Use of cryoablation beyond the prostate

Abstract

Cryoablation has been used for many years as a surgical ablation technique in the prostate and kidney. However, since the introduction of high-intensity focused ultrasound (HIFU) and robotic surgery for prostate tumours, its popularity in the urologic community has declined. In the early 2000s, innovations in cryoablation technology allowed the use of thinner probes, which were suitable for percutaneous application. As a result, radiologists began using cryoablation, first in the liver, and then in other organs or tissues such as the kidney, lung, breast, pancreas, bone, and soft tissue. In most of these locations, cryoablation has great potential given its inherent advantages, including the use of local anaesthesia, little or no pain during and after the procedure, real-time monitoring of the ablation area on US, CT or MRI, the potential for ablation of large tumours with multiple probes, and the ability to change the shape of the ablation in non-spherical tumours. Yet despite these advantages, the use of percutaneous cryoablation among radiologists appears to be far lower than that of heat-based ablation techniques. The aim of this article is to outline specific aspects of cryoablation and to illustrate its potential clinical applications with case presentations.Key Points• Recent advances have made cryoablation suitable for percutaneous use by radiologists with image guidance.• Cryoablation has distinct advantages over heat-based ablation techniques.• Cryoablation is becoming increasingly popular for lung, breast, kidney, bone, and soft tissue tumours.

Evaluation of a numerical simulation for cryoablation – comparison with bench data, clinical kidney and lung cases

“…To analyze the performance of the needles used in this study, gel phantom experiments testing different needle types while measuring the resulting temperatures at a multitude of positions relative to the needles with arrays of thermocouples over time have been performed by Shah et al [11]. We used the measured data of these experiments in this work to assess the accuracy of the numerical simulation.…”

“…A sketch of the TCs together with the grid needle slots locations is shown in Figure 1(b). A more detailed description of the experimental setup can be found in the work of Shah et al [11].…”

“…Cooling rate and temperature significantly influence the tissue damage due to the differences in intra-and extracellular ice formation which result in osmotic tension between intra-and extracellular space and cell dehydration [10]. The majority of cryoablation treatments are performed on the prostate, bone, breast, pancreas [11], but also kidney [12] and lung [13]. To improve the ablation volume, combinations of cryoablation with the injection of liquids with other thermal properties [14], and with immunotherapies [15,16] have been proposed.…”

Oxidative Effects during Irreversible Electroporation of Melanoma Cells—In Vitro Study

“…Physical ablation relates to physical methods inducing damage to treated tissues and includes cryoablation, laser ablation, radiofrequency ablation, microwave ablation and fulguration [ 3 ]. Cryoablation is used in surgical oncology for small prostate tumors, renal cell carcinoma and breast cancer treatments [ 11 , 12 , 13 ] as a treatment for cardiac ablation for patients with arrhythmias [ 14 , 15 ] and in dermatology, where it is used for rejuvenation of aged skin and removal of skin spots and lesions [ 16 , 17 ]. Conversely, laser ablation induces damage by high-temperature-aided vaporization of the tissue [ 18 , 19 ].…”

Dual thermal ablation of pancreatic cancer cells as an improved combinatorial treatment strategy

“…Further, unlike other treatment strategies, molecular drug resistance can be overcome with thermal injury [10]. Although cryoablation is not a mainstream thermal technique for PaCa, it is a primary treatment option in other cancers [6,[16][17][18][19][20][21][22]. In 2008, the American Urological Association published a best practice statement on prostate cancer, recommending cryosurgery as a primary treatment option [23].…”