Therapeutic irreversible electroporation (IRE) is a relatively new technique for targeted tumor ablation. Needle electrodes are placed into or around the targeted region to deliver a series of brief electric pulses that disrupt cell membrane integrity, killing cells in a non-thermal manner that does not affect the extracellular matrix or sensitive structures such as major vasculature and bile ducts; making IRE an advantageous technique, especially for tumors that are unresectable or ineligible for thermal ablation. Here, we present on the imaging findings from IRE liver tumor treatments from ultrasound, computed tomography, magnetic resonance, and positron emission tomography. Imaging aids planning and implementing treatments by visualizing the targeted volume and guiding electrode placement. Immediate changes to the affected IRE region may be observed to verify complete ablation of the tumor with margin during the procedure, and permits follow-up evaluation of clinical outcome. In particular, we present tumor treatments in regions adjacent to sensitive structures that contraindicate thermal therapies.
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