A Systematic Review about Imaging and Histopathological Findings for Detecting and Evaluating Electroporation Based Treatments Response

Vincenza Granata, Roberta Fusco, Simona Salati, Antonella Petrillo, Elio Di Bernardo, Roberta Grassi, Raffaele Palaia, Ginevra Danti, Michelearcangelo La Porta, Matteo Cadossi, Gorana Gašljević, Gregor Sersa and Francesco Izzo
Additional contact information
Vincenza Granata: Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, I-80131 Naples, Italy
Roberta Fusco: Oncology Medical and Research & Development Division, IGEA SpA, I-41012 Carpi, Italy
Simona Salati: Oncology Medical and Research & Development Division, IGEA SpA, I-41012 Carpi, Italy
Antonella Petrillo: Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, I-80131 Naples, Italy
Elio Di Bernardo: Oncology Medical and Research & Development Division, IGEA SpA, I-41012 Carpi, Italy
Roberta Grassi: Radiology Division, Università Degli Studi Della Campania Luigi Vanvitelli, I-80143 Naples, Italy
Raffaele Palaia: Hepatobiliary Surgical Oncology Division, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, I-80131 Naples, Italy
Ginevra Danti: Radiology Division, Azienda Ospedaliero-Universitaria Careggi, I-50139 Florence, Italy
Michelearcangelo La Porta: Department of Radiology, UOC San Severo Hospital, 71016 San Severo, Italy
Matteo Cadossi: Oncology Medical and Research & Development Division, IGEA SpA, I-41012 Carpi, Italy
Gorana Gašljević: Department of Pathology, Institute of Oncology Ljubljana, Zaloska cesta 2, SI-1000 Ljubljana, Slovenia
Gregor Sersa: Department of Experimental Oncology, Institute of Oncology Ljubljana, Zaloska cesta 2, SI-1000 Ljubljana, Slovenia
Francesco Izzo: Hepatobiliary Surgical Oncology Division, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, I-80131 Naples, Italy

IJERPH, 2021, vol. 18, issue 11, 1-26

Abstract: Background: Imaging methods and the most appropriate criteria to be used for detecting and evaluating response to oncological treatments depend on the pathology and anatomical site to be treated and on the treatment to be performed. This document provides a general overview of the main imaging and histopathological findings of electroporation-based treatments (Electrochemotherapy—ECT and Irreversible electroporation—IRE) compared to thermal approach, such as radiofrequency ablation (RFA), in deep-seated cancers with a particular attention to pancreatic and liver cancer. Methods: Numerous electronic datasets were examined: PubMed, Scopus, Web of Science and Google Scholar. The research covered the years from January 1990 to April 2021. All titles and abstracts were analyzed. The inclusion criteria were the following: studies that report imaging or histopathological findings after ablative thermal and not thermal loco-regional treatments (ECT, IRE, RFA) in deep-seated cancers including pancreatic and liver cancer and articles published in the English language. Exclusion criteria were unavailability of full text and congress abstracts or posters and different topic respect to inclusion criteria. Results: 558 potentially relevant references through electronic searches were identified. A total of 38 articles met the inclusion criteria: 20 studies report imaging findings after RFA or ECT or IRE in pancreatic and liver cancer; 17 studies report histopathological findings after RFA or ECT or IRE; 1 study reports both imaging and histopathological findings after RFA or ECT or IRE. Conclusions: Imaging features are related to the type of therapy administrated, to the timing of re-assessment post therapy and to the imaging technique being used to observe the effects. Histological findings after both ECT and IRE show that the treated area becomes necrotic and encapsulated in fibrous tissue, suggesting that the size of the treated lesion cannot be measured as an endpoint to detect response. Moreover, histology frequently reported signs of apoptosis and reduced vital tissue, implying that imaging criteria, which take into account the viability and not the size of the lesion, are more appropriate to evaluate response to treatment.

Keywords: electrochemotherapy; irreversible electroporation; radiofrequency ablation; imaging findings; histopathological findings (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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