Cycled pulsing to mitigate thermal damage for multi-electrode irreversible electroporation therapy

Area of Science:

• Biomedical Engineering
• Electroporation Techniques
• Medical Device Technology

Background:

• Irreversible electroporation (IRE) is an ablation modality utilizing electric pulses to induce cell death.
• Optimizing IRE pulsing parameters is crucial for maximizing therapeutic efficacy while minimizing collateral thermal damage.
• Current research lacks comprehensive evaluation of cycled pulsing schemes versus conventional methods in liver models.

Purpose of the Study:

• To evaluate the impact of various irreversible electroporation (IRE) pulsing paradigms on lesion characteristics, electric current, and temperature changes.
• To compare cycled pulsing schemes with conventional pulsing using a perfused porcine liver model.
• To analyze the effects of cycled pulsing on temperature and thermal injury distribution via finite element modeling.

Main Methods:

• Utilized a 4-monopolar electrode array to deliver IRE therapy to six perfused porcine livers.
• Investigated six cycled pulsing schemes and a conventional pulsing scheme, varying pulse length and inter-pulse delay.
• Employed finite element models to simulate and analyze temperature and thermal injury distributions.

Main Results:

• The 'single pulse cycle with no interpulse delay' scheme deposited the highest energy and resulted in the largest ratio of thermal damage to IRE ablation area.
• The '5 pulse cycle, 0s delay' paradigm yielded the largest average IRE ablation cross-sectional area compared to the conventional method.
• Finite element modeling showed the '10 pulse cycle, 10s delay' generated the least thermal damage, while the '1 pulse cycle, 0s delay' produced the most.

Conclusions:

• Subdividing IRE pulses and incorporating delays can effectively reduce unintended tissue coagulation and electric current.
• Optimized cycled pulsing schemes can maintain IRE treatment sizes while enhancing safety profiles.
• This study provides valuable insights into refining IRE protocols for improved clinical outcomes in liver ablation.