Society of Gastrointestinal Radiologists Roscoe E. Miller Award. Monitoring hepatic cryosurgery with sonography

Onik, Gary; Kane, R A; G, Steele; Mcdermott, WilliamV.; Khettry, Urrnila; Cady, Blake; Jenkins, Roger L.; Katz, Judith; Clouse, Melvin E.; Rubinsky, Boris

doi:10.2214/ajr.147.4.665

Cited by 71 publications

(5 citation statements)

References 0 publications

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“…sponds to the thawed normal hepatic tissue (16). A hypoechogenic rim completely encompassing the tumor following the thaw cycle is supportive of adequate tumor destruction.…”

Section: Discussionmentioning

confidence: 99%

“…Larger vessels have greater resistance to freezing due to dissipation of thermal energy with greater blood flow (15), thus allowing the application of this technique in anatomically difficult locations such as around the hepatic veins and inferior vena cava. Experimental evidence indicates that lowering tissue temperatures to -35°C or below, maintaining the frozen state for several minutes, and slowly rethawing are important considerations for achieving complete tumor destruction (16). Some studies suggest that using 2 complete freeze-thaw cycles provides the greatest cellular destruction (18,19).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cryosurgical Ablation of Colorectal Metastasis to the Liver

Kuhn¹,

McCarty²,

Hurst³

1994

Baylor University Medical Center Proceedings

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“…sponds to the thawed normal hepatic tissue (16). A hypoechogenic rim completely encompassing the tumor following the thaw cycle is supportive of adequate tumor destruction.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cryosurgical Ablation of Colorectal Metastasis to the Liver

Kuhn¹,

McCarty²,

Hurst³

1994

Baylor University Medical Center Proceedings

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“…Intraoperative ultrasound (IOUS) has been used in oncological surgery since 1986 and was widely accepted as the gold standard for intraoperative liver imaging of CRLM at liver resection early in the development of liver surgery …”

Section: Introductionmentioning

confidence: 99%

Intraoperative ultrasound for the colorectal surgeon: current trends and barriers

Walker

Bamford

Finch-Jones

2017

ANZ Journal of Surgery

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Up to two thirds of patients diagnosed with colorectal cancer (CRC) develop colorectal liver metastases (CRLMs) and one quarter of patients present with synchronous metastases. Early detection of CRLM widens the scope of potential treatment. Surgery for CRLM offers the best chance of a cure. Current preoperative staging of CRC relies on computerized tomography and magnetic resonance imaging. Intraoperative ultrasound (IOUS) scans and contrast-enhanced IOUS (CE-IOUS) have been demonstrated to detect additional metastases not seen on routine preoperative imaging. IOUS is not widely used by colorectal surgeons during primary resection for CRC. Confident use of IOUS/CE-IOUS during primary resection of CRC may improve decision-making by providing the most sensitive form of liver staging even when compared with magnetic resonance imaging. This may be particularly important in the era of laparoscopic resections, where the colorectal surgeon loses the opportunity to palpate the liver. There are several implied barriers to the routine use of IOUS/CE-IOUS by colorectal surgeons. These include time pressure, familiarity with techniques, a perceived learning curve, cost implications and limitation of the modality due to operator variations. Inclusion of IOUS in the training of colorectal surgeons and further investigation of potential benefits of IOUS/CE-IOUS could potentially reduce these barriers, enabling usage during primary resection for CRC to become more widespread.

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“…Cryoablation of unresectable liver tumors or metastases in contrast is an indication where vast experience could be gathered in the last decade [9, 10, 11, 12]. …”

Section: Introductionmentioning

confidence: 99%