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Comparison of selective intra-arterial to standard intravenous administration in percutaneous electrochemotherapy (pECT) for liver tumors Cover

Comparison of selective intra-arterial to standard intravenous administration in percutaneous electrochemotherapy (pECT) for liver tumors

Open Access
|Feb 2025

Figures & Tables

FIGURE 1.

(A) Transverse contrast-enhanced T1w MR image of a pancreatic carcinoma metastasis with a maximum diameter of 7 cm in segments V/VI and VII, which no longer responds to systemic chemotherapy and is growing rapidly and progressively. (B) Corresponding slice to A in diffusion imaging. (C) Complete contrast of the metastasis in 2D angiography. (D) Documentation of complete contrast coverage of the metastasis in cone beam CT. (E). Stereotactic navigation (CAS-One® IR) of the electrodes for electroporation. (F). Parallel planning of the electrodes in the tumor to achieve homogeneous electroporation. (G). The transverse contrast-enhanced T1w MR image of the metastasis one month after the electrochemotherapy (ECT) procedure demonstrates the complete loss of perfusion in the entire metastasis. (H) Corresponding slice to G in diffusion imaging.
(A) Transverse contrast-enhanced T1w MR image of a pancreatic carcinoma metastasis with a maximum diameter of 7 cm in segments V/VI and VII, which no longer responds to systemic chemotherapy and is growing rapidly and progressively. (B) Corresponding slice to A in diffusion imaging. (C) Complete contrast of the metastasis in 2D angiography. (D) Documentation of complete contrast coverage of the metastasis in cone beam CT. (E). Stereotactic navigation (CAS-One® IR) of the electrodes for electroporation. (F). Parallel planning of the electrodes in the tumor to achieve homogeneous electroporation. (G). The transverse contrast-enhanced T1w MR image of the metastasis one month after the electrochemotherapy (ECT) procedure demonstrates the complete loss of perfusion in the entire metastasis. (H) Corresponding slice to G in diffusion imaging.

FIGURE 2.

Progression free survival in the 2 groups during the 18-month follow-up period.
Progression free survival in the 2 groups during the 18-month follow-up period.

Response to percutaneous electrochemotherapy (pECT) treatment in the 2 groups

RESPONSEi.v. pECT (N = 21)i.a. pECT (N = 31)P valueP value
N%N%Overall distributionCR vs. non CR
CR1361.9%2580.6%0.34540.1349
PR523.8%412.9%
SD14.8%00.0%
PD00.0%13.2%
Lost to follow up29.5%13.2%

Descriptive characteristics of the patients in the 2 groups

PATIENTSi.v. pECT (N = 18)i.a. pECT (n = 26)P value
N%N%
Gender
  Males844%1558%0.5406
  Females1056%1142%
Diagnosis
  Colorectal cancer739%1038%0.4620
  Breast cancer422%415%
  Hepato cellular carcinoma211%28%
  Cholangio cellular carcinoma00%312%
  Ovarian cancer211%00%
  Non-small cell lung cancer (NSCLC)16%28%
  Anal cancer16%00%
  Pancreatic cancer00%14%
  Parotis carcinoma00%14%
  Neuroendocrine carcinoma00%14%
  Uterus carcinoma00%14%
  Esophageal carcinoma00%14%
  Cancer of unknown primary origin (CUP)16%00%
Liver metastases
  Synchronous844%1662%0.5343
  Metachronous844%831%
  No211%27%
Metastases location other than liver
  None950%1765%0.3613
  Yes950%935%
Other metastasis’ location
  Lung317%312%0.6025
  Bone16%28%
  Kidney16%14%
  Lung + bone + brain16%00%
  Bone + peritoneum16%00%
  Pleural + bone16%00%
  Retroperineal16%00%
  Adrenal gland00%14%
  Lymphnode00%14%
  Bone + lymphnode00%14%
Previous treatments
  Systemic therapy1689%26100%0.1617
  Liver surgery422%1246%0.1251
  Local treatments1161%831%0.0657
Type of local treatments
  TACE843%415%0.1529
  TACE+RFA16%00%
  TACE+CP16%00%
  TACE/MWA/CRYOTH00%28%
  CRYOTH16%00%
  IBT00%28%
Comorbidities
  Cardiac diseases633%727%0.7422
  Pulmonary diseases317%727%0.4889
  Liver diseases950%00%<0.0001
Number of target lesions per patient
  11583%2181%1.000
  2317%519%

Characteristics of target lesions in the 2 groups

LESIONSi.v. pECT (N = 21)i.a. pEC (N = 31)P value
N%N%
Type
  Hypervascular29.5%516.1%0.7664
  Intermediate1466.7%2064.5%
  Hypovascular523.8%619.4%
Challenging location*
  Yes1990.5%2167.7%0.0927
  No29.5%1032.3%
Vessels or bile ducts surrounding the metastases
  Distant (> 10 mm)419.0%825.8%0.5389
  Close (1 mm to 10 mm)628.6%516.1%
  Adjacent (< 1 mm)1152.4%1858.1%
Previous local treatments on the lesion
  Yes733.3%825.8%0.7559
  No1466.7%2374.2%
Type of local treatments on the lesion
  TACE (transarterial chemoembolization)628.6%412.9%0.1474
  CP (chemoperfusion)14.8%00.0%
  IBT (interstitial brachytherapy)00.0%26.5%
  TACE/MWA/CRYOTH00.0%26.5%
Technical success
  Yes2095.2%31100.0%0.2199
  No14.8%00.0%
DOI: https://doi.org/10.2478/raon-2025-0017 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 100 - 109
Submitted on: Jan 23, 2025
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Accepted on: Feb 4, 2025
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Published on: Feb 27, 2025
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2025 Tim Wilke, Erschad Hussain, Hannah Spallek, Francesca de Terlizzi, Lluis M Mir, Peter Bischoff, Andreas Schäfer, Elke Bartmuß, Matteo Cadossi, Alessandro Zanasi, Michael Pinkawa, Attila Kovács, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.