Longitudinal Radiological Remodeling after Irreversible Electroporation Versus Radiofrequency Ablation: A Prospective...

Area of Science:

• Hepatology
• Oncology
• Radiology

Background:

• Liver tumors pose significant treatment challenges.
• Minimally invasive ablation techniques like irreversible electroporation (IRE) and radiofrequency ablation (RFA) are crucial for managing liver tumors.
• Understanding the post-ablation healing process is vital for assessing treatment effectiveness and patient outcomes.

Purpose of the Study:

• To compare the short- to intermediate-term radiological evolution of ablation zones created by IRE and RFA in liver tumors using contrast-enhanced MRI.
• To assess and compare clinically relevant outcomes, including local recurrence-free survival and safety, between IRE and RFA.
• To explore potential immune system changes associated with these ablation modalities.

Main Methods:

• Prospective evaluation of 35 ablation zones in 24 patients within the LIRA Study.
• Serial contrast-enhanced MRI at baseline (day 7), 1 month, and 3 months post-ablation.
• Quantitative analysis of ablation zone geometry and comparison of local recurrence-free survival, disease control, and safety between IRE and RFA groups.

Main Results:

• Distinct ablation zone remodeling patterns were observed between IRE and RFA, with IRE showing smaller normalized volumes and greater surface area-to-volume ratio changes at 3 months.
• Treatment efficacy was comparable between the two groups.
• Procedure-related complications were more frequent with IRE (45%) compared to RFA (0%), and time-dependent immune fluctuations were noted after IRE.

Conclusions:

• Irreversible electroporation (IRE) demonstrates more significant longitudinal radiological evolution of the ablation zone compared to radiofrequency ablation (RFA).
• Despite differences in radiological changes and complication rates, IRE and RFA offer comparable clinical outcomes for liver tumors.
• Exploratory analysis suggests time-dependent immune fluctuations following IRE ablation.