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Percutaneous image guided electrochemotherapy of hepatocellular carcinoma: technological advancement

Mihajlo Djokic
Mihajlo Djokic
, 
Rok Dezman
Rok Dezman
, 
Maja Cemazar
Maja Cemazar
, 
Miha Stabuc
Miha Stabuc
, 
Miha Petric
Miha Petric
, 
Lojze M. Smid
Lojze M. Smid
, 
Rado Jansa
Rado Jansa
, 
Bostjan Plesnik
Bostjan Plesnik
, 
Masa Bosnjak
Masa Bosnjak
, 
Ursa Lampreht Tratar
Ursa Lampreht Tratar
, 
Blaz Trotovsek
Blaz Trotovsek
, 
Bor Kos
Bor Kos
, 
Damijan Miklavcic
Damijan Miklavcic
, 
Gregor Sersa
Gregor Sersa
 and 
Peter Popovic
Peter Popovic
   | Jun 20, 2020
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Article Category: Research Article
Published Online: Jun 20, 2020
Page range: 347 - 352
Received: May 14, 2020
Accepted: Jun 01, 2020
DOI: https://doi.org/10.2478/raon-2020-0038
© 2020 Mihajlo Djokic, Rok Dezman, Maja Cemazar, Miha Stabuc, Miha Petric, Lojze M. Smid, Rado Jansa, Bostjan Plesnik, Masa Bosnjak, Ursa Lampreht Tratar, Blaz Trotovsek, Bor Kos, Damijan Miklavcic, Gregor Sersa, Peter Popovic, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

A 66- year-old male with hepatocellular carcinoma (HCC). Control CT after drug-eluting bead doxorubicin transarterial chemoembolization (DEBDOX TACE) and microwave ablation (MWA) shows non-target progression in segment III, 18 mm the largest diameter. (A) Hypervascular lesion in arterial phase. (B) Washout in venous phase.
A 66- year-old male with hepatocellular carcinoma (HCC). Control CT after drug-eluting bead doxorubicin transarterial chemoembolization (DEBDOX TACE) and microwave ablation (MWA) shows non-target progression in segment III, 18 mm the largest diameter. (A) Hypervascular lesion in arterial phase. (B) Washout in venous phase.

Figure 2

A 66- year-old male with hepatocellular carcinoma (HCC). Cone-beam computed tomography (CBCT) demonstrating HCC before the treatment (A). Position of the electrodes in relation to tumor on CBCT. (B, C) The absence of the contrast enhancement of the ablated tumor was notable 4 minutes after the electrochemotherapy (D).
A 66- year-old male with hepatocellular carcinoma (HCC). Cone-beam computed tomography (CBCT) demonstrating HCC before the treatment (A). Position of the electrodes in relation to tumor on CBCT. (B, C) The absence of the contrast enhancement of the ablated tumor was notable 4 minutes after the electrochemotherapy (D).

Figure 3

Numerical visualization of electric field for successful electrochemotherapy. (A) Reconstruction of actual treatment based on cone-beam computed tomography (CBCT) images. (B) 3 electrode treatment plan based on pre-treatment CECT. (C) 2 electrode treatment plan based on pre-treatment CBCT. (D) Electric field histogram showing the volume fraction of tumor tissue covered by electric fields of at least the strength indicated on the horizontal axis for all three treatments shown in panels A-C.
Numerical visualization of electric field for successful electrochemotherapy. (A) Reconstruction of actual treatment based on cone-beam computed tomography (CBCT) images. (B) 3 electrode treatment plan based on pre-treatment CECT. (C) 2 electrode treatment plan based on pre-treatment CBCT. (D) Electric field histogram showing the volume fraction of tumor tissue covered by electric fields of at least the strength indicated on the horizontal axis for all three treatments shown in panels A-C.

Figure 4

A 66- year-old male with hepatocellular carcinoma (HCC). Control MRI of liver 2 months (A) and 6 months (B) after procedure showing an unenhancing area of ablation – a complete response according to mRECIST criteria.
A 66- year-old male with hepatocellular carcinoma (HCC). Control MRI of liver 2 months (A) and 6 months (B) after procedure showing an unenhancing area of ablation – a complete response according to mRECIST criteria.

VOLTAGES and currents delivered in the treatment

Electrode pairVoltage [V]Current [A]
23280038.0
41280036.5
13230034.5
12200029.4
34180027.7
24180026.5
eISSN:
1581-3207
Language:
English
Publication timeframe:
4 times per year
Journal Subjects:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
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