Paulo A Garcia1,2, Bor Kos3, John H Rossmeisl1,4,5, Denis Pavliha3, Damijan Miklavčič3, Rafael V Davalos1. 1. School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Blacksburg, VA, 24061, USA. 2. Laboratory for Energy and Microsystems Innovation, Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02142, USA. 3. Faculty of Electrical Engineering, University of Ljubljana, Trzaska 25, 1000, Ljubljana, Slovenia. 4. Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA, 24060, USA. 5. Veterinary and Comparative Neuro-oncology Laboratory, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA, 24060, USA.
Abstract
PURPOSE: Irreversible electroporation (IRE) has been developed as a promising minimally invasive treatment to ablate spontaneous brain tumors with pulsed electric fields in canine patients. The purpose of the study is to determine the Peleg-Fermi parameters needed to incorporate pulse number and pulse duration into the therapeutic planning of IRE. METHODS: Seven canine patients were treated with IRE for spontaneous malignant glioma with MRI-based treatment planning. The treatment planning method consists of building patient-specific finite element models and using them to compute electric fields used in the IRE treatment. We evaluate the predictive power of tumor coverage with electric field alone vs. cell kill probability using radiographically confirmed clinical outcomes. RESULTS: Results of post-treatment diagnostic imaging, tumor biopsies, and neurological examinations indicated successful tumor ablation without significant direct neurotoxicity in six of the seven dogs. Objective tumor responses were seen in four (80%) of five dogs with quantifiable target lesions according to RANO criteria. Two dogs experienced survivals in excess of 1 yr, including one dog that resulted in complete response to IRE treatment for 5+ years to date. Tumor fraction exposed to electric field over 600 V/cm was between 0.08 and 0.73, while tumor fraction exposed to electric field over 300 V/cm was between 0.17 and 0.95. Probability of cell kill of ≥ 90% was found in tumor volume fractions between 0.21 and 0.99. CONCLUSIONS: We conclude that IRE is a safe and effective minimally invasive treatment for malignant glioma and can be predicted with the Peleg-Fermi cell kill probability function. A tumor coverage of ≥ 0.9 at a cell kill probability ≥ 90% can be used to guide IRE treatments of spontaneous malignant glioma based on the radiographically confirmed clinical outcomes achieved.
PURPOSE: Irreversible electroporation (IRE) has been developed as a promising minimally invasive treatment to ablate spontaneous brain tumors with pulsed electric fields in caninepatients. The purpose of the study is to determine the Peleg-Fermi parameters needed to incorporate pulse number and pulse duration into the therapeutic planning of IRE. METHODS: Seven caninepatients were treated with IRE for spontaneous malignant glioma with MRI-based treatment planning. The treatment planning method consists of building patient-specific finite element models and using them to compute electric fields used in the IRE treatment. We evaluate the predictive power of tumor coverage with electric field alone vs. cell kill probability using radiographically confirmed clinical outcomes. RESULTS: Results of post-treatment diagnostic imaging, tumor biopsies, and neurological examinations indicated successful tumor ablation without significant direct neurotoxicity in six of the seven dogs. Objective tumor responses were seen in four (80%) of five dogs with quantifiable target lesions according to RANO criteria. Two dogs experienced survivals in excess of 1 yr, including one dog that resulted in complete response to IRE treatment for 5+ years to date. Tumor fraction exposed to electric field over 600 V/cm was between 0.08 and 0.73, while tumor fraction exposed to electric field over 300 V/cm was between 0.17 and 0.95. Probability of cell kill of ≥ 90% was found in tumor volume fractions between 0.21 and 0.99. CONCLUSIONS: We conclude that IRE is a safe and effective minimally invasive treatment for malignant glioma and can be predicted with the Peleg-Fermi cell kill probability function. A tumor coverage of ≥ 0.9 at a cell kill probability ≥ 90% can be used to guide IRE treatments of spontaneous malignant glioma based on the radiographically confirmed clinical outcomes achieved.
Authors: Enric Perera-Bel; Carlos Yagüe; Borja Mercadal; Mario Ceresa; Natalie Beitel-White; Rafael V Davalos; Miguel A González Ballester; Antoni Ivorra Journal: Comput Methods Programs Biomed Date: 2020-08-02 Impact factor: 5.428
Authors: Francois H Cornelis; Helena Cindrič; Bor Kos; Masashi Fujimori; Elena N Petre; Damijan Miklavčič; Stephen B Solomon; Govindarajan Srimathveeravalli Journal: Cardiovasc Intervent Radiol Date: 2019-08-05 Impact factor: 2.740
Authors: Melvin F Lorenzo; Sean C Thomas; Yukitaka Kani; Jonathan Hinckley; Matthew Lee; Joy Adler; Scott S Verbridge; Fang-Chi Hsu; John L Robertson; Rafael V Davalos; John H Rossmeisl Journal: Cancers (Basel) Date: 2019-11-23 Impact factor: 6.639
Authors: Helena Cindrič; Bor Kos; Giuseppe Tedesco; Matteo Cadossi; Alessandro Gasbarrini; Damijan Miklavčič Journal: Technol Cancer Res Treat Date: 2018-01-01
Authors: Matevž Pintar; Janez Langus; Ibrahim Edhemović; Erik Brecelj; Matej Kranjc; Gregor Sersa; Tomaž Šuštar; Tomaž Rodič; Damijan Miklavčič; Tadej Kotnik; Bor Kos Journal: Technol Cancer Res Treat Date: 2018-01-01
Authors: Eduardo L Latouche; Christopher B Arena; Jill W Ivey; Paulo A Garcia; Theresa E Pancotto; Noah Pavlisko; Scott S Verbridge; Rafael V Davalos; John H Rossmeisl Journal: Technol Cancer Res Treat Date: 2018-01-01