Irreversible electroporation for the ablation of pancreatic malignancies: A patient-specific methodology

Background and Objectives: Irreversible Electroporation (IRE) is a focal ablation technique highly attractive to surgical oncologists due to its non-thermal nature that allows for eradication of unresectable tumors in a minimally invasive procedure. In this study, our group sought to address the challenge of predicting the ablation volume with IRE for pancreatic procedures. Methods: In compliance with HIPAA and hospital IRB approval, we established a pre-treatment planning methodology for IRE procedures in pancreas, which optimized treatment protocols for individual cases of locally advanced pancreatic cancer (LAPC). A new method for confirming treatment plans through intraoperative monitoring of tissue resistance was also proved feasible in three patients. Results: Results from computational models showed good correlation with experimental data available in the literature. By implementing the proposed resistance measurement system 210 +/- 26.1 (mean +/- standard deviation) fewer pulses were delivered per electrode-pair. Conclusion: The proposed physics-based pre-treatment plan through finite element analysis and system for actively monitoring resistance changes can be paired to significantly reduce ablation times and risk of thermal effects during IRE procedures for LAPC.