Pilot study comparing needle placement for Irreversible Electroporation (IRE) using CT navigation versus conventional CT-guidance

ISRCTN ISRCTN55383115
DOI https://doi.org/10.1186/ISRCTN55383115
Secondary identifying numbers 1.0
Submission date
24/04/2016
Registration date
09/05/2016
Last edited
14/06/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Irreversible Electroporation (IRE) is a novel method for focused treatment of liver tumors. IRE is a soft tissue ablation technique (that is, a technique used to remove soft body tissues, including tumors) using ultra-short but strong electrical fields to create permanent and hence lethal nanopores (tiny holes) in the cell membrane resulting in cell death. IRE ablation requires the placement of two or more applicator electrodes between which the electrical fields are applied. In order to achieve successful ablation, parallel needle placement at a pre-defined distance is required. Needles are placed under image guidance using ultrasound or computer tomography as imaging methods. Since these methods display one image plane at a time, the realization of multiple parallel needle placements can be challenging. Several attempts may be required to achieve the required geometrical configuration of the needle with respect to other needles and as well as in relation to the anatomical target. Navigation technology for interventional radiology supports IRE treatments by providing comprehensive planning of needle configurations using 3D image data and by supporting needle placement through guidance functionality. This study aims to investigate the potential benefits of CT-navigated stereotactic IRE needle placement compared to non-navigated conventional IRE.

Who can participate?
Adult patients (aged at least 18) about to be treated with IRE for liver tumors.

What does the study involve?
Participants are split into two groups. Those in group 1 undergo the CT-navigated stereotactic IRE. Those in group 2 are treated by conventional IRE using manual needle placement. The time taken for accurate IRE needle placement for all patients is assessed, along with overall time of procedure and the radiation dose required for the IRE session.

What are the possible benefits and risks of participating?
Potential benefits for patients undergoing stereotactic IRE might be faster intervention times. No additional risks or side effects are expected .

Where is the study run from?
Department of Radiology at the University Hospital Regensburg (Germany)

Who is the main contact?
Dr Lukas Beyer

Contact information

Dr Lukas Beyer
Scientific

Franz-Josef-Strauß-Allee 11
Regensburg
93053
Germany

Study information

Study designNon-randomized prospective two-arm study.
Primary study designInterventional
Secondary study designNon randomised study
Study setting(s)Hospital
Study typeTreatment
Participant information sheet ISRCTN55383115_PIS_German.pdf
Scientific titlePilot study comparing needle placement for Irreversible Electroporation (IRE) using CT navigation versus conventional CT-guidance: a non-randomized prospective two-arm study
Study objectivesCT-navigation allows for faster placement of IRE needle applicators with a reduced number of pre-placements and control scans.
Ethics approval(s)University Hospital Regensburg (02/2015).
Health condition(s) or problem(s) studiedLiver cancer
InterventionIrreversible Electroporation (IRE) is a novel method for focused treatment of liver tumors. IRE is a soft tissue ablation technique using ultra short but strong electrical fields to create permanent and hence lethal nanopores in the cell membrane, to disrupt the cellular homeostasis. The resulting cell death results from apoptosis and not necrosis as in all other thermal or radiation based ablation techniques. IRE is used for non-resectable liver tumors in the vicinity of vessels (due to the its selectivity for tumor tissue while preserving vessel structures).

IRE ablation requires the placement of two or more applicator electrodes between which the electrical fields are applied. In order to achieve successful ablation, parallel needle placement at a pre-defined distance is required. Needles are placed under image guidance using ultrasound or computer tomography as imaging methods. As these methods are displaying one image plane at a time, the realization of multiple needle placements can be challenging and can require several attempts until the required geometrical configuration of the needle with respect to other needles and also to the anatomical target is achieved.
Navigation technology for interventional radiology supports IRE treatments by providing comprehensive planning of needle configurations using 3D image data and by supporting needle placement through guidance functionality.

This study aims to investigate the potential benefits of CT-navigated IRE needle placement compared to conventional non-navigated techniques.
Intervention typeDevice
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)Not provided at time of registration
Primary outcome measureTime required for the placement of IRE needles (measured from the time of the first CT scan to the start of the ablation).
Secondary outcome measures1. Accuracy of IRE needle placement compared to a patient-specific ablation strategy (accuracy is measured as distance to the target point, distance between needles, angles between needles)
2. Overall procedure time
3. Number of lesions treated per patient
4. Number of needle replacements
5. Number of control scans
6. Radiation dose
Overall study start date01/07/2015
Completion date01/03/2016

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants20
Key inclusion criteria1. Patients must be scheduled for CT guided percutaneous IRE in the liver
2. Written informed consent
3. Male patients and non-pregnant, non-lactating females aged ≥18 years of age (negative serum/urine pregnancy test result at screening)
Key exclusion criteria1. Any condition which, in the judgment of the clinical investigator or his designee, might increase the risk to the subject or decrease the chance of obtaining satisfactory data to achieve the objectives of the study
2. A mental condition rendering the patient unable to provide informed consent
3. Patients with hereditary haematological / coagulation disorders unrelated to their liver disease.
4. Patients who are currently (within the last 30 days prior to surgery) participating in another clinical trial with any investigational drug or device
5. Patients undergoing liver surgery for the purpose of receiving a liver transplant or for liver trauma
6. Patients with established renal insufficiency (Creatinine >2.5 mg/dl), or a condition requiring hemodialysis
Date of first enrolment01/07/2015
Date of final enrolment31/01/2016

Locations

Countries of recruitment

  • Germany

Study participating centre

University Hospital Regensburg
93053
Germany

Sponsor information

University Hospital Regensburg
Hospital/treatment centre

Franz-Josef-Strauß-Allee 11
Regensburg
930533
Germany

Phone 015151121489
Email lukas@lukasbeyer.com
ROR logo "ROR" https://ror.org/01226dv09

Funders

Funder type

Hospital/treatment centre

Universitätsklinikum Regensburg
Government organisation / Local government
Alternative name(s)
University Hospital Regensburg, UKR
Location
Germany

Results and Publications

Intention to publish date01/03/2017
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination plan
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet 25/05/2016 No Yes
Dataset 14/06/2023 No No
Results article 11/08/2016 14/06/2023 Yes No

Additional files

ISRCTN55383115_PIS_German.pdf
Participant Information Sheet (in German) - uploaded 25/05/2016

Editorial Notes

14/06/2023: The following changes were made to the trial record:
1. Publication reference added.
2. Link to dataset added.
25/05/2016: Uploaded participant information sheet