The optimization of needle electrode number and placement for irreversible electroporation of hepatocellular carcinoma

BACKGROUND: Irreversible electroporation (IRE) is a novel ablation tool that uses brief high-voltage pulses to treat cancer. The efficacy of the therapy depends upon the distribution of the electric field, which in turn depends upon the configuration of electrodes used. METHODS: We sought to optimize the electrode configuration in terms of the distance between electrodes, the depth of electrode insertion, and the number of electrodes. We employed a 3D Finite Element Model and systematically varied the distance between the electrodes and the depth of electrode insertion, monitoring the lowest voltage sufficient to ablate the tumor, V(IRE). We also measured the amount of normal (non-cancerous) tissue ablated. Measurements were performed for two electrodes, three electrodes, and four electrodes. The optimal electrode configuration was determined to be the one with the lowest V(IRE), as that minimized damage to normal tissue. RESULTS: The optimal electrode configuration to ablate a 2.5 cm spheroidal tumor used two electrodes with a distance of 2 cm between the electrodes and a depth of insertion of 1 cm below the halfway point in the spherical tumor, as measured from the bottom of the electrode. This produced a V(IRE) of 3700 V. We found that it was generally best to have a small distance between the electrodes and for the center of the electrodes to be inserted at a depth equal to or deeper than the center of the tumor. We also found the distance between electrodes was far more important in influencing the outcome measures when compared with the depth of electrode insertion. CONCLUSIONS: Overall, the distribution of electric field is highly dependent upon the electrode configuration, but the optimal configuration can be determined using numerical modeling. Our findings can help guide the clinical application of IRE as well as the selection of the best optimization algorithm to use in finding the optimal electrode configuration.