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Inicio Radiología (English Edition) Irreversible electroporation: Beyond the limits of tumor ablation
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Vol. 66. Issue 1.
Pages 47-56 (January - February 2024)
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Vol. 66. Issue 1.
Pages 47-56 (January - February 2024)
Update in Radiology
Irreversible electroporation: Beyond the limits of tumor ablation
Electroporación irreversible: ampliando las fronteras de la ablación
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95
R. Alonso-Gonzáleza,
Corresponding author
rodro.a.g.c@gmail.com

Corresponding author.
, J.M. Abadal Villayandrea, E. Gálvez Gonzaleza, M.J. Álvarez Pereza, S. Méndez Alonsob, M.A. de Gregorio Arizac
a Radiología Vascular Intervencionista, Hospital Universitario Severo Ochoa, Madrid, Spain
b Radiología Vascular Intervencionista, Hospital Universitario Puerta Hierro, Madrid, Spain
c Radiología Vascular Intervencionista, Clínica Quirón, Zaragoza, Spain
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Abstract

Irreversible Electroporation (IRE) is a non-thermal tumor ablation technique. High-voltage electrical pulses are applied between pairs of electrodes inserted around and/or inside a tumor. The generated electric current induces the creation of nanopores in the cell membrane, triggering apoptosis. As a result, IRE can be safely used in areas near delicate vascular structures where other thermal ablation methods are contraindicated.

Currently, IRE has demonstrated to be a successful ablation technique for pancreatic, renal, and liver tumors and is widely used as a focal therapeutic option for prostate cancer.

The need for specific anesthetic management and accurate parallel placement of multiple electrodes entails a high level of complexity and great expertise from the interventional team is required. Nevertheless, IRE is a very promising technique with a remarkable systemic immunological capability and may impact on distant metastases (abscopal effect).

Keywords:
Electroporation
Irreversible electroporation therapy
Ablation techniques
Radiology
Interventional
Medical oncology
Immunotherapy
Pancreatic neoplasms
Renal neoplasm
Liver neoplasms
Resumen

La electroporación irreversible o IRE (Irreversible Electroporation) es una técnica de ablación tumoral no térmica basada en la aplicación de pulsos eléctricos de alto voltaje entre pares de agujas insertadas alrededor de un tumor. La corriente generada favorece la creación de nanoporos en la membrana plasmática, desencadenando la apoptosis. Por ello, la IRE puede utilizarse de manera segura en localizaciones cercanas a estructuras vasculares delicadas, contraindicadas para el resto de técnicas termoablativas.

Actualmente la IRE se emplea con éxito para ablación de tumores en páncreas, riñón e hígado y, de manera muy extendida, como opción terapéutica focal para el cáncer de próstata.

La necesidad de un manejo anestésico específico y la colocación precisa y en paralelo de múltiples agujas implican un alto nivel de complejidad, siendo necesaria una gran experiencia del equipo intervencionista. No obstante, se trata de una técnica muy prometedora con una gran capacidad inmunológica sistémica que puede provocar un efecto a distancia del tumor tratado (efecto abscopal).

Palabras clave:
Electroporación
Electroporación irreversible
Técnicas ablativas
Radiología
Radiología intervencionista
Oncología
Inmunoterapia
Neoplasias pancreáticas
Neoplasias renales
Neoplasias hepáticas

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