Liver Function Tests Following Irreversible Electroporation of Liver Tumors: Experience in 174 Procedures

Tatiana Froud, Shree Venkat, Katuzka J. Barbery, Arora Gunjan, Govindarajan Narayanan

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Irreversible electroporation (IRE) is a relatively new ablation modality that uses electric currents to cause cell death. It is commonly used to treat primary and secondary liver tumors in patients with normal liver function and preexisting cirrhosis. Retrospective analysis of 205 procedures sought to evaluate changes in liver function after IRE. Liver function tests (LFTs) results before and after IRE were evaluated from 174 procedures in 124 patients. Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase (ALKP), and total bilirubin levels were analyzed. The study was Health Insurance Portability and Accountability Act compliant and institutional review board approved. Informed consent was waived. Changes in LFT results after IRE were compared with baseline and were followed up over time to see if they resolved. Changes were compared with volume of ablation. The greatest perturbations were in transaminase levels. The levels increased sharply within 24 hours after IRE in 129 (74.1%) procedures to extreme levels (more than 20 times the upper limit of normal in one-third of cases). Resolution occurred in 95% and was demonstrated to have occurred by a mean of approximately 10 weeks, many documented as early as 7 days after procedure. ALKP levels elevated in 10% procedures, was slower to increase, and was less likely to resolve. Total bilirubin level demonstrated 2 different patterns of elevation-early and late-and similar to ALKP, it was more likely to remain elevated. There was no increased risk in patients with cirrhosis or cholangiocarcinoma. There was no correlation of levels with volume of ablation. IRE results in significant abnormalities in LFT results, but in most of the cases, these are self-limiting, do not preclude treatment, and are similar to the changes seen after radiofrequency and cryoablation in the liver.

Original languageEnglish (US)
Pages (from-to)140-146
Number of pages7
JournalTechniques in Vascular and Interventional Radiology
Volume18
Issue number3
DOIs
StatePublished - Sep 1 2015

Fingerprint

Electroporation
Liver Function Tests
Liver
Alkaline Phosphatase
Neoplasms
Bilirubin
Fibrosis
Health Insurance Portability and Accountability Act
Cryosurgery
Cholangiocarcinoma
Research Ethics Committees
Aspartate Aminotransferases
Transaminases
Informed Consent
Alanine Transaminase
Cause of Death
Cell Death

Keywords

  • Alanine aminotransaminase
  • Alkaline phosphatase
  • ALKP
  • ALT
  • Aspartate aminotransaminase
  • AST
  • Bilirubin
  • Cirrhosis
  • IRE
  • LFTs
  • Liver function
  • TBIL
  • Tumor
  • XXX SGOT
  • XXX SGPT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Liver Function Tests Following Irreversible Electroporation of Liver Tumors : Experience in 174 Procedures. / Froud, Tatiana; Venkat, Shree; Barbery, Katuzka J.; Gunjan, Arora; Narayanan, Govindarajan.

In: Techniques in Vascular and Interventional Radiology, Vol. 18, No. 3, 01.09.2015, p. 140-146.

Research output: Contribution to journalArticle

Froud, Tatiana ; Venkat, Shree ; Barbery, Katuzka J. ; Gunjan, Arora ; Narayanan, Govindarajan. / Liver Function Tests Following Irreversible Electroporation of Liver Tumors : Experience in 174 Procedures. In: Techniques in Vascular and Interventional Radiology. 2015 ; Vol. 18, No. 3. pp. 140-146.
@article{7eb30966ba98493788f776e5df224525,
title = "Liver Function Tests Following Irreversible Electroporation of Liver Tumors: Experience in 174 Procedures",
abstract = "Irreversible electroporation (IRE) is a relatively new ablation modality that uses electric currents to cause cell death. It is commonly used to treat primary and secondary liver tumors in patients with normal liver function and preexisting cirrhosis. Retrospective analysis of 205 procedures sought to evaluate changes in liver function after IRE. Liver function tests (LFTs) results before and after IRE were evaluated from 174 procedures in 124 patients. Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase (ALKP), and total bilirubin levels were analyzed. The study was Health Insurance Portability and Accountability Act compliant and institutional review board approved. Informed consent was waived. Changes in LFT results after IRE were compared with baseline and were followed up over time to see if they resolved. Changes were compared with volume of ablation. The greatest perturbations were in transaminase levels. The levels increased sharply within 24 hours after IRE in 129 (74.1{\%}) procedures to extreme levels (more than 20 times the upper limit of normal in one-third of cases). Resolution occurred in 95{\%} and was demonstrated to have occurred by a mean of approximately 10 weeks, many documented as early as 7 days after procedure. ALKP levels elevated in 10{\%} procedures, was slower to increase, and was less likely to resolve. Total bilirubin level demonstrated 2 different patterns of elevation-early and late-and similar to ALKP, it was more likely to remain elevated. There was no increased risk in patients with cirrhosis or cholangiocarcinoma. There was no correlation of levels with volume of ablation. IRE results in significant abnormalities in LFT results, but in most of the cases, these are self-limiting, do not preclude treatment, and are similar to the changes seen after radiofrequency and cryoablation in the liver.",
keywords = "Alanine aminotransaminase, Alkaline phosphatase, ALKP, ALT, Aspartate aminotransaminase, AST, Bilirubin, Cirrhosis, IRE, LFTs, Liver function, TBIL, Tumor, XXX SGOT, XXX SGPT",
author = "Tatiana Froud and Shree Venkat and Barbery, {Katuzka J.} and Arora Gunjan and Govindarajan Narayanan",
year = "2015",
month = "9",
day = "1",
doi = "10.1053/j.tvir.2015.06.004",
language = "English (US)",
volume = "18",
pages = "140--146",
journal = "Techniques in Vascular and Interventional Radiology",
issn = "1089-2516",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - Liver Function Tests Following Irreversible Electroporation of Liver Tumors

T2 - Experience in 174 Procedures

AU - Froud, Tatiana

AU - Venkat, Shree

AU - Barbery, Katuzka J.

AU - Gunjan, Arora

AU - Narayanan, Govindarajan

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Irreversible electroporation (IRE) is a relatively new ablation modality that uses electric currents to cause cell death. It is commonly used to treat primary and secondary liver tumors in patients with normal liver function and preexisting cirrhosis. Retrospective analysis of 205 procedures sought to evaluate changes in liver function after IRE. Liver function tests (LFTs) results before and after IRE were evaluated from 174 procedures in 124 patients. Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase (ALKP), and total bilirubin levels were analyzed. The study was Health Insurance Portability and Accountability Act compliant and institutional review board approved. Informed consent was waived. Changes in LFT results after IRE were compared with baseline and were followed up over time to see if they resolved. Changes were compared with volume of ablation. The greatest perturbations were in transaminase levels. The levels increased sharply within 24 hours after IRE in 129 (74.1%) procedures to extreme levels (more than 20 times the upper limit of normal in one-third of cases). Resolution occurred in 95% and was demonstrated to have occurred by a mean of approximately 10 weeks, many documented as early as 7 days after procedure. ALKP levels elevated in 10% procedures, was slower to increase, and was less likely to resolve. Total bilirubin level demonstrated 2 different patterns of elevation-early and late-and similar to ALKP, it was more likely to remain elevated. There was no increased risk in patients with cirrhosis or cholangiocarcinoma. There was no correlation of levels with volume of ablation. IRE results in significant abnormalities in LFT results, but in most of the cases, these are self-limiting, do not preclude treatment, and are similar to the changes seen after radiofrequency and cryoablation in the liver.

AB - Irreversible electroporation (IRE) is a relatively new ablation modality that uses electric currents to cause cell death. It is commonly used to treat primary and secondary liver tumors in patients with normal liver function and preexisting cirrhosis. Retrospective analysis of 205 procedures sought to evaluate changes in liver function after IRE. Liver function tests (LFTs) results before and after IRE were evaluated from 174 procedures in 124 patients. Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase (ALKP), and total bilirubin levels were analyzed. The study was Health Insurance Portability and Accountability Act compliant and institutional review board approved. Informed consent was waived. Changes in LFT results after IRE were compared with baseline and were followed up over time to see if they resolved. Changes were compared with volume of ablation. The greatest perturbations were in transaminase levels. The levels increased sharply within 24 hours after IRE in 129 (74.1%) procedures to extreme levels (more than 20 times the upper limit of normal in one-third of cases). Resolution occurred in 95% and was demonstrated to have occurred by a mean of approximately 10 weeks, many documented as early as 7 days after procedure. ALKP levels elevated in 10% procedures, was slower to increase, and was less likely to resolve. Total bilirubin level demonstrated 2 different patterns of elevation-early and late-and similar to ALKP, it was more likely to remain elevated. There was no increased risk in patients with cirrhosis or cholangiocarcinoma. There was no correlation of levels with volume of ablation. IRE results in significant abnormalities in LFT results, but in most of the cases, these are self-limiting, do not preclude treatment, and are similar to the changes seen after radiofrequency and cryoablation in the liver.

KW - Alanine aminotransaminase

KW - Alkaline phosphatase

KW - ALKP

KW - ALT

KW - Aspartate aminotransaminase

KW - AST

KW - Bilirubin

KW - Cirrhosis

KW - IRE

KW - LFTs

KW - Liver function

KW - TBIL

KW - Tumor

KW - XXX SGOT

KW - XXX SGPT

UR - http://www.scopus.com/inward/record.url?scp=84941274241&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84941274241&partnerID=8YFLogxK

U2 - 10.1053/j.tvir.2015.06.004

DO - 10.1053/j.tvir.2015.06.004

M3 - Article

C2 - 26365543

AN - SCOPUS:84941274241

VL - 18

SP - 140

EP - 146

JO - Techniques in Vascular and Interventional Radiology

JF - Techniques in Vascular and Interventional Radiology

SN - 1089-2516

IS - 3

ER -