Systematic Review of the Safety and Efficacy of Irreversible Electroporation
Table 3. Efficacy of Hepatic IRE demonstrates overall primary efficacy ranging from 67-100% across a number of primary and metastatic liver lesions.
This paper reviews a relatively new and unique technique to allow for a potentially curative therapy for patients who previously would not be offered such. This review is limited by the data which the reviewers had available to consolidate. The safety and efficacy profiles seem encouraging based on the available studies. However, there is a significant gap in the quality and quantity of the more traditional RF and microwave ablation data. The theory behind altered cell membrane permeability in the use of ablation has been well studied in the pre-clinical setting, and it does seem to have effectiveness in clinical practice. However, the complication rate is not trivial, and implementing IRE in practice requires careful planning from the operator to the anesthesia team. The fact that this therapy could become a primary curative treatment in some settings for central liver lesions as well as pancreatic lesions is encouraging. Future directions are promising with ten active studies investigating IRE.
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Scheffer HJ, Nielsen K, de Jong, MC, et al. Irreversible Electroporation for Nonthermal Tumor Ablation in the Clinical Setting: A Systematic Review of Safety and Efficacy. J Vasc Interv Radiol. 2014; 25: 997-1011.
Daniel P. Sheeran, MD
Department of Radiology and Medical Imaging
Section of Vascular and Interventional Radiology
University of Virginia