Work

Gelified ethanol as a low-cost non-thermal ablative agent for percutaneous liver ablation: a first-phase preclinical feasibility study

Year: 2026

Type: article

Abstract: Purpose To evaluate the reproducibility, injectability, and hepatic ablative effect of ethylcellulose-ethanol (EC-OH) mixtures at three concentrations in ex vivo and in vivo porcine liver models, as a formulational selection step before evaluation in a tumor model. Materials and methods EC-OH at 3%, 6%, and 12% ethylcellulose (EC3, EC6, EC12) was compared with pure ethanol (OH). Injectability was tested through 18–22 G needles and microcatheters. Ex vivo experiments used one explanted porcine liver, obtained from a concurrent, unrelated animal experiment in accordance with the 3Rs principle of Reduction in animal research (8 needles; 1–2 mL per injection). In vivo hepatic ablation was performed in four swine (6 ultrasound-guided injections of 2 mL per formulation per animal; 24 injections total). Lesion volumes were assessed by CT and macroscopy. Results All formulations were reproducible and injectable; EC12 showed resistance through 20–22 G needles and could not be aspirated through 22 G. Estimated cost for one full EC-OH preparation and injection (2 mL) was approximately €2.9, on the order of < €5. Ex vivo, mean CT lesion volumes per mL injected were 0.2, 0.1, 0.1, and 1.2 cm 3 for OH, EC3, EC6, and EC12. EC-OH produced nodular ablation patterns versus the linear tracts seen with OH. In vivo, mean (± SD) CT lesion volumes were 0.4 (± 0.4), 0.3 (± 0.3), 0.7 (± 0.5), and 1.8 (± 1.1) cm 3 for OH, EC3, EC6, and EC12 (EC6 × 2.0; EC12 × 4.5 vs OH). CT-visible vascular complications (portal or hepatic venous thrombosis, hepatic infarcts) occurred in 1/6 injections each for OH, EC3, and EC6, and in 3/6 (50%) for EC12. Conclusion EC-OH is easily and inexpensively prepared. Among the tested formulations, EC6 demonstrated the most favorable balance of injectability, ablative effect, and safety, and was selected as the candidate formulation for future evaluation in a hepatic tumor model (rabbit VX2 carcinoma). EC12 showed unacceptable technical handling limitations and a higher risk of vascular embolization.

Source: CVIR Oncology

DOI: 10.1007/s44343-026-00069-9

Authors: Manuel Gargiulo, Cécile Di-Rocco, Clotylde Dumas, Pauline Brige, Vincent Vidal, Farouk Tradi