Lv Y, Zhang Y, Huang J, Wang Y, Rubinsky B. A Study on Nonthermal Irreversible Electroporation of the Thyroid.
Technol Cancer Res Treat 2020;
18:1533033819876307. [PMID:
31564220 PMCID:
PMC6767733 DOI:
10.1177/1533033819876307]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background:
Nonthermal irreversible electroporation is a minimally invasive surgery technology that
employs high and brief electric fields to ablate undesirable tissues. Nonthermal
irreversible electroporation can ablate only cells while preserving intact functional
properties of the extracellular structures. Therefore, nonthermal irreversible
electroporation can be used to ablate tissues safely near large blood vessels, the
esophagus, or nerves. This suggests that it could be used for thyroid ablation abutting
the esophagus. This study examines the feasibility of using nonthermal irreversible
electroporation for thyroid ablation.
Methods:
Rats were used to evaluate the effects of nonthermal irreversible electroporation on
the thyroid. The procedure entails the delivery of high electric field pulses (1-3
kV/cm, 100 microseconds) between 2 surface electrodes bracing the thyroid. The right
lobe was treated with various nonthermal irreversible electroporation pulse sequences,
and the left was the control. After 24 hours of the nonthermal irreversible
electroporation treatment, the thyroid was examined with hemotoxylin and eosin
histological analysis. Mathematical models of electric fields and the Joule
heating-induced temperature raise in the thyroid were developed to examine the
experimental results.
Results:
Treatment with nonthermal irreversible electroporation leads to follicular cells
damage, associated with cell swelling, inflammatory cell infiltration, and cell
ablation. Nonthermal irreversible electroporation spares the trachea structure.
Unusually high electric fields, for these types of tissue, 3000 V/cm, are needed for
thyroid ablation. The mathematical model suggests that this may be related to the
heterogeneous structure of the thyroid-induced distortion of local electric fields.
Moreover, most of the tissue does not experience thermal damage inducing temperature
elevation. However, the heterogeneous structure of the thyroid may cause local hot spots
with the potential for local thermal damage.
Conclusion:
Nonthermal irreversible electroporation with 3000 V/cm can be used for thyroid
ablation. Possible applications are treatment of hyperthyroidism and thyroid cancer. The
highly heterogeneous structure of the thyroid distorts the electric fields and
temperature distribution in the thyroid must be considered when designing treatment
protocols for this tissue type.
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