RADIOLOGIC FINDINGS OF PORCINE LIVER AFTER ELECTROCHEMOTHERAPY WITH BLEOMYCIN

Abstract

Background. Radiologic findings after electrochemotherapy of large hepatic blood vessels and healthy hepatic parenchyma have notyetbeen described.

Materials and methods. Prospective animal model study with regulatory approval, including nine grower pigs. In each animal,four ultrasound-guided electroporated regions were created; in three regions,electrodes were inserted intothelumen of large hepatic vessels. Two types of electrodes were tested; variable linear- and fixed hexagonal-geometry electrodes. Ultrasonographic examinations were performed immediately and up to 20 minutes after the procedure. Dynamic computed tomography was performed before and at 60 to 90 minutes and one week after theprocedure.

Results. Radiologic examinations of the treated areas showed intact vessel wallsand patency; no hemorrhage or thrombi were noted. Ultrasonographic findings were dynamic and evolved from hyperechogenic microbubbles along electrode tracks to hypoechogenicity of treated parenchyma, diffusion of hyperechogenic microbubbles, and hypoechogenicity fading. Contrast-enhanced ultrasound showed decreased perfusion ofthetreated area. Dynamic computed tomography at 60 to 90 minutes after the procedure showed hypoenhancing areas. The totalhypoenhancing area was smaller after treatment with fixed hexagonal electrodes than after treatment with variable linear geometry electrodes.

Conclusions. Radiologic findings of porcine liver after electrochemotherapy with bleomycin did not show clinically significant damage to the liver,even ifa hazardous treatment strategy, such as large vessel intraluminal electrode insertion, was employed, and thus further support safety and clinical use of electrochemotherapy for treatment of hepatic neoplasia.