Does Drug-Eluting Bead TACE Enhance the Local Effect of IRE? Imaging and Histopathological Evaluation in a Porcine Model

  • Peter IsfortEmail author
  • Philip Rauen
  • Hong-Sik Na
  • Nobutake Ito
  • Saskia von Stillfried
  • Christiane Kuhl
  • Philipp Bruners
Laboratory Investigation



We conducted an in vivo trial on swine to compare the ablation volumes of irreversible electroporation (IRE) followed by drug-eluting beads transarterial chemoembolization (DEB-TACE) versus IRE only.

Materials and Methods

Nine swine underwent CT-guided IRE in one liver lobe and IRE immediately followed by DEB-TACE in a different liver lobe. For DEB-TACE, 100–300 µm beads (DC-Beads®) were loaded with 50 mg doxorubicin. For IRE, the NanoKnife® was used employing two electrodes according to the vendor’s protocol. Imaging follow-up was performed including CT-based lesion volume assessment using contrast-enhanced CT (venous phase) on days 1, 3, and 7 after the procedure. Three animals were killed for histopathological analysis after each follow-up.


Ablation volumes in CT in the IRE + DEB-TACE group were 15.4 ± 10.5 ml on day 1, 8.7 ± 5.6 ml on day 3, and 1.6 ± 0.7 ml on day 7. In the IRE group, the corresponding values were 5.2 ± 5.2 ml on day 1, 1.0 ± 1.2 ml on day 3, and 0.1 ± 0.1 ml on day 7. On day 1 and day 3, ablation volumes of IRE + TACE group were significantly larger than in the IRE group (p < 0.05). 96% of beads were depicted in or around ablative lesions. 69% of these beads were found in the surrounding hemorrhagic infiltration and 31% within the ablative lesion itself.


Combination of IRE immediately followed by DEB-TACE resulted in larger ablation volumes compared to IRE alone, suggesting that local efficacy of IRE can be enhanced by post-IRE DEB-TACE.


Irreversible electroporation Transarterial chemoembolization Drug-eluting bead TACE Hepatocellular carcinoma Experimental study 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

Informed Consent

For this type of study, informed consent is not required.

Consent for Publication

For this type of study, consent for publication is not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  1. 1.Department of Diagnostic and Interventional RadiologyRWTH Aachen University HospitalAachenGermany

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