This book provides a comprehensive overview of the clinical use of irreversible electroporation (IRE) – better known by its commercial name, NanoKnife – which is one of the most exciting new needle-guided cancer treatments. The coverage includes the history of IRE, general technique, preclinical research, applications in clinical practice and early clinical results, and future perspectives. Contraindications, treatment planning, potential complications, follow-up imaging, and other practical aspects are fully discussed, with highlighting of useful tips and tricks.
Through the delivery of short but highly intense electrical pulses, IRE results in tumor cell membrane permeabilization, causing cells to go into apoptosis. The minimally invasive nature of IRE, combined with the prospect of completely eradicating tumors while preserving delicate structures in the ablation zone, makes IRE the object of worldwide clinical research. This book will be of value for practitioners and trainees in interventional and diagnostic radiology, surgery, medical oncology, HPB and gastroenterology, urology, and radiation oncology.
Introduction: History of image-guided tumor ablation.- History of electroporation. Preclinical Research: Multi-scale biophysical principles in clinical irreversible electroporation.- Numerical modelling for prediction and evaluation of treatment outcome.- The effect of irreversible electroporation on blood vessels, bile ducts, urinary tract, intestines and nerves. Technique, tips and tricks: Anaesthetic management during irreversible electroporation procedure.- Complications and procedures to enhance safety.- Treatment planning, needle insertion, image-guidance, endpoint Assessment.- Thermal effects of irreversible electroporation.- Clinical practice: Irreversible electroporation of liver tumors .- Irreversible electroporation of pancreatic tumors.- Irreversible electroporation for perihilar cholangiocarcinoma (Klatskin tumors).- Irreversible electroporation of kidney tumors.- Irreversible Electroporation of Prostate Tumors.- Irreversible electroporation of tumors within the pelvic cavity.- Irreversible Electroporation of Lung Tumors.- Future prospectives: From local to systemic treatment: leveraging antitumor immunity following irreversible electroporation.- Future perspectives of IRE.
Martijn Meijerink, MD, PhD is an interventional radiologist with interventional oncology as special field of expertise at the VU University Medical Center (VUmc) in Amsterdam, affiliated with the Cancer Center Amsterdam (CCA) which houses one of the largest academic oncology centers in Europe. He is a renowned expert in the field of interventional oncology procedures, such as radiofrequency ablation, microwave ablation, irreversible electroporation (nanoknife), transarterial bland embolization, chemo- and Y90 radioembolization. As chief of the research center for image-guided tumor ablation in Amsterdam he is continuously searching for ways to improve survival and quality of life of patients with cancer.
Hester Scheffer, MD is a senior-researcher at the VU University Medical Center in Amsterdam and one of the key opinion leaders in the field of irreversible electroporation research. Having conducted extensive translational research she was the first to prove actual cell death in the clinical setting caused by irreversible electroporation. In the preclinical setting, she focuses on electrical field modeling and the thermal component of irreversible electroporation, whereas in the clinical setting she coordinates several large trials on the efficacy of hepatic and pancreatic irreversible electroporation and she is the author of the only issued systematic review on irreversible electroporation. Together with Dr. Meijerink she is the founder of a worldwide network for irreversible electroporation research in the field of interventional oncology.
This book provides a comprehensive overview of the clinical use of irreversible electroporation (IRE) – better known by its commercial name, NanoKnife – which is one of the most exciting new needle-guided cancer treatments. The coverage includes the history of IRE, general technique, preclinical research, applications in clinical practice and early clinical results, and future perspectives. Contraindications, treatment planning, potential complications, follow-up imaging, and other practical aspects are fully discussed, with highlighting of useful tips and tricks.
Through the delivery of short but highly intense electrical pulses, IRE results in tumor cell membrane permeabilization, causing cells to go into apoptosis. The minimally invasive nature of IRE, combined with the prospect of completely eradicating tumors while preserving delicate structures in the ablation zone, makes IRE the object of worldwide clinical research. This book will be of value for practitioners and trainees in interventional and diagnostic radiology, surgery, medical oncology, HPB and gastroenterology, urology, and radiation oncology.
Describes the clinical applications of irreversible electroporation/NanoKnife and early clinical results
Discusses preclinical research and outcomes
Offers full coverage of practical aspects, with highlighting of useful tips and tricks
