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Understanding Factors Governing Distribution Volume of Ethyl Cellulose-Ethanol to Optimize Ablative Therapy in the Liver.

Publication ,  Journal Article
Morhard, R; Mueller, JL; Tang, Q; Nief, C; Chelales, E; Lam, CT; Alvarez, DA; Rubinstein, M; Katz, DF; Ramanujam, N
Published in: IEEE transactions on bio-medical engineering
August 2020

Ethanol ablation, the injection of ethanol to induce necrosis, was originally used to treat hepatocellular carcinoma, with survival rates comparable to surgery. However, efficacy is limited due to leakage into surrounding tissue. To reduce leakage, we previously reported incorporating ethyl cellulose (EC) with ethanol as this mixture forms a gel when injected into tissue. To further develop EC-ethanol injection as an ablative therapy, the present study evaluates the extent to which salient injection parameters govern the injected fluid distribution.Utilizing ex vivo swine liver, injection parameters (infusion rate, EC%, infusion volume) were examined with fluorescein added to each solution. After injection, tissue samples were frozen, sectioned, and imaged.While leakage was higher for ethanol and 3%EC-ethanol at a rate of 10 mL/hr compared to 1 mL/hr, leakage remained low for 6%EC-ethanol regardless of infusion rate. The impact of infusion volume and pressure were also investigated first in tissue-mimicking surrogates and then in tissue. Results indicated that there is a critical infusion pressure beyond which crack formation occurs leading to fluid leakage. At a rate of 10 mL/hr, a volume of 50 μL remained below the critical pressure.Although increasing the infusion rate increases stress on the tissue and the risk of crack formation, injections of 6%EC-ethanol were localized regardless of infusion rate. To further limit leakage, multiple low-volume infusions may be employed.These results, and the experimental framework developed to obtain them, can inform optimizing EC-ethanol to treat a range of medical conditions.

Duke Scholars

Published In

IEEE transactions on bio-medical engineering

DOI

EISSN

1558-2531

ISSN

0018-9294

Publication Date

August 2020

Volume

67

Issue

8

Start / End Page

2337 / 2348

Related Subject Headings

  • Swine
  • Liver Neoplasms
  • Ethanol
  • Cellulose
  • Catheter Ablation
  • Carcinoma, Hepatocellular
  • Biomedical Engineering
  • Animals
  • 4603 Computer vision and multimedia computation
  • 4009 Electronics, sensors and digital hardware
 

Citation

APA
Chicago
ICMJE
MLA
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Morhard, R., Mueller, J. L., Tang, Q., Nief, C., Chelales, E., Lam, C. T., … Ramanujam, N. (2020). Understanding Factors Governing Distribution Volume of Ethyl Cellulose-Ethanol to Optimize Ablative Therapy in the Liver. IEEE Transactions on Bio-Medical Engineering, 67(8), 2337–2348. https://doi.org/10.1109/tbme.2019.2960049
Morhard, Robert, Jenna L. Mueller, Qishun Tang, Corrine Nief, Erika Chelales, Christopher T. Lam, Daniel Adrianzen Alvarez, Michael Rubinstein, David F. Katz, and Nimmi Ramanujam. “Understanding Factors Governing Distribution Volume of Ethyl Cellulose-Ethanol to Optimize Ablative Therapy in the Liver.IEEE Transactions on Bio-Medical Engineering 67, no. 8 (August 2020): 2337–48. https://doi.org/10.1109/tbme.2019.2960049.
Morhard R, Mueller JL, Tang Q, Nief C, Chelales E, Lam CT, et al. Understanding Factors Governing Distribution Volume of Ethyl Cellulose-Ethanol to Optimize Ablative Therapy in the Liver. IEEE transactions on bio-medical engineering. 2020 Aug;67(8):2337–48.
Morhard, Robert, et al. “Understanding Factors Governing Distribution Volume of Ethyl Cellulose-Ethanol to Optimize Ablative Therapy in the Liver.IEEE Transactions on Bio-Medical Engineering, vol. 67, no. 8, Aug. 2020, pp. 2337–48. Epmc, doi:10.1109/tbme.2019.2960049.
Morhard R, Mueller JL, Tang Q, Nief C, Chelales E, Lam CT, Alvarez DA, Rubinstein M, Katz DF, Ramanujam N. Understanding Factors Governing Distribution Volume of Ethyl Cellulose-Ethanol to Optimize Ablative Therapy in the Liver. IEEE transactions on bio-medical engineering. 2020 Aug;67(8):2337–2348.

Published In

IEEE transactions on bio-medical engineering

DOI

EISSN

1558-2531

ISSN

0018-9294

Publication Date

August 2020

Volume

67

Issue

8

Start / End Page

2337 / 2348

Related Subject Headings

  • Swine
  • Liver Neoplasms
  • Ethanol
  • Cellulose
  • Catheter Ablation
  • Carcinoma, Hepatocellular
  • Biomedical Engineering
  • Animals
  • 4603 Computer vision and multimedia computation
  • 4009 Electronics, sensors and digital hardware