SIR 2024
Interventional Oncology
Daniel H. Kim, MD
Medical Student
David Geffen School of Medicine at UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
Robert Suh, MD
Clinical Professor, Radiological Sciences
David Geffen School of Medicine at UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
Fereidoun Abtin, MD
Professor
David Geffen School of Medicine at UCLA
Disclosure information not submitted.
Scott Genshaft, MD
Associate Clinical Professor
UCLA Interventional Radiology
Disclosure information not submitted.
Jason Chiang, MD, PhD (he/him/his)
Assistant Professor
Interventional Radiology, UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
Frank Hao, MD
Assistant Clinical Professor
University of California- Los Angeles
Disclosure information not submitted.
David S. Lu, MD (he/him/his)
Professor of Radiology, and Surgery
David Geffen School of Medicine at UCLA
Disclosure information not submitted.
Steven Raman, MD, FSAR, FSIR
Professor of Radiology, Urology and Surgery
David Geffen School of Medicine At UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
To assess the safety of image-guided pulsed electric field (PEF) ablation in target and off-target tumors within one-month post-procedure follow up.
Materials and Methods:
In this IRB-approved, HIPAA compliant retrospective study, 24 tumors in 14 patients who underwent CT- and US-guided PEF ablation from 5/2023 to 8/2023 were evaluated. Data collected included demographic, tumor characteristic, procedural protocols, and clinical follow-up visits. Size changes of the target tumors that was ablated, and off-target tumors from immune response were recorded in one-month intervals, whenever possible. Adverse events were categorized using the Society of Interventional Radiology adverse events classification.
Results:
Total of 18 PEF ablation sessions for 24 metastatic multifocal cancers in 14 patients were included. The mean patient age was 52.3 (20 – 94) years, 9/15 (60%) were male, and 8/15 (53%) were on systemic chemo or immunotherapy. The mean target tumor size was 2.8 (0.4 – 6.9) cm. 16/24 tumors were in the lung, 3/24 in the liver, and one each in kidney, iliacus, submandibular region, submental region, level II lymph node station. Metastases comprised multihistology sarcomas, renal cell carcinoma, melanoma, mucoepidermoid, nerve sheath tumor, and colorectal cancer. PEF ablation was delivered with 100 pulse packets with 3000 V for 5 minutes. Of the ablated target tumors, 13/24 (54%) tumors decreased in size or remained stable, 5/24 (21%) increased in size, and 6/24 (25%) did not reach one-month follow-up. Of the followed nine off-target tumors, 8/9 (89%) decreased or remained stable in size at one-month follow up. Notably, cell free DNA of patient with hemangiopericytoma has decreased from 290 to 3 MTM/mL at one-month post-PEF. One patient with colorectal cancer deceased before one-month post-PEF unrelated to cancer. 5/18 (28%) PEF ablation sessions resulted in mild adverse events which were self-limited, and rest of the 13/18 (72%) sessions did not have any adverse events.
Conclusion:
Percutaneous image-guided PEF ablation appears to be a reliable treatment option with decreasing or stable size of both target and off-target tumors with low rates and severity of adverse events.