Impact of needle positioning on ablation success of irreversible electroporation: a unicentric retrospective analysis

Abstract Irreversible electroporation (IRE) is an ablation procedure in which cell death is induced by ultrashort electrical pulses. In this unicentric retrospective study we investigated the influence of needle positioning on ablation success. 15 IREs with residual tumor after ablation, detected in...

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Autores principales:	René Michael Mathy, Parham Tinoush, Ricardo Daniel da Florencia, Alexander Braun, Omid Ghamarnejad, Boris Radeleff, Hans-Ulrich Kauczor, De-Hua Chang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/726babb3cbe449219b5b57f093aa6e20
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spelling	oai:doaj.org-article:726babb3cbe449219b5b57f093aa6e202021-12-02T13:58:13ZImpact of needle positioning on ablation success of irreversible electroporation: a unicentric retrospective analysis10.1038/s41598-020-78660-02045-2322https://doaj.org/article/726babb3cbe449219b5b57f093aa6e202020-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-78660-0https://doaj.org/toc/2045-2322Abstract Irreversible electroporation (IRE) is an ablation procedure in which cell death is induced by ultrashort electrical pulses. In this unicentric retrospective study we investigated the influence of needle positioning on ablation success. 15 IREs with residual tumor after ablation, detected in the first follow-up MRI, were included, and compared with 30 successful ablations. Evaluation of needle geometry revealed significantly higher values for needle divergence (NDiv, 7.0° vs. 3.7°, p = 0.02), tumor-center-to-ablation-center distance (TACD, 11.6 vs. 3.2 mm, p < 0.001), tumor-to-needle distance (4.7 vs. 1.9 mm, p = 0.04), and tumor diameter per needle (7.5 vs. 5.9 mm/needle, p = 0.01) in patients with residual tumor. The average number of needles used was higher in the group without residual tumor after ablation (3.1 vs. 2.4, p = 0.04). In many cases with residual tumor, needle depth was too short (2.1 vs. 6.8 mm tumor overlap beyond the most proximal needle tip, p < 0.01). The use of a stereotactic navigation system in 10 cases resulted in a lower NDiv value (2.1° vs. 5.6°, p < 0.01). Thus, correct needle placement seems to be a crucial factor for success and the assistance of a stereotactic navigation system might be helpful. As most important geometrical parameter TACD could be identified. Main reasons for high TACD were insufficient needle depth and a lesion location out of the needle plane.René Michael MathyParham TinoushRicardo Daniel da FlorenciaAlexander BraunOmid GhamarnejadBoris RadeleffHans-Ulrich KauczorDe-Hua ChangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-10 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q René Michael Mathy Parham Tinoush Ricardo Daniel da Florencia Alexander Braun Omid Ghamarnejad Boris Radeleff Hans-Ulrich Kauczor De-Hua Chang Impact of needle positioning on ablation success of irreversible electroporation: a unicentric retrospective analysis
description	Abstract Irreversible electroporation (IRE) is an ablation procedure in which cell death is induced by ultrashort electrical pulses. In this unicentric retrospective study we investigated the influence of needle positioning on ablation success. 15 IREs with residual tumor after ablation, detected in the first follow-up MRI, were included, and compared with 30 successful ablations. Evaluation of needle geometry revealed significantly higher values for needle divergence (NDiv, 7.0° vs. 3.7°, p = 0.02), tumor-center-to-ablation-center distance (TACD, 11.6 vs. 3.2 mm, p < 0.001), tumor-to-needle distance (4.7 vs. 1.9 mm, p = 0.04), and tumor diameter per needle (7.5 vs. 5.9 mm/needle, p = 0.01) in patients with residual tumor. The average number of needles used was higher in the group without residual tumor after ablation (3.1 vs. 2.4, p = 0.04). In many cases with residual tumor, needle depth was too short (2.1 vs. 6.8 mm tumor overlap beyond the most proximal needle tip, p < 0.01). The use of a stereotactic navigation system in 10 cases resulted in a lower NDiv value (2.1° vs. 5.6°, p < 0.01). Thus, correct needle placement seems to be a crucial factor for success and the assistance of a stereotactic navigation system might be helpful. As most important geometrical parameter TACD could be identified. Main reasons for high TACD were insufficient needle depth and a lesion location out of the needle plane.
format	article
author	René Michael Mathy Parham Tinoush Ricardo Daniel da Florencia Alexander Braun Omid Ghamarnejad Boris Radeleff Hans-Ulrich Kauczor De-Hua Chang
author_facet	René Michael Mathy Parham Tinoush Ricardo Daniel da Florencia Alexander Braun Omid Ghamarnejad Boris Radeleff Hans-Ulrich Kauczor De-Hua Chang
author_sort	René Michael Mathy
title	Impact of needle positioning on ablation success of irreversible electroporation: a unicentric retrospective analysis
title_short	Impact of needle positioning on ablation success of irreversible electroporation: a unicentric retrospective analysis
title_full	Impact of needle positioning on ablation success of irreversible electroporation: a unicentric retrospective analysis
title_fullStr	Impact of needle positioning on ablation success of irreversible electroporation: a unicentric retrospective analysis
title_full_unstemmed	Impact of needle positioning on ablation success of irreversible electroporation: a unicentric retrospective analysis
title_sort	impact of needle positioning on ablation success of irreversible electroporation: a unicentric retrospective analysis
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/726babb3cbe449219b5b57f093aa6e20
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Impact of needle positioning on ablation success of irreversible electroporation: a unicentric retrospective analysis

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