Dong Jin Chung1, Kyunghyun Sung2, Ferdnand C Osuagwu2, Holden H Wu2, Charles Lassman2, David S K Lu3. 1. Departments of Radiological Sciences and Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095; Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 2. Departments of Radiological Sciences and Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095. 3. Departments of Radiological Sciences and Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095. Electronic address: DLu@mednet.ucla.edu.
Abstract
PURPOSE: To analyze ablated tissue zones after irreversible electroporation (IRE) of porcine liver using computed tomography (CT) perfusion imaging with histopathologic correlation. MATERIALS AND METHODS: Under ultrasound and CT guidance, 10 IRE ablations were performed percutaneously in three Yorkshire pigs using a single bipolar electrode. CT perfusion imaging was performed in all pigs immediately after ablation and on day 2. Pathologic sections were prepared for correlation with histopathology (hematoxylin-eosin and terminal deoxynucleotidyl transferase dUTP nick end labeling stains, 5-mm-thick slices). The short diameter of different enhancing zones on CT was correlated with the gross specimen. RESULTS: CT perfusion images showed three differently enhancing zones: zone 1, inner nonenhancing zone; zone 2, middle well-defined progressive internal enhancement zone; and zone 3, outer ill-defined arterial enhancement zone with rapid washout. On histopathology, zone 1 showed a strong correlation with a pale zone, and zone 2 correlated with a red zone, together accounting for the extent of cell death. Zone 3 was outside of the ablation zone and contained inflammatory cells. Each enhancing zone had different perfusion parameters. CONCLUSIONS: CT perfusion imaging in the acute setting effectively demonstrates histopathologic tissue zones after IRE ablation. Zone 2 is unique to IRE not seen in thermal ablation, characterized by progressive intra-zonal enhancement, and its outer boundary defines the extent of cell death.
PURPOSE: To analyze ablated tissue zones after irreversible electroporation (IRE) of porcine liver using computed tomography (CT) perfusion imaging with histopathologic correlation. MATERIALS AND METHODS: Under ultrasound and CT guidance, 10 IRE ablations were performed percutaneously in three Yorkshire pigs using a single bipolar electrode. CT perfusion imaging was performed in all pigs immediately after ablation and on day 2. Pathologic sections were prepared for correlation with histopathology (hematoxylin-eosin and terminal deoxynucleotidyl transferase dUTP nick end labeling stains, 5-mm-thick slices). The short diameter of different enhancing zones on CT was correlated with the gross specimen. RESULTS: CT perfusion images showed three differently enhancing zones: zone 1, inner nonenhancing zone; zone 2, middle well-defined progressive internal enhancement zone; and zone 3, outer ill-defined arterial enhancement zone with rapid washout. On histopathology, zone 1 showed a strong correlation with a pale zone, and zone 2 correlated with a red zone, together accounting for the extent of cell death. Zone 3 was outside of the ablation zone and contained inflammatory cells. Each enhancing zone had different perfusion parameters. CONCLUSIONS: CT perfusion imaging in the acute setting effectively demonstrates histopathologic tissue zones after IRE ablation. Zone 2 is unique to IRE not seen in thermal ablation, characterized by progressive intra-zonal enhancement, and its outer boundary defines the extent of cell death.
Authors: Jan Zmuc; Gorana Gasljevic; Gregor Sersa; Ibrahim Edhemovic; Nina Boc; Alenka Seliskar; Tanja Plavec; Maja Brloznik; Nina Milevoj; Erik Brecelj; Bor Kos; Jani Izlakar; Tomaz Jarm; Marko Snoj; Marina Stukelj; Damijan Miklavcic; Maja Cemazar Journal: Sci Rep Date: 2019-03-06 Impact factor: 4.379
Authors: Maja Brloznik; Nina Boc; Gregor Sersa; Jan Zmuc; Gorana Gasljevic; Alenka Seliskar; Rok Dezman; Ibrahim Edhemovic; Nina Milevoj; Tanja Plavec; Vladimira Erjavec; Darja Pavlin; Masa Bosnjak; Erik Brecelj; Ursa Lampreht Tratar; Bor Kos; Jani Izlakar; Marina Stukelj; Damijan Miklavcic; Maja Cemazar Journal: Radiol Oncol Date: 2019-10-10 Impact factor: 2.991