Validation of a low-cost, carbon dioxide-based cryoablation system for percutaneous tumor ablation

Abstract

Breast cancer rates are rising in low- and middle-income countries (LMICs), yet there is a lack of accessible and cost-effective treatment. As a result, the cancer burden and death rates are highest in LMICs. In an effort to meet this need, our work presents the design and feasibility of a low-cost cryoablation system using widely-available carbon dioxide as the only consumable. This system uses an 8-gauge outer-diameter needle and Joule-Thomson expansion to percutaneously necrose tissue with cryoablation. Bench top experiments characterized temperature dynamics in ultrasound gel demonstrated that isotherms greater than 2 cm were formed. Further, this system was applied to mammary tumors in an in vivo rat model and necrosis was verified by histopathology. Finally, freezing capacity under a large heat load was assessed with an in vivo porcine study, where volumes of necrosis greater than 1.5 cm in diameter confirmed by histopathology were induced in a highly perfused liver after two 7-minute freeze cycles. These results demonstrate the feasibility of a carbon-dioxide based cryoablation system for improving solid tumor treatment options in resource-constrained environments.

Recent progress in cryoablation cancer therapy and nanoparticles mediated cryoablation

“…Currently, the most common cooling method of cryoablation involves circulating cooled fluids such as nitrogen or argon through probes 3 , which then rapidly expand into gas, creating temperatures as low as -190 °C in what is known as Joule-Thomson effect 5 . While argon and helium have been widely used in cooling the cryo-probe, the accessibility and cost of the noble gases have delayed the application of cryoablation treatment in low and middle-income countries 6 . To circumvent this problem, a low-cost carbon dioxide-based cryoablation device was developed 7 .…”

Cryoablation and immune synergistic effect for lung cancer: A review

“…The temperature of argon will drop after being throttled, while the temperature of helium will rise after being throttled. The Cryocare Surgical System uses high-pressure argon gas at room temperature as refrigerant and high-pressure helium gas as heat to treat tumors using the Joule-Thomson principle ( 13 ). Cryoablation has been used to treat liver tumors in the operating room setting for more than three decades ( 14 ).…”

Comparison of Probe Materials for Tissue Cryoablation: Operational Properties of Metal and Sapphire Cryoprobes

“…And since the introduction of the first system for cryosurgery [6], the instrumentation and technique for tissue cryoablation were improved significantly. The development of technology and navigation methods resulted in the fact that cryosurgical approaches today are applied in oncology, dermatology, urology and other fields for treatment of such diseases as renal [7,8], hepatic [9], endometrial [4], lung [10], prostate [11], breast cancer [12][13][14], skin melanoma [15], as well as chronic rhinitis [16], and oral lesion [17].…”

“…Despite the variety of nosologies and localizations of tissue lesions that can be treated by cryoablation, it is possible to distinguish percutaneous and superficial applications. Percutaneous cryoablation implies thin needle-like probes, which are often based on Joule-Thomson effect and flow of high-pressure gas, for example, argon [12,[18][19][20][21][22]. Such probes can be even combined with an endoscope, since it is possible to make them flexible and thermally insulated, except for metal tips that are in the direct contact with tissues [23].…”