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      High-Frequency Irreversible Electroporation for Treatment of Primary Liver Cancer: A Proof-of-Principle Study in Canine Hepatocellular Carcinoma

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          Abstract

          To determine the safety and feasibility of percutaneous high frequency irreversible electroporation (HFIRE) for primary liver cancer, and evaluate the HFIRE-induced local immune response. HFIRE therapy was delivered percutaneously in three canine patients with resectable hepatocellular carcinoma (HCC) in the absence of intraoperative paralytics or cardiac synchronization. Pre- and post-HFIRE biopsy samples were processed with histopathology and immunohistochemistry for CD3, CD4, CD8, and CD79a. Blood was collected on days 0, 2 and 4 for complete blood count (CBC) and chemistry. Numerical models were developed to determine the treatment specific lethal thresholds for malignant canine liver tissue and healthy porcine liver tissue. HFIRE resulted in predictable ablation volumes as assessed by post-treatment CT. No detectable cardiac interference and minimal muscle contraction occurred during HFIRE. No clinically significant adverse events occurred secondary to HFIRE. Microscopically, a well-defined ablation zone surrounded by a reactive zone was evident in the majority of samples. This zone was composed primarily of maturing collagen interspersed with CD3+/CD4−/CD8− lymphocytes, in a pro-inflammatory microenvironment. The average ablation volumes for the hepatocellular carcinoma canine patients and the healthy porcine tissue were 3.89 ± 0.74 cm 3 and 1.56 ± 0.16 cm 3 , respectively (p=0.03), while the average lethal thresholds were 710 ± 28.2 V/cm and 957 ± 24.4 V/cm, respectively (p=0.0004). HFIRE can safely and effectively be delivered percutaneously, results in a predictable ablation volume, and is associated with lymphocytic tumor infiltration. This is the first step towards using HFIRE for treatment of unresectable liver tumors.

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          Author and article information

          Journal
          Journal of Vascular and Interventional Radiology
          Journal of Vascular and Interventional Radiology
          Elsevier BV
          10510443
          January 2020
          January 2020
          Article
          10.1016/j.jvir.2019.10.015
          7418213
          31956003
          ff5a5e12-393f-4312-add4-b9ac1dcfaebd
          © 2020

          https://www.elsevier.com/tdm/userlicense/1.0/

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