Irreversible Electroporation Enhanced by Radiofrequency Ablation: An In Vitro and Computational Study in a 3D Liver Tumor Model.

In the present study, we used a computational and experimental study in a 3D liver tumor model (LTM) to explore the tumor ablation enhancement of irreversible electroporation (IRE) by pre-heating with radiofrequency ablation (RFA) and elucidate the mechanism whereby this enhancement occurs. Three ablation protocols, including IRE alone, RFA45 → IRE (with the pre-heating temperature of 45 °C), and RFA60 → IRE (with the pre-heating temperature of 60 °C) were investigated. Both the thermal conductivity and electrical conductivity of the 3D LTM were characterized with the change in the pre-heating temperature. The results showed, compared to IRE alone, a significant increase in the tumor ablation volume (19.59 [Formula: see text] 0.61 vs. 15.29 ± 0.61 mm3, p = 0.002 and 22.87 [Formula: see text] 0.35 vs. 15.29 ± 0.61 mm3, p < 0.001) was observed with both RFA45 → IRE and RFA60 → IRE, leading to a decrease in lethal electric filed strength (8 and 17%, correspondingly). The mechanism can be attributed to the change of cell microenvironment by pre-heating and/or a synergistic effect of RFA and IRE. The proposed enhancing method might contribute to the improvement of interventional oncology in the treatment of large tumors close to critical organs (e.g., large blood vessels and bile ducts).