Cryotechnology in Diagnosing and Treating Lung Diseases

Tomic, Rade; Podgaetz, Eitan; Andrade, Rafael S.; Dinçer, H. Erhan

doi:10.1097/lbr.0000000000000103

Cited by 16 publications

(10 citation statements)

References 49 publications

(51 reference statements)

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“…Particular attention was devoted to the position of the biopsy; thus, biopsies taken from the same segment were taken in the same position (the same subsegment). Once brought into position, the probe was cooled for approximately 5 s and then retracted, with the frozen lung tissue attached to the tip of the probe [19] . Each biopsy was performed with a non-inflated Fogarty balloon placed in the lobar bronchus; the balloon was always inflated after biopsy, then immediately deflated in the absence of haemorrhage.…”

Section: Methodsmentioning

confidence: 99%

Transbronchial Lung Cryobiopsy in Diffuse Parenchymal Lung Disease: Comparison between Biopsy from 1 Segment and Biopsy from 2 Segments - Diagnostic Yield and Complications

et al. 2017

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Background: Transbronchial lung cryobiopsy is an innovative method of obtaining samples from the parenchyma of patients with diffuse parenchymal lung diseases. However, the technique is not yet standardized, and uncertainty exists about the optimal protocol, including the number of samples, the biopsy size, and the choice of the biopsy site. Objectives: To compare the diagnostic yield and complications of cryobiopsy with different strategies adopted to sample lung tissue (number of samples, biopsy site, and sample size). Methods: We prospectively enrolled 46 patients with suspected diffuse parenchymal lung diseases for the diagnosis of which a biopsy was deemed useful. All patients underwent transbronchial lung cryobiopsy, and they were randomly assigned to group A (4 samples obtained from the same segment) or group B (2 samples obtained from one segment and 2 samples obtained from a different segment of the same lobe). Analysis of the samples was performed sequentially (from the first to the last sample), and pathologists reformulated their histopathologic diagnosis with the addition of each sample. Results: The mean diagnostic yield of the procedure combining the 2 groups and performing only the first sampling was 69%. When a second biopsy was performed as well, the mean diagnostic yield improved, but this increase was significant only when the 2 samples were obtained from 2 different segments (96%, group B). Conclusions: This study suggests that the strategy of performing 2 biopsies with a cryoprobe may be associated with an increased diagnostic yield in diffuse parenchymal lung diseases if these samples are obtained from 2 different segments within the same lobe.

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Section: Methodsmentioning

confidence: 99%

Transbronchial Lung Cryobiopsy in Diffuse Parenchymal Lung Disease: Comparison between Biopsy from 1 Segment and Biopsy from 2 Segments - Diagnostic Yield and Complications

et al. 2017

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“…Lung cancer is the most common cancer worldwide, and is the leading cause of cancer-related death in both men and women [ 1 ]. Surgical resection is the standard treatment for early-stage patients.…”

Section: Introductionmentioning

confidence: 99%

3.0T MRI for long-term observation of lung nodules post cryoablation: a pilot study

Zhang

et al. 2017

Cancer Imaging

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BackgroundThe purpose of this study was to use serial magnetic resonance imaging (MRI) examinations to observe changes in malignant lung tumors over time post-cryoablation.MethodsThe study protocol was approved by Institutional Review Board, and written informed consent was obtained from each participant in accordance with the Declaration of Helsinki. Patients with primary or metastatic lung tumors eligible for cryoablation were included in this prospective study. Cryoablation was performed according to standard procedures. Unenhanced and dynamic contrast-enhanced MRI scans were performed pre-cryoablation and at 1 day, 1 week, and 3-, 6-, and 12 months after cryoablation. At each time point, the signal intensity of the ablated zone on both T1WI and T2WI images, and volume and characteristics of the ablation zone were examined, and changes over time analyzed.ResultsA total of 26 nodules in 23 patients were included in the study. The mean patient age was 53.7 ± 13.6 years, and 57.7% were males. Ablation zone volume increased to 1 week after the procedure, and then returned to baseline by 3 months. Cavitation post-cryoablation was found in 34.6% (9/26) of the nodules 1 month after treatment. Two types of time-signal intensity curves post-cryoablation were found: a straight line representing no definite enhancement from 1-day to 1-month, and an inflow curve representing mild delayed enhancement from month 3 to month 12. Local progression was associated with an incomplete hypointense rim around the ablation zone and absence of cavitation post-treatment.ConclusionsCharacteristic changes are present on MRI after cryoablation of lung tumors. A complete hypointense rim and cavitation may be signs of adequate treatment and that local tumor progression is less likely.Electronic supplementary materialThe online version of this article (doi:10.1186/s40644-017-0131-7) contains supplementary material, which is available to authorized users.

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“…Cryogenic gas is capable of delivering a cryogenic temperature of approximately -89°C distal to the probe. When compared with other thermal methods performed through endobronchial routes, such as laser and electrocautery, its effects occur in a late period within hours and days (5). Cryotherapy is used in the emergency treatment of airway obstructions for bronchoscopic cryorecanalization (6).…”

Section: A B C Dmentioning

confidence: 99%

Are flexible bronchoscopic cryoextraction practices an alternative to rigid bronchoscopy?

et al. 2019

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Are flexible bronchoscopic cryoextraction practices an alternative to rigid bronchoscopy? Introduction: We aimed to evaluate the efficacy of flexible bronchoscopic cryoextraction in the treatment of airw ay obstruction arise from mucus plugs and blood clots and present our experience. Materials and Methods: The present study evaluated patients who previously underwent unsuccessful flexible bronchoscopy for the removal of secretions and blood clots in the central airway and who underwent flexible bronchoscopic cryoextraction between January 2013-November 2017. results: The study included seven patients with a mean age of 58.29 ± 18.56 years (28-76). Three patients underwent bedside intervention in the intensive care unit, and four patients underwent an intervention in the bronchoscopy unit. Seven patients underwent a total of nine sessions of cryoextraction. Severe complications or mortality did not occur during the cryoextraction sessions. Conclusion: Flexible bronchoscopic cryoextraction offers a safe treatment strategy as an alternative to rigid bronchoscopy in patients in whom airway patency cannot be achieved using other flexible bronchoscopic interventions.

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Cryotechnology in Diagnosing and Treating Lung Diseases

Cited by 16 publications

References 49 publications

Transbronchial Lung Cryobiopsy in Diffuse Parenchymal Lung Disease: Comparison between Biopsy from 1 Segment and Biopsy from 2 Segments - Diagnostic Yield and Complications

Transbronchial Lung Cryobiopsy in Diffuse Parenchymal Lung Disease: Comparison between Biopsy from 1 Segment and Biopsy from 2 Segments - Diagnostic Yield and Complications

3.0T MRI for long-term observation of lung nodules post cryoablation: a pilot study

Are flexible bronchoscopic cryoextraction practices an alternative to rigid bronchoscopy?

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