1
|
Schwartz J, Auloge P, Koch G, Robinson JM, Garnon J, Cazzato RL, Perruisseau-Carrier J, Debry C, Gangi A. Percutaneous Cryoablation for Recurrent Head and Neck Tumors. Cardiovasc Intervent Radiol 2022; 45:791-799. [PMID: 35378612 DOI: 10.1007/s00270-022-03120-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 03/07/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To report techniques and results of 16 cryoablation procedures in 11 patients treated for recurrent head and neck cancer. METHODS AND MATERIALS This retrospective study reviewed 11 consecutive patients with head and neck cancer recurrence after primary treatment by surgery and radiotherapy, treated with cryoablation between 2016 and 2020. Efficacy was measured by local control rate evaluated on MRI or/and PET. Tumor characteristics, number of cryoprobes, thermoprotective measures and complications were documented. RESULTS Sixteen cryoablation procedures were performed in 11 patients with head and neck cancer recurrence after surgery or radiotherapy, deemed ineligible for classic salvage treatment. Among 11 patients, four were treated for an epidermoid carcinoma, four for an adenocarcinoma and three for other types: 1 muco-epidermoid carcinoma, 1 adenoid cystic carcinoma and 1 esthesioneuroblastoma, 10/11 patients had prior surgery, 7/11 patients had prior chemotherapy and 3/11 patients had prior radiotherapy. Median number of cryoprobes was 4, [IQR, 3-6 cryoprobes], thermoprotective measures to protect surrounding organs were required for 10/16 procedures. After cryoablation, local control rate was 45.4% at a mean follow-up of 11.7 months (range 3-34 months). Among the 16 cryoablation procedures, four resulted in complications, two were considered major complications: one septic shock on inhalation pneumopathy during extubation, requiring intensive care; and one dysphonia due to a recurrent nerve injury. CONCLUSION Cryoablation as a salvage treatment for recurrence of head and neck tumors after surgery and/or radiotherapy is an effective option, especially for patients that cannot benefit from salvage surgery.
Collapse
Affiliation(s)
- Jean Schwartz
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 1, place de l'hopital, 67000, Strasbourg, France.
| | - Pierre Auloge
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 1, place de l'hopital, 67000, Strasbourg, France
| | - Guillaume Koch
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 1, place de l'hopital, 67000, Strasbourg, France
| | - Joey Marie Robinson
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 1, place de l'hopital, 67000, Strasbourg, France
| | - Julien Garnon
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 1, place de l'hopital, 67000, Strasbourg, France
| | - Roberto Luigi Cazzato
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 1, place de l'hopital, 67000, Strasbourg, France
| | - Joffrey Perruisseau-Carrier
- Service d'oto-rhino-laryngologie, Hopitaux Universitaire de Strasbourg, 1, avenue Molière, 67200, Strasbourg, France
| | - Christian Debry
- Service d'oto-rhino-laryngologie, Hopitaux Universitaire de Strasbourg, 1, avenue Molière, 67200, Strasbourg, France
| | - Afshin Gangi
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 1, place de l'hopital, 67000, Strasbourg, France
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, WC2R 2LS, UK
| |
Collapse
|
2
|
Serrano E, Zarco F, Gill AE, Hawkins CM, Macías N, Inarejos Clemente EJ, Torner F, Barber I, Corominas D, González EL, López-Rueda A, Gómez FM. Percutaneous cryoablation of chondroblastoma and osteoblastoma in pediatric patients. Insights Imaging 2021; 12:106. [PMID: 34313884 PMCID: PMC8314258 DOI: 10.1186/s13244-021-01036-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To review the safety and efficacy of percutaneous cryoablation for the treatment of chondroblastoma and osteoblastoma in the pediatric and adolescent population. MATERIALS AND METHODS A retrospective review from 2016 to 2020 was performed to evaluate clinical and imaging response to percutaneous cryoablation in 11 symptomatic patients with diagnosis of chondroblastoma and osteoblastoma treated from two pediatric hospitals with at least 12-month follow-up. Technical success (correct needle placement and potential full coverage of the tumor with the planned ablation zone) and clinical success (relief of the symptoms) were evaluated. The primary objective was to alleviate pain related to the lesion(s). Immediate and late complications were recorded. Patients were followed in clinic and with imaging studies such as MRI or CT for a minimum of 6 months. RESULTS A total of 11 patients were included (mean 14 years, age range 9-17; male n = 8). Diagnoses were osteoblastoma (n = 4) and chondroblastoma (n = 7). Locations were proximal humerus (n = 1), femur condyle (n = 1), and proximal femur (n = 1) tibia (n = 3), acetabulum (n = 3), thoracic vertebra (n = 1) and lumbar vertebra (n = 1). Cryoablation was technically successful in all patients. Clinical success (cessation of pain) was achieved in all patients. No signs of recurrence were observed on imaging follow-up in any of the patients. One of the patients developed periprocedural right L2-L3 transient radiculopathy as major immediate complication. CONCLUSIONS Percutaneous image-guided cryoablation can be considered potentially safe and effective treatment for chondroblastoma and osteoblastoma in children and adolescents.
Collapse
Affiliation(s)
- Elena Serrano
- Department of Interventional Radiology, Hospital Clínic Barcelona, Barcelona, Spain.,Department of Interventional Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Federico Zarco
- Department of Interventional Radiology, Hospital Clínic Barcelona, Barcelona, Spain.,Department of Interventional Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Anne E Gill
- Department of Interventional Radiology, Children's Healthcare of Atlanta, Egleston Hospital, Atlanta, Georgia
| | - C Matthew Hawkins
- Department of Interventional Radiology, Children's Healthcare of Atlanta, Egleston Hospital, Atlanta, Georgia
| | - Napoleón Macías
- Department of Interventional Radiology, Hospital Clínic Barcelona, Barcelona, Spain.,Department of Interventional Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | | | - Ferran Torner
- Pediatric Orthopaedics and Traumatology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Ignasi Barber
- Department of Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Daniel Corominas
- Department of Interventional Radiology, Hospital Clínic Barcelona, Barcelona, Spain.,Department of Interventional Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Enrique Ladera González
- Department of Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Antonio López-Rueda
- Department of Interventional Radiology, Hospital Clínic Barcelona, Barcelona, Spain.,Department of Interventional Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Fernando M Gómez
- Department of Interventional Radiology, Hospital Clínic Barcelona, Barcelona, Spain. .,Department of Interventional Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
| |
Collapse
|
3
|
Auloge P, Garnon J, Robinson JM, Thenint MA, Koch G, Caudrelier J, Weiss J, Cazzato RL, Kurtz JE, Gangi A. Percutaneous cryoablation for advanced and refractory extra-abdominal desmoid tumors. Int J Clin Oncol 2021; 26:1147-1158. [PMID: 33709291 DOI: 10.1007/s10147-021-01887-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/11/2021] [Indexed: 01/21/2023]
Abstract
PURPOSE To assess efficacy and safety of percutaneous cryoablation (CA) for advanced and refractory extra-abdominal desmoid tumors. MATERIALS AND METHODS This retrospective study reviewed 30 consecutive patients with symptomatic desmoid tumors evolving after "wait and watch" periods, and despite medical treatment, treated by CA between 2007 and 2019. Progression free survival (PFS), objective response rate, pain reduction (decreased of visual analogic scale pain (VAS)[Formula: see text] 3 or disappearance of pain), total volume lesion (TVL) and complications were documented. Kaplan Meier method was used to outline PFS. Paired sample t test was used to compare volume of tumors before treatment and at 1 and 3 year. RESULTS With a median follow-up of 18.5 months (range 6-93 months, interquartile range (IQR): 12-55), the PFS was 85.1% at 1 year and 77.3% at 3 years. Objective response was obtained for 80% of patients with a complete response for 43% patients. Pain reduction was obtained for 96.7% (95% confidence interval (95% CI): 90.3, 100) of patients. Median volume of desmoid tumor before treatment was 124.1cm3 (range 2-1727cm3, IQR: 54-338cm3). Median change of TLV after ablation was 66.6% (95% CI: 37.2, 72.3; p = 0.002) at 1 year and 76.4% (95% CI: 59.1, 89.8; p = 0.002) at 3 year. Adverse events rate was 36.6%, the most common was edema and temporary increase of pain in the days following CA. Four patients experienced a major complication (13.3%): 2 skin necrosis, 1 infection and 1 brachial plexopathy. CONCLUSION CA is an effective treatment for advanced and refractory extra-abdominal desmoid tumor, that induces durable responses.
Collapse
Affiliation(s)
- Pierre Auloge
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 3 rue des Alisiers, 67100, Strasbourg, France.
| | - Julien Garnon
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 3 rue des Alisiers, 67100, Strasbourg, France
| | - Joey Marie Robinson
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 3 rue des Alisiers, 67100, Strasbourg, France
| | | | - Guillaume Koch
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 3 rue des Alisiers, 67100, Strasbourg, France
| | - Jean Caudrelier
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 3 rue des Alisiers, 67100, Strasbourg, France
| | - Julia Weiss
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 3 rue des Alisiers, 67100, Strasbourg, France
| | - Roberto Luigi Cazzato
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 3 rue des Alisiers, 67100, Strasbourg, France
| | - Jean Emmanuel Kurtz
- Service d'Oncologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Afshin Gangi
- Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 3 rue des Alisiers, 67100, Strasbourg, France
| |
Collapse
|
4
|
Magalov Z, Avraham S, David D. A Novel, Efficient, Unit Circle-Based, Method for Positioning and Operating Cryo-Surgical Probes in Convex Target Areas. J Biomech Eng 2021; 143:021007. [PMID: 32909598 DOI: 10.1115/1.4048402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Indexed: 11/08/2022]
Abstract
A novel method for positioning and operating needle-like cryo-surgical probes in 2D convex target areas is presented. The method is based on the recorded dynamic performance of a single probe, termed "unit circle," (UC) embedded in a semi-infinite, tissue-like medium. Up to 15 cryo-probes, inserted into the same depth, are operated uniformly for 2-5 min. A predetermined number of probes are rearranged inside the target area until a "tight configuration" is obtained. The probes are initially arranged inside the target area such that the "lethal temperature" circles produced by them are tangent to its contour and to both adjacent lethal temperature circles. Subsequently, all probes are repositioned inwardly, each at a specific distance that depends on the local radius of curvature of the target area. Resulting total "defect areas"-internal and external-for a number of demonstrated cases, amounted to between 2.5% and 7.6% of the target area. The lower values of the defect areas were obtained with increasing numbers of inserted probes coupled with shorter operating times. Possible freezing damages to regions beyond the target area were reduced by up to about 30% for these cases. Similar results were obtained for a case of combined convex-concave target area, treated with additional, externally inserted, heating probes.
Collapse
Affiliation(s)
- Zaur Magalov
- Department of Mechanical Engineering, Technion, Israel Institute of Technology, Haifa 32000, Israel
| | - Shitzer Avraham
- Department of Mechanical Engineering, Technion, Israel Institute of Technology, Haifa 32000, Israel
| | - Degani David
- Department of Mechanical Engineering, Technion, Israel Institute of Technology, Haifa 32000, Israel
| |
Collapse
|
5
|
Validation of a Web-Based Planning Tool for Percutaneous Cryoablation of Renal Tumors. Cardiovasc Intervent Radiol 2020; 43:1661-1670. [PMID: 32935141 PMCID: PMC7591419 DOI: 10.1007/s00270-020-02634-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 08/20/2020] [Indexed: 01/29/2023]
Abstract
Purpose To validate a simulation environment for virtual planning of percutaneous cryoablation of renal tumors. Materials and Methods Prospectively collected data from 19 MR-guided procedures were used for validation of the simulation model. Volumetric overlap of the simulated ablation zone volume (Σ) and the segmented ablation zone volume (S; assessed on 1-month follow-up scan) was quantified. Validation metrics were DICE Similarity Coefficient (DSC; the ratio between twice the overlapping volume of both ablation zones divided by the sum of both ablation zone volumes), target overlap (the ratio between the overlapping volume of both ablation zones to the volume of S; low ratio means S is underestimated), and positive predictive value (the ratio between the overlapping volume of both ablation zones to the volume of Σ; low ratio means S is overestimated). Values were between 0 (no alignment) and 1 (perfect alignment), a value > 0.7 is considered good. Results Mean volumes of S and Σ were 14.8 cm3 (± 9.9) and 26.7 cm3 (± 15.0), respectively. Mean DSC value was 0.63 (± 0.2), and ≥ 0.7 in 9 cases (47%). Mean target overlap and positive predictive value were 0.88 (± 0.11) and 0.53 (± 0.24), respectively. In 17 cases (89%), target overlap was ≥ 0.7; positive predictive value was ≥ 0.7 in 4 cases (21%) and < 0.6 in 13 cases (68%). This indicates S is overestimated in the majority of cases. Conclusion The validation results showed a tendency of the simulation model to overestimate the ablation effect. Model adjustments are necessary to make it suitable for clinical use.
Collapse
|
6
|
Golkar E, Rao PP, Joskowicz L, Gangi A, Essert C. GPU-based 3D iceball modeling for fast cryoablation simulation and planning. Int J Comput Assist Radiol Surg 2019; 14:1577-1588. [PMID: 31407156 DOI: 10.1007/s11548-019-02051-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 08/05/2019] [Indexed: 02/01/2023]
Abstract
PURPOSE The elimination of abdominal tumors by percutaneous cryoablation has been shown to be an effective and less invasive alternative to open surgery. Cryoablation destroys malignant cells by freezing them with one or more cryoprobes inserted into the tumor through the skin. Alternating cycles of freezing and thawing produce an enveloping iceball that causes the tumor necrosis. Planning such a procedure is difficult and time-consuming, as it is necessary to plan the number and cryoprobe locations and predict the iceball shape which is also influenced by the presence of heating sources, e.g., major blood vessels and warm saline solution, injected to protect surrounding structures from the cold. METHODS This paper describes a method for fast GPU-based iceball modeling based on the simulation of thermal propagation in the tissue. Our algorithm solves the heat equation within a cube around the cryoprobes tips and accounts for the presence of heating sources around the iceball. RESULTS Experimental results of two studies have been obtained: an ex vivo warm gel setup and simulation on five retrospective patient cases of kidney tumors cryoablation with various levels of complexity of the vascular structure and warm saline solution around the tumor tissue. The experiments have been conducted in various conditions of cube size and algorithm implementations. Results show that it is possible to obtain an accurate result within seconds. CONCLUSION The promising results indicate that our method yields accurate iceball shape predictions in a short time and is suitable for surgical planning.
Collapse
Affiliation(s)
- Ehsan Golkar
- ICube, Université de Strasbourg, Strasbourg, France
- Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Pramod P Rao
- Department of Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - Leo Joskowicz
- School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Afshin Gangi
- Department of Radiology, University Hospital of Strasbourg, Strasbourg, France
| | | |
Collapse
|
7
|
Auloge P, Cazzato RL, Rousseau C, Caudrelier J, Koch G, Rao P, Chiang JB, Garnon J, Gangi A. Complications of Percutaneous Bone Tumor Cryoablation: A 10-year Experience. Radiology 2019; 291:521-528. [PMID: 30806603 DOI: 10.1148/radiol.2019181262] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background Percutaneous cryoablation has been shown to be effective in the management of painful bone tumors. However, knowledge of the complication rate and risk factors for complication is currently lacking. Purpose To report the complication rate and associated risk factors for bone tumor cryoablation. Materials and Methods This retrospective study reviewed complications in 239 consecutive patients (131 men and 108 women; median age, 64 years; age range, 6-86 years) who underwent cryoablation of 320 primary or metastatic bone tumors between January 2008 and November 2017. Common Terminology Criteria for Adverse Events was used to categorize complications as major (grade 3-4) or minor (grade 1-2). Multivariable analysis was performed for variables with P values less than .20, including age, tumor location, adjacent critical structures, number of cryoprobes, and Eastern Cooperative Oncology Group performance status (ECOG-PS). Results Among the 320 tumors, the total complication rate was 9.1% (29 of 320; 95% confidence interval [CI]: 6%, 12.2%). The major complication rate was 2.5% (eight of 320; 95% CI: 0.8%, 4.2%), with secondary fracture the most frequent complication (1.2% [four of 320]; mean delay, 71 days); cryoablation site infection, tumor seeding, bleeding, and severe hypotension were each observed in 0.3% (one of 320) of procedures. Minor complications included postprocedural pain (2.2% [seven of 320]), peripheral neuropathy (0.9% [three of 320]), and temporary paresthesia (0.9% [three of 320]). For all complications, associated risk factors included ECOG-PS greater than 2 (odds ratio [OR], 3.1 [95% CI: 3, 7.6]; P = .01), long-bone cryoablation (OR, 17.8 [95% CI: 2.3, 136.3]; P = .01), and use of more than three cryoprobes (OR, 2.5 [95% CI: 1.0, 6.0]; P = .04); for major complications, associated risk factors included age greater than 70 years (OR, 7.1 [95% CI: 1.6, 31.7]; P = .01) and use of more than three cryoprobes (OR, 23.6 [95% CI: 2.8, 199.0]; P = .01). Conclusion Bone tumor cryoablation is safe, with a 2.5% rate of major complications, most commonly secondary fracture (1.2%). Major complications are associated with age greater than 70 years and use of more than three cryoprobes. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Jennings in this issue.
Collapse
Affiliation(s)
- Pierre Auloge
- From the Department of Interventional Radiology, Nouvel Hôpital Civil, University Hospital of Strasbourg, 1 Place de l'Hôpital, BP 426, 67091 Strasbourg, France (P.A., R.L.C., J.C., G.K., J.G., A.G.); Clinical Investigation Center INSERM 1414, University Hospital of Rennes and University of Rennes, Rennes, France (C.R.); Division of Robotics and Department of Interventional Radiology, ICube, University of Strasbourg and Nouvel Hopital Civil, Strasbourg, France (P.R.); and Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong (J.B.C.)
| | - Roberto L Cazzato
- From the Department of Interventional Radiology, Nouvel Hôpital Civil, University Hospital of Strasbourg, 1 Place de l'Hôpital, BP 426, 67091 Strasbourg, France (P.A., R.L.C., J.C., G.K., J.G., A.G.); Clinical Investigation Center INSERM 1414, University Hospital of Rennes and University of Rennes, Rennes, France (C.R.); Division of Robotics and Department of Interventional Radiology, ICube, University of Strasbourg and Nouvel Hopital Civil, Strasbourg, France (P.R.); and Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong (J.B.C.)
| | - Chloé Rousseau
- From the Department of Interventional Radiology, Nouvel Hôpital Civil, University Hospital of Strasbourg, 1 Place de l'Hôpital, BP 426, 67091 Strasbourg, France (P.A., R.L.C., J.C., G.K., J.G., A.G.); Clinical Investigation Center INSERM 1414, University Hospital of Rennes and University of Rennes, Rennes, France (C.R.); Division of Robotics and Department of Interventional Radiology, ICube, University of Strasbourg and Nouvel Hopital Civil, Strasbourg, France (P.R.); and Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong (J.B.C.)
| | - Jean Caudrelier
- From the Department of Interventional Radiology, Nouvel Hôpital Civil, University Hospital of Strasbourg, 1 Place de l'Hôpital, BP 426, 67091 Strasbourg, France (P.A., R.L.C., J.C., G.K., J.G., A.G.); Clinical Investigation Center INSERM 1414, University Hospital of Rennes and University of Rennes, Rennes, France (C.R.); Division of Robotics and Department of Interventional Radiology, ICube, University of Strasbourg and Nouvel Hopital Civil, Strasbourg, France (P.R.); and Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong (J.B.C.)
| | - Guillaume Koch
- From the Department of Interventional Radiology, Nouvel Hôpital Civil, University Hospital of Strasbourg, 1 Place de l'Hôpital, BP 426, 67091 Strasbourg, France (P.A., R.L.C., J.C., G.K., J.G., A.G.); Clinical Investigation Center INSERM 1414, University Hospital of Rennes and University of Rennes, Rennes, France (C.R.); Division of Robotics and Department of Interventional Radiology, ICube, University of Strasbourg and Nouvel Hopital Civil, Strasbourg, France (P.R.); and Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong (J.B.C.)
| | - Pramod Rao
- From the Department of Interventional Radiology, Nouvel Hôpital Civil, University Hospital of Strasbourg, 1 Place de l'Hôpital, BP 426, 67091 Strasbourg, France (P.A., R.L.C., J.C., G.K., J.G., A.G.); Clinical Investigation Center INSERM 1414, University Hospital of Rennes and University of Rennes, Rennes, France (C.R.); Division of Robotics and Department of Interventional Radiology, ICube, University of Strasbourg and Nouvel Hopital Civil, Strasbourg, France (P.R.); and Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong (J.B.C.)
| | - Jeanie Betsy Chiang
- From the Department of Interventional Radiology, Nouvel Hôpital Civil, University Hospital of Strasbourg, 1 Place de l'Hôpital, BP 426, 67091 Strasbourg, France (P.A., R.L.C., J.C., G.K., J.G., A.G.); Clinical Investigation Center INSERM 1414, University Hospital of Rennes and University of Rennes, Rennes, France (C.R.); Division of Robotics and Department of Interventional Radiology, ICube, University of Strasbourg and Nouvel Hopital Civil, Strasbourg, France (P.R.); and Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong (J.B.C.)
| | - Julien Garnon
- From the Department of Interventional Radiology, Nouvel Hôpital Civil, University Hospital of Strasbourg, 1 Place de l'Hôpital, BP 426, 67091 Strasbourg, France (P.A., R.L.C., J.C., G.K., J.G., A.G.); Clinical Investigation Center INSERM 1414, University Hospital of Rennes and University of Rennes, Rennes, France (C.R.); Division of Robotics and Department of Interventional Radiology, ICube, University of Strasbourg and Nouvel Hopital Civil, Strasbourg, France (P.R.); and Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong (J.B.C.)
| | - Afshin Gangi
- From the Department of Interventional Radiology, Nouvel Hôpital Civil, University Hospital of Strasbourg, 1 Place de l'Hôpital, BP 426, 67091 Strasbourg, France (P.A., R.L.C., J.C., G.K., J.G., A.G.); Clinical Investigation Center INSERM 1414, University Hospital of Rennes and University of Rennes, Rennes, France (C.R.); Division of Robotics and Department of Interventional Radiology, ICube, University of Strasbourg and Nouvel Hopital Civil, Strasbourg, France (P.R.); and Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong (J.B.C.)
| |
Collapse
|
8
|
Bellil M, Saidane A, Bennaoum M. A TLM study of bioheat transfer during freeze-thaw cryosurgery. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aae40e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
9
|
Overduin CG, Fütterer JJ, Scheenen TW. 3D MR thermometry of frozen tissue: Feasibility and accuracy during cryoablation at 3T. J Magn Reson Imaging 2016; 44:1572-1579. [DOI: 10.1002/jmri.25301] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 04/21/2016] [Accepted: 04/21/2016] [Indexed: 11/06/2022] Open
Affiliation(s)
- Christiaan G. Overduin
- Department of Radiology and Nuclear Medicine; Radboud University Medical Center; Nijmegen the Netherlands
| | - Jurgen J. Fütterer
- Department of Radiology and Nuclear Medicine; Radboud University Medical Center; Nijmegen the Netherlands
- MIRA Institute for Biomedical Engineering and Technical Medicine; University of Twente; Enschede the Netherlands
| | - Tom W.J. Scheenen
- Department of Radiology and Nuclear Medicine; Radboud University Medical Center; Nijmegen the Netherlands
| |
Collapse
|
10
|
Etheridge ML, Choi J, Ramadhyani S, Bischof JC. Methods for characterizing convective cryoprobe heat transfer in ultrasound gel phantoms. J Biomech Eng 2013; 135:021002. [PMID: 23445047 DOI: 10.1115/1.4023237] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
While cryosurgery has proven capable in treating of a variety of conditions, it has met with some resistance among physicians, in part due to shortcomings in the ability to predict treatment outcomes. Here we attempt to address several key issues related to predictive modeling by demonstrating methods for accurately characterizing heat transfer from cryoprobes, report temperature dependent thermal properties for ultrasound gel (a convenient tissue phantom) down to cryogenic temperatures, and demonstrate the ability of convective exchange heat transfer boundary conditions to accurately describe freezing in the case of single and multiple interacting cryoprobe(s). Temperature dependent changes in the specific heat and thermal conductivity for ultrasound gel are reported down to -150 °C for the first time here and these data were used to accurately describe freezing in ultrasound gel in subsequent modeling. Freezing around a single and two interacting cryoprobe(s) was characterized in the ultrasound gel phantom by mapping the temperature in and around the "iceball" with carefully placed thermocouple arrays. These experimental data were fit with finite-element modeling in COMSOL Multiphysics, which was used to investigate the sensitivity and effectiveness of convective boundary conditions in describing heat transfer from the cryoprobes. Heat transfer at the probe tip was described in terms of a convective coefficient and the cryogen temperature. While model accuracy depended strongly on spatial (i.e., along the exchange surface) variation in the convective coefficient, it was much less sensitive to spatial and transient variations in the cryogen temperature parameter. The optimized fit, convective exchange conditions for the single-probe case also provided close agreement with the experimental data for the case of two interacting cryoprobes, suggesting that this basic characterization and modeling approach can be extended to accurately describe more complicated, multiprobe freezing geometries. Accurately characterizing cryoprobe behavior in phantoms requires detailed knowledge of the freezing medium's properties throughout the range of expected temperatures and an appropriate description of the heat transfer across the probe's exchange surfaces. Here we demonstrate that convective exchange boundary conditions provide an accurate and versatile description of heat transfer from cryoprobes, offering potential advantages over the traditional constant surface heat flux and constant surface temperature descriptions. In addition, although this study was conducted on Joule-Thomson type cryoprobes, the general methodologies should extend to any probe that is based on convective exchange with a cryogenic fluid.
Collapse
Affiliation(s)
- Michael L Etheridge
- Department of Mechanical Engineering, Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | | | | | | |
Collapse
|
11
|
Investigating the cryoablative efficacy of a hybrid cryoprobe operating under freeze–thaw cycles. Cryobiology 2013; 66:239-49. [DOI: 10.1016/j.cryobiol.2013.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 01/03/2013] [Accepted: 02/04/2013] [Indexed: 11/21/2022]
|
12
|
Young JL, McCormick DW, Kolla SB, Sountoulides PG, Kaufmann OG, Ortiz-Vanderdys CG, Huynh VB, Kaplan AG, Jain NS, Pick DL, Andrade LA, Osann KE, McDougall EM, Clayman RV. Are multiple cryoprobes additive or synergistic in renal cryotherapy? Urology 2011; 79:484.e1-6. [PMID: 22192230 DOI: 10.1016/j.urology.2011.10.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 10/21/2011] [Accepted: 10/21/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the relationship between multiple cryoprobes was investigated to determine whether they work in an additive or synergistic fashion in an in vivo animal model because 1.47 mm (17-gauge) cryoprobes have been introduced to the armamentarium for renal cryotherapy. METHODS Laparoscopic-guided percutaneous cryoablation was performed in both renal poles of 3 pigs using 3 IceRod cryoprobes. These 12 cryolesions were compared with 12 cryolesions using a single IceRod cryoprobe. Each cycle consisted of two 10-minute freeze cycles separated by a 5-minute thaw. The iceball volume was measured using intraoperative ultrasonography. The kidneys were harvested, and cryolesion surface area was calculated. The lesions were fixed and excised to obtain a volume measurement. Statistical analysis was used to compare the single probe results multiplied by 3 to the multiple probe group for iceball volume, cryolesion surface area, and cryolesion volume. RESULTS The iceball volume for the first freeze cycle for the single cryoprobe multiplied by 3 was 8.55 cm3 compared with 9.79 cm3 for the multiple cryoprobe group (P=.44) and 10.01 cm3 versus 16.58 cm3 for the second freeze (P=.03). The cryolesion volume for the single cryoprobe multiplied by 3 was 11.29 cm3 versus 14.75 cm3 for the multiple cyroprobe group (P=.06). The gross cryolesion surface area for the single cryoprobe multiplied by 3 was 13.14 cm2 versus 13.89 cm2 for the multiple probe group (P=.52). CONCLUSION The cryolesion created by 3 simultaneously activated 1.47-mm probes appears to be larger than that of an additive effect. The lesions were significantly larger as measured by ultrasonography and nearly so (P=.06) as measured by the gross cryolesion volume.
Collapse
|
13
|
Affiliation(s)
- Jennifer L. Young
- Department of Urology, University of California Irvine, Orange, California
| | - Ralph V. Clayman
- Department of Urology, University of California Irvine, Orange, California
| |
Collapse
|
14
|
Zhao F, Chen ZQ, Shi MH. Numerical study on freezing-thawing phase change heat transfer in biological tissue embedded with two cryoprobes. ACTA ACUST UNITED AC 2009. [DOI: 10.1007/s11771-009-0055-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
15
|
Rabin Y. Key issues in bioheat transfer simulations for the application of cryosurgery planning. Cryobiology 2008; 56:248-50. [PMID: 18374324 DOI: 10.1016/j.cryobiol.2008.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Revised: 02/11/2008] [Accepted: 02/19/2008] [Indexed: 10/22/2022]
Abstract
The bioheat transfer simulation is undoubtedly the foundation for developing computerized tools for cryosurgery planning and analysis. While a large variety of techniques for bioheat transfer simulations are available in the literature of the past several decades, it is only their integration with clinical criteria and constraints which can make computerized planning a practical reality. This brief communication outlines (in the opinion of this author) the key issues that must be addressed in the application of bioheat transfer to cryosurgery planning and analysis, while drawing attention to recent and relevant publications in other journals, with reference to the most recent publication on the topic in the Journal of Cryobiology [Z. Magalov, A. Shitzer, D. Degani, Isothermal volume contours generated in a freezing gel by embedded cryo-needles with applications to cryo-surgery, Cryobiology 55 (2) (2007) 127-137].
Collapse
Affiliation(s)
- Yoed Rabin
- Biothermal Technology Laboratory, Department of Mechanical Engineering, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15237, USA.
| |
Collapse
|