Abstract
Irreversible electroporation (IRE), otherwise known as non-thermal pulsed field ablation (PFA), is an attractive focal ablation modality due to its ability to destroy aberrant cells with limited disruption of extracellular tissue architecture. Despite its non-thermal cell death mechanism, application of electrical energy results in Joule heating that, if ignored, can cause undesired thermal injury. Engineered thermal mitigation (TM) technologies including phase change materials (PCMs) and active cooling (AC) have been reported and tested in isolated preliminary studies to limit the risk of thermal damage, but their performance compared to one another is relatively unknown. Further, the effects of pulsing paradigm, electrode geometry, PCM composition, and chosen active cooling parameters have not been examined. Here, we develop a computational model of conventional bipolar and monopolar probes with solid, PCM-filled, or actively cooled cores and simulate clinical IRE treatments in pancreatic tissue. We find that probes with integrated PCM cores can be tuned to drastically limit thermal damage compared to traditional solid probes. Actively cooled probes, on the other hand, provide even more control over thermal effects within the probe vicinity and can altogether eliminate thermal damage. In practice, these differences in performance are tempered by the increased time, expense, and effort necessary to use actively cooled probes compared to traditional solid probes or those containing a PCM core.
A Comparative Modeling Study of Thermal Mitigation Strategies in Irreversible Electroporation Treatments
