[Irreversible electroporation: a new form of image-guided tumour ablation]

Irreversible electroporation (IRE) is a new, non-thermal image-guided tumour ablation technique. The repeated application of high-voltage electrical pulses causes pores to form in the cell membrane, so that cells lose their homeostatic properties, and die. The advantage of IRE over other local ablation techniques is that IRE selectively destroys cells, whilst the surrounding extracellular matrix structures remain intact. Therefore, the anatomic framework that gives vulnerable structures such as bile ducts, blood vessels, ureters and nerves their shape and strength is preserved during IRE, which allows for safe ablation of tumours near these vulnerable structures. Both in the Netherlands and worldwide, various clinical studies are being run on the safety and efficacy of IRE for centrally located hepatic and pancreatic tumours, which are unsuitable for the current local therapies (surgical resection, irradiation or thermal ablation) due to their anatomic location. Although the long-term results are as yet unknown, the future of IRE appears promising. IRE may prove a valuable tool to add in the multidisciplinary treatment of cancer.