Treatment of Uveal Melanoma by Nonthermal Irreversible Electroporation: Electrical and Bioheat Finite Element Model of the Human Eye

2012 ◽  
Vol 134 (11) ◽  
Author(s):  
Yossi Mandel ◽  
Boris Rubinsky
Keyword(s):  
Minimally Invasive ◽  
Electric Field ◽  
Uveal Melanoma ◽  
Treatment Efficacy ◽  
Malignant Tumors ◽  
Electric Pulse ◽  
Irreversible Electroporation ◽  
Treatment Protocol ◽  
Invasive Treatment ◽  
Nonthermal Irreversible Electroporation

Nonthermal irreversible electroporation (NTIRE) is an new minimally invasive tissue ablation modality that uses high electric field pulses to produce irreversible permeation of the cell membrane (irreversible electroporation) while avoiding thermal damage and is applied to treat malignant tumors. This paper describes efforts to develop NTIRE as a new minimally invasive treatment modality for uveal melanoma, the most common primary intraocular malignancy in adults, and other ocular malignancies. The paper deals with a 3D mathematical simulation model of the eye that employs the simultaneous solution to the electric field equation and to the Pennes bioheat equation to predict the electric field in the eye as well as the rise in eye temperature in response to the application of a high power electric pulse. Treatment efficacy was defined as the fraction of tumor volume in which the electric field exceeded a predefined target field and treatment safety was calculated by the ratio of the electric field in the tumor to the electric field in the vitreous humor or in the macula. Results show that treatment efficacy and safety are criteria that can be used to optimize the NTIRE treatment protocol.

scholarly journals Facial cellulitis caused by Giant parotid sialolith: a minimally invasive treatment for a rare occurrence

2021 ◽  
Vol 10 (3) ◽  
pp. e58210313754
Author(s):  
Moacyr Tadeu Vicente Rodrigues ◽  
Filipe Ebenezer de Aguiar Schueng ◽  
Bruno Coelho Mendes ◽  
Jose Marcelo Vargas Pinto ◽  
Fabricio Guimaraes de Souza ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Rare Case ◽  
Treatment Protocol ◽  
Common Disease ◽  
Rare Occurrence ◽  
Parotid Glands ◽  
Invasive Treatment ◽  
And Function

Sialolithiasis is a common disease that affects the major salivary glands and can occur at any age. Parotid glands are rarely involved and, even rarer are the cases of sialoliths larger than 10 mm. This report presents the rare case of a giant parotid sialolith associated with facial cellulitis in a 75-year-old man. The treatment involved initially non-surgical approach followed by a minimally invasive surgery to restore health and function. The treatment protocol was completely successful and proved effective in clinical and surgical management of giant parotid sialolith associated with facial cellulitis.

Endovascular Nonthermal Irreversible Electroporation: A Finite Element Analysis

2010 ◽  
Vol 132 (3) ◽  
Author(s):  
Elad Maor ◽  
Boris Rubinsky
Keyword(s):  
Finite Element ◽  
Electric Field ◽  
Electric Fields ◽  
Joule Heating ◽  
Arterial Wall ◽  
Thermal Damage ◽  
Irreversible Electroporation ◽  
Phospholipid Bilayer ◽  
Tissue Ablation ◽  
Nonthermal Irreversible Electroporation

Tissue ablation finds an increasing use in modern medicine. Nonthermal irreversible electroporation (NTIRE) is a biophysical phenomenon and an emerging novel tissue ablation modality, in which electric fields are applied in a pulsed mode to produce nanoscale defects to the cell membrane phospholipid bilayer, in such a way that Joule heating is minimized and thermal damage to other molecules in the treated volume is reduced while the cells die. Here we present a two-dimensional transient finite element model to simulate the electric field and thermal damage to the arterial wall due to an endovascular NTIRE novel device. The electric field was used to calculate the Joule heating effect, and a transient solution of the temperature is presented using the Pennes bioheat equation. This is followed by a kinetic model of the thermal damage based on the Arrhenius formulation and calculation of the Henriques and Moritz thermal damage integral. The analysis shows that the endovascular application of 90, 100 μs pulses with a potential difference of 600 V can induce electric fields of 1000 V/cm and above across the entire arterial wall, which are sufficient for irreversible electroporation. The temperature in the arterial wall reached a maximum of 66.7°C with a pulse frequency of 4 Hz. Thermal damage integral showed that this protocol will thermally damage less than 2% of the molecules around the electrodes. In conclusion, endovascular NTIRE is possible. Our study sets the theoretical basis for further preclinical and clinical trials with endovascular NTIRE.

scholarly journals Industry Perspective: Maximizing the Benefit of Improved Detection with Guided and Monitored Thermal Ablation of Small Tumors

2005 ◽  
Vol 4 (2) ◽  
pp. 123-129 ◽  
Author(s):  
Morgan W. Nields
Keyword(s):  
Minimally Invasive ◽  
Digital Mammography ◽  
Breast Imaging ◽  
Malignant Tumors ◽  
Screening Mammography ◽  
Invasive Treatment ◽  
Monitoring Method ◽  
Continuous Growth ◽  
Screening Programs ◽  
Ablative Techniques

The continuous growth of mammography is driven by global acceptance of the demonstrated ability of screening mammography to reduce mortality from breast cancer. An increasing number of benign and malignant tumors are being diagnosed as a result of the growth in mammography, improvements in technology, especially digital mammography, as well as by an increase in patient surveillance. Breast imaging technology for cancer screening continues to improve, with the integration of ultrasound with digital mammography showing promise that an even larger number of small abnormalities will be detected in screening programs. The results of minimally invasive ablative techniques as tested in pilot clinical studies for breast tumor ablation are reviewed. A new x-ray based thermal monitoring method is described. An improved ability to intraoperatively monitor thermal ablative methods may enable more accurate minimally invasive treatment of an ever increasing number of both benign and malignant breast tumors.

scholarly journals Laser interstitial thermotherapy (LITT) for the treatment of tumors of the brain and spine: a brief review

2021 ◽  
Vol 151 (3) ◽  
pp. 429-442
Author(s):  
Clark Chen ◽  
Ian Lee ◽  
Claudio Tatsui ◽  
Theresa Elder ◽  
Andrew E. Sloan
Keyword(s):  
Brain Tumors ◽  
Minimally Invasive ◽  
Radiation Necrosis ◽  
Spinal Metastasis ◽  
Clinical Approach ◽  
Invasive Treatment ◽  
Primary Indication ◽  
Interstitial Thermotherapy ◽  
The Brain

Abstract Introduction Laser Interstitial Thermotherapy (LITT; also known as Stereotactic Laser Ablation or SLA), is a minimally invasive treatment modality that has recently gained prominence in the treatment of malignant primary and metastatic brain tumors and radiation necrosis and studies for treatment of spinal metastasis has recently been reported. Methods Here we provide a brief literature review of the various contemporary uses for LITT and their reported outcomes. Results Historically, the primary indication for LITT has been for the treatment of recurrent glioblastoma (GBM). However, indications have continued to expand and now include gliomas of different grades, brain metastasis (BM), radiation necrosis (RN), other types of brain tumors as well as spine metastasis. LITT is emerging as a safe, reliable, minimally invasive clinical approach, particularly for deep seated, focal malignant brain tumors and radiation necrosis. The role of LITT for treatment of other types of tumors of the brain and for spine tumors appears to be evolving at a small number of centers. While the technology appears to be safe and increasingly utilized, there have been few prospective clinical trials and most published studies combine different pathologies in the same report. Conclusion Well-designed prospective trials will be required to firmly establish the role of LITT in the treatment of lesions of the brain and spine.

scholarly journals EAU, AUA and NICE Guidelines on Surgical and Minimally Invasive Treatment of Benign Prostate Hyperplasia: A Critical Appraisal of the Guidelines Using the AGREE-II Tool

2021 ◽  
pp. 1-10
Author(s):  
Dmitry Enikeev ◽  
Vincent Misrai ◽  
Enrique Rijo ◽  
Roman Sukhanov ◽  
Denis Chinenov ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Treatment Options ◽  
Stakeholder Involvement ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Agree Ii ◽  
Prostate Hyperplasia ◽  
Assessment Score ◽  
Nice Guideline ◽  
Agree Ii Tool

<b><i>Objective:</i></b> To critically appraise the methodological rigour of the clinical practice guidelines (CPGs) vis-à-vis BPH surgery as used by specialist research associations in the US, Europe and UK, and to compare whether the guidelines cover all or only some of the available treatments. <b><i>Methods:</i></b> The current guidelines issued by the EUA, AUA and NICE associations have been analyzed by 4 appraisers using the AGREE-II instrument. We also compared the recommendations given in the guidelines for surgical and minimally invasive treatment to find out which of these CPGs include most of the available treatment options. <b><i>Results:</i></b> According to the AGREE II tool, the median scores of domains were: domain 1 scope and purpose 66.7%, domain 2 stakeholder involvement 50.0%, domain 3 rigor of development 65.1%, domain 4 clarity of presentation 80.6%, domain 5 applicability 33.3%, domain 6 editorial independence 72.9%. The overall assessment according to AGREE II is 83.3%. The NICE guideline scored highest on 5 out of 6 domains and the highest overall assessment score (91.6%). The EAU guideline scored lowest on 4 out of 6 domains and has the lowest overall assessment score (79.1%). <b><i>Conclusions:</i></b> The analyzed CPGs comprehensively highlight the minimally invasive and surgical treatment options for BPH. According to the AGREE II tool, the domains for clarity of presentation and editorial independence received the highest scores. The stakeholder involvement and applicability domains were ranked as the lowest. Improving the CPG in these domains may help to improve the clinical utility and applicability of CPGs.

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