The Influence of a Metal Stent on the Distribution of Thermal Energy during Irreversible Electroporation
Irreversible electroporation (IRE) uses short duration, high-voltage electrical pulses to induce cell death via nanoscale defects resulting from altered transmembrane potential. The technique is gaining interest for ablations in unresectable pancreatic and hepatobiliary cancer. Metal stents are ofte...
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| Veröffentlicht in: | PloS one 2016-02, Vol.11 (2), p.e0148457 |
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| creator | Scheffer, Hester J Vogel, Jantien A van den Bos, Willemien Neal, 2nd, Robert E van Lienden, Krijn P Besselink, Marc G H van Gemert, Martin J C van der Geld, Cees W M Meijerink, Martijn R Klaessens, John H Verdaasdonk, Rudolf M |
| description | Irreversible electroporation (IRE) uses short duration, high-voltage electrical pulses to induce cell death via nanoscale defects resulting from altered transmembrane potential. The technique is gaining interest for ablations in unresectable pancreatic and hepatobiliary cancer. Metal stents are often used for palliative biliary drainage in these patients, but are currently seen as an absolute contraindication for IRE due to the perceived risk of direct heating of the metal and its surroundings. This study investigates the thermal and tissue viability changes due to a metal stent during IRE.
IRE was performed in a homogeneous tissue model (polyacrylamide gel), without and with a metal stent placed perpendicular and parallel to the electrodes, delivering 90 and 270 pulses (15-35 A, 90 μsec, 1.5 cm active tip exposure, 1.5 cm interelectrode distance, 1000-1500 V/cm, 90 pulses/min), and in-vivo in a porcine liver (4 ablations). Temperature changes were measured with an infrared thermal camera and with fiber-optic probes. Tissue viability after in-vivo IRE was investigated macroscopically using 5-triphenyltetrazolium chloride (TTC) vitality staining.
In the gel, direct stent-heating was not observed. Contrarily, the presence of a stent between the electrodes caused a higher increase in median temperature near the electrodes (23.2 vs 13.3°C [90 pulses]; p = 0.021, and 33.1 vs 24.8°C [270 pulses]; p = 0.242). In-vivo, no temperature difference was observed for ablations with and without a stent. Tissue examination showed white coagulation 1mm around the electrodes only. A rim of vital tissue remained around the stent, whereas ablation without stent resulted in complete tissue avitality.
IRE in the vicinity of a metal stent does not cause notable direct heating of the metal, but results in higher temperatures around the electrodes and remnant viable tissue. Future studies should determine for which clinical indications IRE in the presence of metal stents is safe and effective. |
| doi_str_mv | 10.1371/journal.pone.0148457 |
| format | Article |
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IRE was performed in a homogeneous tissue model (polyacrylamide gel), without and with a metal stent placed perpendicular and parallel to the electrodes, delivering 90 and 270 pulses (15-35 A, 90 μsec, 1.5 cm active tip exposure, 1.5 cm interelectrode distance, 1000-1500 V/cm, 90 pulses/min), and in-vivo in a porcine liver (4 ablations). Temperature changes were measured with an infrared thermal camera and with fiber-optic probes. Tissue viability after in-vivo IRE was investigated macroscopically using 5-triphenyltetrazolium chloride (TTC) vitality staining.
In the gel, direct stent-heating was not observed. Contrarily, the presence of a stent between the electrodes caused a higher increase in median temperature near the electrodes (23.2 vs 13.3°C [90 pulses]; p = 0.021, and 33.1 vs 24.8°C [270 pulses]; p = 0.242). In-vivo, no temperature difference was observed for ablations with and without a stent. Tissue examination showed white coagulation 1mm around the electrodes only. A rim of vital tissue remained around the stent, whereas ablation without stent resulted in complete tissue avitality.
IRE in the vicinity of a metal stent does not cause notable direct heating of the metal, but results in higher temperatures around the electrodes and remnant viable tissue. Future studies should determine for which clinical indications IRE in the presence of metal stents is safe and effective.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0148457</identifier><identifier>PMID: 26844550</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Ablation ; Analysis ; Animals ; Apoptosis ; Biology and Life Sciences ; Cancer ; Cancer therapies ; Cancer treatment ; Cell death ; Coagulation ; Electrodes ; Electroporation ; Electroporation - methods ; Energy distribution ; Engineering and Technology ; Experiments ; Fiber optics ; Heat ; Heating ; High temperature ; Hot Temperature ; Implants ; Infrared cameras ; Liver ; Liver - injuries ; Liver - pathology ; Medical technology ; Medicine and Health Sciences ; Membrane potential ; Metals ; Metals - adverse effects ; Methods ; Nuclear medicine ; Optical fibers ; Pancreas ; Pancreatic cancer ; Physical Sciences ; Physics ; Physiological aspects ; Research and Analysis Methods ; Risk perception ; Stents ; Stents - adverse effects ; Surgical implants ; Swine ; Temperature ; Temperature changes ; Temperature effects ; Thermal energy ; Tissues ; Triphenyltetrazolium chloride ; Tumors ; Viability</subject><ispartof>PloS one, 2016-02, Vol.11 (2), p.e0148457</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Scheffer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Scheffer et al 2016 Scheffer et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-a7a235a471dade5ae0950dd98093795ddc46b6d6635d98905fba25c84549e06c3</citedby><cites>FETCH-LOGICAL-c692t-a7a235a471dade5ae0950dd98093795ddc46b6d6635d98905fba25c84549e06c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4742246/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4742246/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26844550$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Scheffer, Hester J</creatorcontrib><creatorcontrib>Vogel, Jantien A</creatorcontrib><creatorcontrib>van den Bos, Willemien</creatorcontrib><creatorcontrib>Neal, 2nd, Robert E</creatorcontrib><creatorcontrib>van Lienden, Krijn P</creatorcontrib><creatorcontrib>Besselink, Marc G H</creatorcontrib><creatorcontrib>van Gemert, Martin J C</creatorcontrib><creatorcontrib>van der Geld, Cees W M</creatorcontrib><creatorcontrib>Meijerink, Martijn R</creatorcontrib><creatorcontrib>Klaessens, John H</creatorcontrib><creatorcontrib>Verdaasdonk, Rudolf M</creatorcontrib><title>The Influence of a Metal Stent on the Distribution of Thermal Energy during Irreversible Electroporation</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Irreversible electroporation (IRE) uses short duration, high-voltage electrical pulses to induce cell death via nanoscale defects resulting from altered transmembrane potential. The technique is gaining interest for ablations in unresectable pancreatic and hepatobiliary cancer. Metal stents are often used for palliative biliary drainage in these patients, but are currently seen as an absolute contraindication for IRE due to the perceived risk of direct heating of the metal and its surroundings. This study investigates the thermal and tissue viability changes due to a metal stent during IRE.
IRE was performed in a homogeneous tissue model (polyacrylamide gel), without and with a metal stent placed perpendicular and parallel to the electrodes, delivering 90 and 270 pulses (15-35 A, 90 μsec, 1.5 cm active tip exposure, 1.5 cm interelectrode distance, 1000-1500 V/cm, 90 pulses/min), and in-vivo in a porcine liver (4 ablations). Temperature changes were measured with an infrared thermal camera and with fiber-optic probes. Tissue viability after in-vivo IRE was investigated macroscopically using 5-triphenyltetrazolium chloride (TTC) vitality staining.
In the gel, direct stent-heating was not observed. Contrarily, the presence of a stent between the electrodes caused a higher increase in median temperature near the electrodes (23.2 vs 13.3°C [90 pulses]; p = 0.021, and 33.1 vs 24.8°C [270 pulses]; p = 0.242). In-vivo, no temperature difference was observed for ablations with and without a stent. Tissue examination showed white coagulation 1mm around the electrodes only. A rim of vital tissue remained around the stent, whereas ablation without stent resulted in complete tissue avitality.
IRE in the vicinity of a metal stent does not cause notable direct heating of the metal, but results in higher temperatures around the electrodes and remnant viable tissue. Future studies should determine for which clinical indications IRE in the presence of metal stents is safe and effective.</description><subject>Ablation</subject><subject>Analysis</subject><subject>Animals</subject><subject>Apoptosis</subject><subject>Biology and Life Sciences</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Cancer treatment</subject><subject>Cell death</subject><subject>Coagulation</subject><subject>Electrodes</subject><subject>Electroporation</subject><subject>Electroporation - methods</subject><subject>Energy distribution</subject><subject>Engineering and Technology</subject><subject>Experiments</subject><subject>Fiber optics</subject><subject>Heat</subject><subject>Heating</subject><subject>High temperature</subject><subject>Hot Temperature</subject><subject>Implants</subject><subject>Infrared cameras</subject><subject>Liver</subject><subject>Liver - injuries</subject><subject>Liver - pathology</subject><subject>Medical technology</subject><subject>Medicine and Health Sciences</subject><subject>Membrane potential</subject><subject>Metals</subject><subject>Metals - adverse effects</subject><subject>Methods</subject><subject>Nuclear medicine</subject><subject>Optical fibers</subject><subject>Pancreas</subject><subject>Pancreatic cancer</subject><subject>Physical Sciences</subject><subject>Physics</subject><subject>Physiological aspects</subject><subject>Research and Analysis Methods</subject><subject>Risk perception</subject><subject>Stents</subject><subject>Stents - adverse effects</subject><subject>Surgical implants</subject><subject>Swine</subject><subject>Temperature</subject><subject>Temperature changes</subject><subject>Temperature effects</subject><subject>Thermal energy</subject><subject>Tissues</subject><subject>Triphenyltetrazolium chloride</subject><subject>Tumors</subject><subject>Viability</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl9r1EAUxYMotla_gWhAEHzYdTL_krwIpa66UCnY6uswO3OTnZLNbGcmxX5773bTsgEFyUPCze-cuXM4Wfa6IPOClcXHaz-EXnfzre9hTgpecVE-yY6LmtGZpIQ9Pfg-yl7EeE2IYJWUz7MjKivOhSDH2fpqDfmyb7oBegO5b3Kdf4eku_wyQZ9y3-cJic8upuBWQ3I4QAhVYYPQoofQ3uV2CK5v82UIcAshulUH-aIDk4Lf-qB3qpfZs0Z3EV6N75Ps55fF1dm32fnF1-XZ6fnMyJqmmS41ZULzsrDagtBAakGsrStSs7IW1houV9JKyQQOayKalabC4OV5DUQadpK93ftuOx_VGFJURSmpLPH-AonlnrBeX6ttcBsd7pTXTt0PfGiVDsmZDhSeWNiCUah1xRnuQCS1nJdQswrDLdDr03jasNqANRhZ0N3EdPqnd2vV-lvFS04pl2jwbjQI_maAmP6x8ki1GrdyfePRzGxcNOqUc4oIFxSp-V8ofCxsnMGaNA7nE8GHiQCZBL9Tq4cY1fLyx_-zF7-m7PsDdg26S-vou_v2xCnI96AJPsYAzWNyBVG7lj-koXYtV2PLUfbmMPVH0UOt2R_3QfaH</recordid><startdate>20160204</startdate><enddate>20160204</enddate><creator>Scheffer, Hester J</creator><creator>Vogel, Jantien A</creator><creator>van den Bos, Willemien</creator><creator>Neal, 2nd, Robert E</creator><creator>van Lienden, Krijn P</creator><creator>Besselink, Marc G H</creator><creator>van Gemert, Martin J C</creator><creator>van der Geld, Cees W M</creator><creator>Meijerink, Martijn R</creator><creator>Klaessens, John H</creator><creator>Verdaasdonk, Rudolf M</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20160204</creationdate><title>The Influence of a Metal Stent on the Distribution of Thermal Energy during Irreversible Electroporation</title><author>Scheffer, Hester J ; Vogel, Jantien A ; van den Bos, Willemien ; Neal, 2nd, Robert E ; van Lienden, Krijn P ; Besselink, Marc G H ; van Gemert, Martin J C ; van der Geld, Cees W M ; Meijerink, Martijn R ; Klaessens, John H ; Verdaasdonk, Rudolf M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-a7a235a471dade5ae0950dd98093795ddc46b6d6635d98905fba25c84549e06c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Ablation</topic><topic>Analysis</topic><topic>Animals</topic><topic>Apoptosis</topic><topic>Biology and Life Sciences</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Cancer treatment</topic><topic>Cell death</topic><topic>Coagulation</topic><topic>Electrodes</topic><topic>Electroporation</topic><topic>Electroporation - 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The technique is gaining interest for ablations in unresectable pancreatic and hepatobiliary cancer. Metal stents are often used for palliative biliary drainage in these patients, but are currently seen as an absolute contraindication for IRE due to the perceived risk of direct heating of the metal and its surroundings. This study investigates the thermal and tissue viability changes due to a metal stent during IRE.
IRE was performed in a homogeneous tissue model (polyacrylamide gel), without and with a metal stent placed perpendicular and parallel to the electrodes, delivering 90 and 270 pulses (15-35 A, 90 μsec, 1.5 cm active tip exposure, 1.5 cm interelectrode distance, 1000-1500 V/cm, 90 pulses/min), and in-vivo in a porcine liver (4 ablations). Temperature changes were measured with an infrared thermal camera and with fiber-optic probes. Tissue viability after in-vivo IRE was investigated macroscopically using 5-triphenyltetrazolium chloride (TTC) vitality staining.
In the gel, direct stent-heating was not observed. Contrarily, the presence of a stent between the electrodes caused a higher increase in median temperature near the electrodes (23.2 vs 13.3°C [90 pulses]; p = 0.021, and 33.1 vs 24.8°C [270 pulses]; p = 0.242). In-vivo, no temperature difference was observed for ablations with and without a stent. Tissue examination showed white coagulation 1mm around the electrodes only. A rim of vital tissue remained around the stent, whereas ablation without stent resulted in complete tissue avitality.
IRE in the vicinity of a metal stent does not cause notable direct heating of the metal, but results in higher temperatures around the electrodes and remnant viable tissue. Future studies should determine for which clinical indications IRE in the presence of metal stents is safe and effective.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26844550</pmid><doi>10.1371/journal.pone.0148457</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2016-02, Vol.11 (2), p.e0148457 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1762675385 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Ablation Analysis Animals Apoptosis Biology and Life Sciences Cancer Cancer therapies Cancer treatment Cell death Coagulation Electrodes Electroporation Electroporation - methods Energy distribution Engineering and Technology Experiments Fiber optics Heat Heating High temperature Hot Temperature Implants Infrared cameras Liver Liver - injuries Liver - pathology Medical technology Medicine and Health Sciences Membrane potential Metals Metals - adverse effects Methods Nuclear medicine Optical fibers Pancreas Pancreatic cancer Physical Sciences Physics Physiological aspects Research and Analysis Methods Risk perception Stents Stents - adverse effects Surgical implants Swine Temperature Temperature changes Temperature effects Thermal energy Tissues Triphenyltetrazolium chloride Tumors Viability |
| title | The Influence of a Metal Stent on the Distribution of Thermal Energy during Irreversible Electroporation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T04%3A37%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Influence%20of%20a%20Metal%20Stent%20on%20the%20Distribution%20of%20Thermal%20Energy%20during%20Irreversible%20Electroporation&rft.jtitle=PloS%20one&rft.au=Scheffer,%20Hester%20J&rft.date=2016-02-04&rft.volume=11&rft.issue=2&rft.spage=e0148457&rft.pages=e0148457-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0148457&rft_dat=%3Cgale_plos_%3EA442385452%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1762675385&rft_id=info:pmid/26844550&rft_galeid=A442385452&rft_doaj_id=oai_doaj_org_article_7951d132e9a843809062d447e9381931&rfr_iscdi=true |