High-frequency irreversible electroporation for gliomas: A feasibility study using patient-specific finite element models.

Background: High-frequency irreversible electroporation (H-FIRE) has gradually become an attractive alternative treatment of intracranial tumors due to its clinically favorable characteristics, such as mild muscle contractions, precise ablation margins, and preservation of vessel structures. Encouraging results have been obtained in pre-clinical trials with animal models. However, a more comprehensive understanding of spatiotemporal distributions of electric field and temperature in clinically relevant intracranial tissue during the treatment of H-FIRE is still required prior to its clinical implementation.

Purpose: In this study, we performed the first attempt to numerically investigate the electric field and temperature distributions for the conformal ablation of intracranial tumors in patient-specific glioma tumor models.

Methods: Four representative 3D patient-specific glioma models were constructed based on T1-weighted MR images of four clinical patients. The treatment protocols of H-FIRE were optimized for the conformal ablation of these glioma patients by using a multi-objective optimization genetic algorithm. To alleviate the temperature increase during the H-FIRE administration, a new ablation procedure was designed and tested numerically.

Results: The results achieved in this study demonstrated that the conformal ablation of gliomas with differing sizes and shapes can be achieved by optimizing the number of electrodes, applied pulse voltage, active tip length, electrode gap, and electrode insertion depth. The temperature increases due to the administration of H-FIRE pulses can be effectively alleviated by introducing a pulse-off time between two ablation procedures.

Conclusion: This study contributes to the field of H-FIRE in the treatment of intracranial tumors and promotes its clinical implementation.