Intra-arterial Injection of Lidocaine as a Cell Sensitizer during Irreversible Electroporation |
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Affiliation: | 1. Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, 69120 Heidelberg, Germany;2. Department of Neuroradiology, University Hospital Heidelberg, INF 110, 69120 Heidelberg, Germany;3. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Sheng, China;4. Department of General Pathology, University Hospital Mainz, Mainz, Germany;5. Clinic for Radiology, Minimally-invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Heilbronn, Germany;6. Clinic for Diagnostic and Interventional Radiology, Klinikum Stuttgart, Stuttgart, Germany;1. Department of Medical Imaging, Division of Interventional Radiology, Western University, 1151 Richmond St, London, ON, Canada, N6A 5A5;2. Lawson Health Research Institute, London, Ontario, Canada;1. Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, 510 South Kingshighway Boulevard, CB 8131, St. Louis, MO 63139;2. Department of Biostatistics, Washington University in St. Louis, St. Louis, Missouri;1. Image Guided Therapy, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada;2. Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada;3. Pediatric Interventional Radiology, Department of Diagnostic Imaging, Pediatric Interventional Radiology, University Children’s Hospital Zurich, Switzerland;1. Duke University School of Medicine, Durham, North Carolina 27710;2. Vascular and Interventional Specialists, Charlotte Radiology, Charlotte, North Carolina;3. Department of Radiology, Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland;4. Department of Radiology, Division of Interventional Radiology, Duke University Medical Center, 2301 Erwin Road, Box 3808, Durham, NC;1. Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China;2. Department of Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China;3. Department of Pathology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China;4. Academy of Military Medical Sciences, Institute of Pharmacology and Toxicology, Beijing, P.R. China;5. Department of Urology Surgery, Second Hospital of Beijing Municipality, Beijing, P.R. China;1. Department of Radiology, University Hospitals of Geneva, Geneva, Switzerland;2. Hepato- Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland |
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Abstract: | PurposeTo investigate whether intra-arterial injection of lidocaine enhances irreversible electroporation (IRE) in a liver model.Materials and MethodsConventional IRE (C-IRE) and lidocaine-enhanced IRE (L-IRE) were performed in 8 pig livers. Protocol 1 (tip exposure and electrode distance of 2.0 cm each) and protocol 2 (increased tip exposure and electrode distance 2.5 cm each) were used. Animals were sacrificed 3 hours after IRE. Study goals included electrical tissue properties (eg, current, conductivity) during IRE, geometry of IRE zones analyzed using computed tomography and magnetic resonance imaging (eg, volume and sphericity index), degree of acute liver damage, and irreversible cell death analyzed using microscopy (hematoxylin and eosin staining and terminal deoxynucleotidyl transferase deoxyuridine 5-triphosphate nick end labeling). Statistical comparisons were performed using the paired t test and Wilcoxon test.ResultsAll treatments were performed without adverse events. Electrical tissue properties were not significantly different between C-IRE and L-IRE. For protocol 1, the diameter of the largest sphere within the IRE zone was significantly larger for L-IRE than for C-IRE (25.0 ± 4.7 mm vs 18.4 ± 3.1 mm [P = .013]). For protocol 2, the volume of IRE zone was significantly larger for L-IRE compared with C-IRE (46.0 ± 5.4 cm3 vs 22.6 ± 6.4 cm3 [P = .018]), as well as the diameter of the largest sphere within the IRE zone (27.1 ± 2.2 mm vs 19.8 ± 2.3 mm [P = .020]). For protocol 1, a significantly higher degree of irreversible cell death was noted for L-IRE than for C-IRE (1.8 ± 1.0 vs 0.8 ± 1.0 [P = .046]).ConclusionsIntra-arterial injection of lidocaine can enhance IRE in terms of larger IRE zones and an increase of irreversible cell death. |
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Keywords: | C-IRE" },{" #name" :" keyword" ," $" :{" id" :" kwrd0015" }," $$" :[{" #name" :" text" ," _" :" conventional irreversible electroporation HE" },{" #name" :" keyword" ," $" :{" id" :" kwrd0025" }," $$" :[{" #name" :" text" ," _" :" hematoxylin and eosin IRE" },{" #name" :" keyword" ," $" :{" id" :" kwrd0035" }," $$" :[{" #name" :" text" ," _" :" irreversible electroporation L-IRE" },{" #name" :" keyword" ," $" :{" id" :" kwrd0045" }," $$" :[{" #name" :" text" ," _" :" lidocaine-enhanced irreversible electroporation TUNEL" },{" #name" :" keyword" ," $" :{" id" :" kwrd0055" }," $$" :[{" #name" :" text" ," _" :" terminal deoxynucleotidyl transferase deoxyuridine 5-triphosphate nick end labeling |
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