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Zotov AK, Pushkarev AV, Alekseeva AI, Zaytsev KI, Ryabikin SS, Tsiganov DI, Zhidkov DA, Burkov IA, Kurlov VN, Dolganova IN. Optical Sensing of Tissue Freezing Depth by Sapphire Cryo-Applicator and Steady-State Diffuse Reflectance Analysis. SENSORS (BASEL, SWITZERLAND) 2024; 24:3655. [PMID: 38894444 PMCID: PMC11175356 DOI: 10.3390/s24113655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/31/2024] [Accepted: 06/02/2024] [Indexed: 06/21/2024]
Abstract
This work describes a sapphire cryo-applicator with the ability to sense tissue freezing depth during cryosurgery by illumination of tissue and analyzing diffuse optical signals in a steady-state regime. The applicator was manufactured by the crystal growth technique and has several spatially resolved internal channels for accommodating optical fibers. The method of reconstructing freezing depth proposed in this work requires one illumination and two detection channels. The analysis of the detected intensities yields the estimation of the time evolution of the effective attenuation coefficient, which is compared with the theoretically calculated values obtained for a number of combinations of tissue parameters. The experimental test of the proposed applicator and approach for freezing depth reconstruction was performed using gelatin-based tissue phantom and rat liver tissue in vivo. It revealed the ability to estimate depth up to 8 mm. The in vivo study confirmed the feasibility of the applicator to sense the freezing depth of living tissues despite the possible diversity of their optical parameters. The results justify the potential of the described design of a sapphire instrument for cryosurgery.
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Affiliation(s)
- Arsen K. Zotov
- Osipyan Institute of Solid State Physics of the Russian Academy of Sciences, Chernogolovka 142432, Russia; (A.K.Z.)
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow 119991, Russia
| | - Aleksandr V. Pushkarev
- Bauman Moscow State Technical University, Moscow 105005, Russia
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education”, Ministry of Healthcare of the Russian Federation, Moscow 125993, Russia
| | - Anna I. Alekseeva
- Avtsyn Research Institute of Human Morphology, FSBSI “Petrovsky National Research Centre of Surgery”, Moscow 117418, Russia
| | - Kirill I. Zaytsev
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow 119991, Russia
| | - Sergey S. Ryabikin
- Bauman Moscow State Technical University, Moscow 105005, Russia
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education”, Ministry of Healthcare of the Russian Federation, Moscow 125993, Russia
| | - Dmitry I. Tsiganov
- Bauman Moscow State Technical University, Moscow 105005, Russia
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education”, Ministry of Healthcare of the Russian Federation, Moscow 125993, Russia
| | - Dmitriy A. Zhidkov
- Bauman Moscow State Technical University, Moscow 105005, Russia
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education”, Ministry of Healthcare of the Russian Federation, Moscow 125993, Russia
| | - Ivan A. Burkov
- Bauman Moscow State Technical University, Moscow 105005, Russia
| | - Vladimir N. Kurlov
- Osipyan Institute of Solid State Physics of the Russian Academy of Sciences, Chernogolovka 142432, Russia; (A.K.Z.)
| | - Irina N. Dolganova
- Osipyan Institute of Solid State Physics of the Russian Academy of Sciences, Chernogolovka 142432, Russia; (A.K.Z.)
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Misuraca L, Lugnani F, Brassetti A, Cacciatore L, Tedesco F, Anceschi U, Bove AM, D'Annunzio S, Ferriero M, Guaglianone S, Mastroianni R, Tuderti G, Panebianco V, Sentinelli S, Simone G. Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study. J Pers Med 2023; 13:978. [PMID: 37373967 DOI: 10.3390/jpm13060978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Our study explored frozen section reliability in prostate cancer (PCa) diagnoses and described surgical steps of a 3D magnetic resonance imaging (MRI)-ultrasound (US)-guided prostate biopsy (PB) and focal cryoablation of the index lesion (IL) in a single-setting procedure. Patients with a suspicious prostatic specific antigen (PSA) value, with a PIRADS 4 or 5 single lesion, were enrolled for trans perineal 3D MRI-US-guided PB and TRUS-guided focal cryoablation. Three cores were taken from the IL, three cores from the surrounding area, while systematic sampling was performed for the rest of the gland. After confirmation of PCa in frozen sections, focal cryoablation was performed. The 1st-year follow-up schedule included a PSA test at a 3-month interval, MRI 3 months and 1 year postoperatively and PB of the treated area at 1 year. Following the follow-up schedule, an involved PSA test at a 3-month interval and yearly MRI were performed. The PCa diagnosis was histologically confirmed in all three patients with frozen sections. At final histology, a single Gleason score upgrade from 6 (3 + 3) to 7 (3 + 4) was observed. All patients were discharged on postoperative day 1. At the 3-month evaluation, mean PSA values decreased from 12.54 (baseline) to 1.73 ng/mL and MRI images showed complete ablation of the IL in all patients. Urinary continence and potency were preserved in all patients. At the 1-year follow-up, one patient had suspicious ipsilateral recurrence on MRI and underwent a new analogous procedure. Post follow-up was uneventful and PSA remained stable in all patients. Three-dimensional MRI-US-guided frozen sectioning and focal cryoablation of the IL is a step forward towards a "patient-tailored" minimally invasive approach to the diagnosis and cure of PCa.
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Affiliation(s)
- Leonardo Misuraca
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy
| | - Franco Lugnani
- Department of Urology, Hippocrates D.O.O, 6215 Divaca, Slovenia
| | - Aldo Brassetti
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy
| | - Loris Cacciatore
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Francesco Tedesco
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Umberto Anceschi
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy
| | - Alfredo Maria Bove
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy
| | - Simone D'Annunzio
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy
| | | | - Salvatore Guaglianone
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy
| | - Riccardo Mastroianni
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy
| | - Gabriele Tuderti
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy
| | | | - Steno Sentinelli
- Department of Pathology, IRCCS "Regina Elena" National Cancer Institute, 00128 Rome, Italy
| | - Giuseppe Simone
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy
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