Irreversible Electroporation: First Patient Experience Focal Therapy of Prostate Cancer

Irreversible electroporation (IRE) is a new non-thermal ablation modality that uses short pulses of DC electric current to create irreversible pores in the cell membrane thus causing cell death. This method has been shown by Rubinsky et al. to have significant advantages in ablating prostatic tissue, such as rapid lesion creation, rapid lesion resolution, sparing of structures such as vessels, nerves and urethra, and uniform destruction throughout the IRE lesion (1). The underlying principles are well covered in other chapters in this book. This discussion will deal with the first human applications of IRE and whether its theoretical promises of improved clinical outcomes, have been delivered. For a number of reasons, including the ability to carry out extensive post operative biopsies to confirm the adequate ablation of cancer, the first human experience was carried out in the prostate.