Second Place Platform Award (BEMS Curtis Carl Johnson Memorial Award): Bor Kos

Published on: Sep 29, 2013

Applied treatment planning of electroporation-based medical interventions

Bor Kos1, Denis Pavliha, Anže Župani?, Marija Mar?an, Gregor Serša & Damijan Miklavcic

1Laboratory of Biocybernetics, University of Ljubljana, Ljubljana, Slovenia, 1000

I was born in Ljubljana, Slovenia and studied electrical engineering at the University of Ljubljana, Slovenia. I started my PhD project at the same university in 2008.

I presented the talk titled “Applied treatment planning of electroporation-based medical interventions”. Electroporation is a physical phenomenon in which high intensity applied electric fields increase the permeability of the cellular membrane to various molecules both from inside and from outside of the cell. This allows several different approaches for use in medicine, such as electrochemotherapy (by increasing uptake of chemotherapeutic drugs into tumor cells, non-thermal ablation by irreversible electroporation (by causing cell death from permanent membrane disruption), and gene electrotransfer for gene therapy and DNA vaccination (by enabling the uptake of DNA).

Electrochemotherapy was used to treat skin tumors and metastases in more than 3000 patients in the previous year alone, but its use for deep-seated tumors is just starting to be investigated. Similarly, NT-IRE is being researched as a method for percutaneous treatment of liver and kidney tumors. My work is focused on developing and validating treatment planning procedures for using electroporation-based treatments in deep-seated targets. With any electroporation-based therapy, it is necessary to achieve appropriate coverage of the target tissue with sufficiently strong electric fields. In order to ensure treatment success, we believe that appropriate treatment planning is crucially important. Treatment planning for electroporation involves segmenting patient medical images and reconstruction of the patients’ organ geometry. Electrodes need to be inserted in surgically feasible way and appropriate voltages chosen between each electrode pair.

Our aim with this work was to integrate several different research and engineering areas into an integrated web-based system for patient-specific treatment planning of any kind of electroporation-based treatment. We have integrated automatic algorithms for image segmentation and three-dimensional reconstruction, finite-element method-based computation of electric fields and electrode positions and comprehensive visual representation of generated treatment plans. The goal of this is to provide surgeons and interventional radiologists with a simple-to-use tool for planning any kind of electroporation-based treatment, which they could use without specialized engineering knowledge. Together with my coauthors on this BioEM presentation we are also working on a startup with the aims of commercializing this research (www.ectplan.com).

Recently I finished my PhD with thesis entitled “Numerical computation of electromagnetic fields in the human body for preventive and therapeutic applications”. I am currently a post-doc in the group of prof Damijan Miklavcic. In the future, I would like to bring treatment planning and with it more efficient electroporation treatment of difficult-to-treat tumors to patients worldwide. I would be very interested in collaborating with researchers and physicians who are starting clinical trials using electroporation-based treatments, both as a way to empower them and improve the successfulness of their treatments, and as a way to improve the usability and general applicability of our treatment planning platform.