A Retrospective Comparison of CT Imaging and Computational Simulations of Irreversible Electroporation in the Liver.

ObjectivesIrreversible Electroporation (IRE) is both open surgery and minimally invasive cancer therapy used in the treatment of liver tumors. The therapy demands precision and accuracy to ensure complete tumor ablation. Reliable simulation tools can help achieve this goal by predicting the tissue regions that will reach the required electric field threshold and by suggesting correcting actions when the predicted outcome is inadequate. This article retrospectively compares segmented ablations from intra-procedural computed tomography (CT) scans with computer simulations to check their validity in predicting the operation outcome and the required electric field threshold.Methods10 patient ablation procedures were retrospectively analyzed using a detailed computational model of electroporation, informed by the patient-specific geometry of each case. CT scans were analyzed by three physicians over two sessions to assess intra- and inter-observer variability. Same day postoperative images were used for accuracy. The resulting measured ablations from the patient's data were compared to simulation predictions, both in terms of ablated volumes and 3D similarity scores (Dice coefficient).ResultsSimulated ablation volumes were computed across electric field thresholds (465-750 V/cm), showing highest volumes at 465 V/cm and lowest at 750 V/cm. Comparison with physician segmented volumes showed best match for 500-600 V/cm ablation threshold: this result was consistent across different patients despite differences among patient's conditions and characteristics. 3D analysis revealed Dice scores between 0.63 and 0.77 (mean: 0.71), indicating moderate to good agreement. Visual and statistical comparisons further validated the reliability of the simulation model within this threshold range.ConclusionThis study highlighted the accuracy of IRE ablation volume predictions by comparing retrospective CT based ablation volume segmentations with electric field simulations. The best match occurred at 500 to 600 V/cm thresholds, with post-procedure measurements. Despite observer variability and modeling limitations, Dice scores showed moderate to good agreement, validating the simulation model and emphasizing timely imaging for accuracy.