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Integrated Nanosecond Pulse Irreversible Electroporation (INSPIRE): Impact of Exposed Electrode Length on Ablation Geometry in an In Vivo Liver Model

Title: Integrated Nanosecond Pulse Irreversible Electroporation (INSPIRE): Impact of Exposed Electrode Length on Ablation Geometry in an In Vivo Liver Model
Authors: Jordan A. Fong; Logan Reeg; Jewels Darrow; Robert H. Williamson; Anna Riordan; Alexia K. Cash; Max Beecroft; Callie A. Fogle; Kyle G. Mathews; Nathan C. Nelson; Alina C. Iuga; David A. Gerber; Michael B. Sano
Source: Cancers ; Volume 17 ; Issue 17 ; Pages: 2891
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2025
Collection: MDPI Open Access Publishing
Subject Terms: INSPIRE; IRE; pulsed field ablation; inoperable tumors; focal ablation
Description: Objectives: There is a critical need for effective focal therapies for patients with inoperable or anatomically complex tumors where conventional ablation techniques pose high risk or are ineffective. Integrated Nanosecond Pulsed Irreversible Electroporation (INSPIRE) is a novel non-thermal ablation modality which uses real time temperature feedback during pulse delivery to safely treat tumors near critical structures. This study evaluated the impact of exposed electrode length on ablation zone size, reproducibility, and cardiac safety in a large animal model. Methods: INSPIRE treatments were performed in an in vivo healthy porcine liver model. All treatments administered 6000 V 1000 ns pulses with a 45 °C temperature set point. Treatments were administered percutaneously via an electrode and grounding pad approach using an internally cooled electrode applicator. The exposed electrode region at the distal end of the applicator was set to either 0.5, 1.0, 1.5, or 2.0 cm. Ablation zones were assessed via ultrasound, contrast-enhanced CT, and gross pathology one week post-treatment. Cardiac safety was evaluated by measuring pre- and post-treatment serum Troponin levels. Results: All treatments were completed without adverse events. Troponin levels remained stable (pre: 0.249 ng/mL; post: 0.224 ng/mL), indicating no measurable cardiac injury. The 1.5 cm exposure length produced the largest and most consistent ablation volumes, with a mean volume of 12.8 ± 2.6 cm3 and average dimensions of 3.7 × 2.7 cm in under 6 min. Increasing exposure length beyond 1.5 cm introduced greater variability and reduced treatment volumes. Conclusions: INSPIRE enables safe, large-volume, single-applicator ablation without a need for electrical pulse synchronization with R wave in cardiac rhythm. The 1.5 cm exposure length offers optimal balance between energy delivery and treatment consistency. These findings support further clinical investigation of INSPIRE for non-thermal ablation of inoperable tumors.
Document Type: text
File Description: application/pdf
Language: English
Relation: Methods and Technologies Development; https://dx.doi.org/10.3390/cancers17172891
DOI: 10.3390/cancers17172891
Availability: https://doi.org/10.3390/cancers17172891
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.5BA64C89
Database: BASE