Electroporation

Nonthermal irreversible electroporation (NTIRE) is a minimally invasive tissue ablation modality in which high field strength, nanosecond to millisecond long pulsed electric fields are delivered across the cell to produce nanoscale defects in the cell mem

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Electroporation Mohammad Hjouj and Boris Rubinsky

Abstract

Nonthermal irreversible electroporation (NTIRE) is a minimally invasive tissue ablation modality in which high field strength, nanosecond to millisecond long pulsed electric fields are delivered across the cell to produce nanoscale defects in the cell membrane and thereby induce cell death. An important attribute of this technique is its ability to ablate cells in volumes of tissues while leaving intact the extracellular scaffold, including the mechanical scaffold of blood vessels and ducts. This is a review of the technology with a special emphasis on medical imaging. The review contains a background on the technology, mathematical modeling for treatment planning, fundamental findings from animal studies, first clinical results, and aspects of medical imaging.

Introduction Electroporation is an electric field-induced biophysical phenomenon in which the cell membrane permeability to transmembrane molecular transport is increased by exposing the cell to short nanosecond to millisecond scale and high field, kV/cm scale, electric pulses [1, 2]. Such increase

M. Hjouj (*) School of Computer Science and Engineering, Hebrew University of Jerusalem, Jerusalem, Israel Department of Medical Imaging, Al–Quds University, Abu–Dis, Palestine e-mail: [email protected] B. Rubinsky Department of Mechanical Engineering, University of California at Berkeley, Berkeley, CA, USA e-mail: [email protected]; [email protected]

in permeability [3] is, presumably [4], related to the formation of nanoscale defects or pores in the cell membrane, from which the term electro“poration” [5] stems. For certain electric pulses, membrane permeabilization is permanent, and the process leads to cell lysis. It is in this sense of permanent permeabilization that most authors define irreversible electroporation (IRE). However, it must be noted that temporary permeabilization can also cause a severe disruption of the cell homeostasis which can finally result in cell death, either necrotic or apoptotic. Therefore, in a broader sense, IRE could be defined as the permanent or temporal membrane electroporation process that causes cells to die. The phenomenon of irreversible electroporation – cell death due to the applications of short electric pulses – has been recognized, in various forms, for centuries and until

D.E. Dupuy et al. (eds.), Image-Guided Cancer Therapy, DOI 10.1007/978-1-4419-0751-6_4, # Springer Science+Business Media New York 2013

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recently used primarily in the food industry [6]. The biophysical phenomenon referred in medical applications as “irreversible electroporation” is known in food technology as pulsed electric field processing or electroplasmolysis, in reference to the lysis of cell membranes in tissue, for extracting their contents, or the bactericidal effect in treatment of fluids [7]. The “pulsed electrical field” concept is broader than just irreversible electroporation. It has been recently shown to include also the effects of nanoscale pulses on