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An “Off-the-Shelf” System for Intraprocedural Electrical Current Evaluation and Monitoring of Irreversible Electroporation Therapy

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Abstract

Introduction

Irreversible electroporation (IRE) ablation uses a series of brief electric pulses to create nanoscale defects in cell membranes, killing the cells. It has shown promise in numerous soft-tissue tumor applications. Larger voltages between electrodes will increase ablation volume, but exceeding electrical limits may risk damage to the patient, cause ineffective therapy delivery, or require generator restart. Monitoring electrical current for these conditions in real-time enables managing these risks. This capacity is not presently available in clinical IRE generators.

Methods

We describe a system using a Tektronix TCP305 AC/DC Current Probe connected to a TCPA300 AC/DC Current Probe Amplifier, which is read on a computer using a Protek DSO-2090 USB computer-interfacing oscilloscope. Accuracy of the system was tested with a resistor circuit and by comparing measured currents with final outputs from the NanoKnife clinical electroporation pulse generator.

Results

Accuracy of measured currents was 1.64 ± 2.4 % relative to calculations for the resistor circuit and averaged 0.371 ± 0.977 % deviation from the NanoKnife. During clinical pulse delivery, the system offers real-time evaluation of IRE procedure progress and enables a number of methods for identifying approaching issues from electrical behavior of therapy delivery, facilitating protocol changes before encountering therapy delivery issues.

Conclusions

This system can monitor electrical currents in real-time without altering the electric pulses or modifying the pulse generator. This facilitates delivering electric pulse protocols that remain within the optimal range of electrical currents—sufficient strength for clinically relevant ablation volumes, without the risk of exceeding safe electric currents or causing inadequate ablation.

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Acknowledgments

The authors thank Christopher Arena for assistance with system design. This work funded by the Flack Trustees and The Alfred Foundation.

Conflict of interest

Robert Neal holds pending patents in the field of irreversible electroporation, including royalty payments from AngioDynamics, Inc. and has previously served an advisory role for AngioDynamics, Inc. Helen Kavnoudias and Kenneth Thomson received donated research materials for unrelated IRE studies.

Statement of Informed Consent

Informed consent for the IRE tumor ablation study was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Radiology Research Unit, Department of Radiology, The Alfred Hospital, 1st Floor Philip Block, 55 Commercial Road, Melbourne, VIC, 3004, Australia

    Robert E. Neal II, Helen Kavnoudias & Kenneth R. Thomson

Authors
  1. Robert E. Neal II
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  2. Helen Kavnoudias
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  3. Kenneth R. Thomson
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Corresponding author

Correspondence to Robert E. Neal II.

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Neal, R.E., Kavnoudias, H. & Thomson, K.R. An “Off-the-Shelf” System for Intraprocedural Electrical Current Evaluation and Monitoring of Irreversible Electroporation Therapy. Cardiovasc Intervent Radiol 38, 736–741 (2015). https://doi.org/10.1007/s00270-014-0961-7

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  • DOI: https://doi.org/10.1007/s00270-014-0961-7

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