状，PCM成分，和选择的主动冷却参数，这意味着缺乏方法之间的直接比较。在这项研究中，我们开发了一个计算模型的传统双极和单极探头与固体，PCM填充，或主动冷却的核心，以模拟临床IRE治疗胰腺组织。这种方法表明，与现有的固体探头相比，具有集成PCM芯的探头可以被调谐以极大地限制热损伤。此外，主动冷却探头提供了对探头附近热效应的额外控制，并且可以完全消除热损伤。在实践中，与现有的固体探针相比，这种性能差异必须与改进的探针所需的增加的时间、费用和努力进行权衡。
Irreversible electroporation (IRE), also referred to as nonthermal pulsed field ablation (PFA), is an attractive focal ablation modality for solid tumors and cardiac tissue due to its ability to destroy aberrant cells with limited disruption of the underlying tissue architecture. Despite its nonthermal cell death mechanism, application of electrical energy results in Joule heating that, if ignored, can cause undesired thermal injury. Engineered thermal mitigation (TM) technologies including phase change materials (PCMs) and active cooling (AC) have been reported and tested as a potential means to limit thermal damage. However, several variables affect TM performance including the pulsing paradigm, electrode geometry, PCM composition, and chosen active cooling parameters, meaning direct comparisons between approaches are lacking. In this study, we developed a computational model of conventional bipolar and monopolar probes with solid, PCM-filled, or actively cooled cores to simulate clinical IRE treatments in pancreatic tissue. This approach reveals that probes with integrated PCM cores can be tuned to drastically limit thermal damage compared to existing solid probes. Furthermore, actively cooled probes provide additional control over thermal effects within the probe vicinity and can altogether abrogate thermal damage. In practice, such differences in performance must be weighed against the increased time, expense, and effort required for modified probes compared to existing solid probes.