Evaluation of thermal injury to liver, pancreas and kidney during irreversible electroporation in an in vivo experimental model. BJS 2014; 101: 1113-1121.

Conclusion

IRE can generate thermal energy, and even thermal injury, based on tissue type, probe exposure lengths, pulse lengths and proximity to metal. Awareness of probe placement regarding proximity to critical structures as well as probe exposure length and pulse length are necessary to ensure safety and prevent thermal injury. A probe exposure of 2·5 cm or less for liver IRE, and 1·5 cm or less for pancreas, with maximum pulse length of 90 µs will result in safe and non‐thermal energy delivery with spacing of 1·5–2·3 cm between probe pairs.

In this experimental investigation, irreversible electroporation (IRE) is studied in a porcine model to establish set device and probe guidelines, so that any type of thermal damage can be avoided. This IRE device is currently in use in the treatment of locally advanced soft tissue tumours, and the issue of potential thermal damage is therefore of clinical interest. This is further underlined by the fact that there is an underestimation among some IRE end‐users that IRE energy delivery is non‐thermal regardless of the circumstances. It is shown here that IRE can generate thermal energy, and even thermal injury, based on tissue type, probe exposure lengths, pulse lengths and proximity to metal (clips and stents).

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