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Chua GWY, Li L. Treatment Options for Early Stage Inoperable Breast Cancer: Cryoablation or Radiotherapy? Breast Care (Basel) 2024; 19:106-115. [PMID: 38645759 PMCID: PMC11026071 DOI: 10.1159/000536413] [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: 09/16/2023] [Accepted: 01/18/2024] [Indexed: 04/23/2024] Open
Abstract
Background Surgical removal of the tumour is the gold standard treatment for early stage invasive breast cancer. However, with a global ageing population, a larger number of diagnoses are occurring in women with comorbidities that render them unsuitable for surgery. Hence, it is of interest to explore alternative treatment strategies for this group of women. Summary Our narrative review aims to explore two such techniques, cryoablation and external beam radiotherapy, providing a brief summary of the evidence behind each technique. Following this, we discuss which groups of patients would gain the most benefit from each technique. Factors favouring the use of radiotherapy include patients with larger tumours, more superficial tumours, and those with less well-demarcated tumours where there is uncertainty regarding tumour extent. Meanwhile, patients who may benefit more from cryoablation include those who desire a smaller number of treatment sessions, have concerns regarding cosmesis and skin pigmentation, or who have relative contraindications to radiotherapy such as scleroderma, systemic lupus erythematosus, reduced lung function, or cardiac comorbidities. Key Messages Continued advancements in both cryoablation and radiotherapy technologies are taking place, in tandem with imaging technologies enabling greater certainty in tumour detection and delineation. These factors will help increase local control rates in this group of non-operable early stage breast cancer patients. Through this review, we hope to aid in the clinical decision-making process regarding the selection and referral of patients for each treatment.
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Affiliation(s)
- Gail Wan Ying Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Lucia Li
- Medical Sciences Division, University of Cambridge, Cambridge, UK
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2
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Mokbel K, Kodresko A, Ghazal H, Mokbel R, Trembley J, Jouhara H. Cryogenic Media in Biomedical Applications: Current Advances, Challenges, and Future Perspectives. In Vivo 2024; 38:1-39. [PMID: 38148045 PMCID: PMC10756490 DOI: 10.21873/invivo.13407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 12/28/2023]
Abstract
This paper explores the crucial role of cryogenic mediums in driving breakthroughs within the biomedical sector. The objective was to investigate, critically discuss, and present the current knowledge and state-of-the-art practices, along with the challenges and perspectives of the most common applications. Through an extensive literature review, this work aims to supplement existing research, offering a comprehensive and up-to-date understanding of the subject. Biomedical research involving cryogenic mediums is advancing on multiple fronts, including the development of advanced medical technologies, clinical treatments for life-threatening conditions, high-quality biospecimen preservation, and antimicrobial interventions in industrial food processing. These advances open new horizons and present cutting-edge opportunities for research and the medical community. While the current body of evidence showcases the impressive impact of cryogenic mediums, such as nitrogen, helium, argon, and oxygen, on revolutionary developments, reaching definitive conclusions on their efficiency and safety remains challenging due to process complexity and research scarcity with a moderate certainty of evidence. Knowledge gaps further underline the need for additional studies to facilitate cryogenic research in developing innovative technological processes in biomedicine. These advancements have the potential to reshape the modern world and significantly enhance the quality of life for people worldwide.
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Affiliation(s)
- Kefah Mokbel
- The London Breast Institute, Princess Grace Hospital, London, U.K
| | - Alevtina Kodresko
- Heat Pipe and Thermal Management Research Group, College of Engineering, Design and Physical Sciences, Brunel University, London, U.K
| | - Heba Ghazal
- Kingston University, School of Pharmacy and Chemistry, Kingston Upon Thames, U.K
| | - Ramia Mokbel
- The Princess Grace Hospital, part of HCA Healthcare UK, London, U.K
| | - Jon Trembley
- Air Products PLC, Hersham Place Technology Park, Surrey, U.K
| | - Hussam Jouhara
- Heat Pipe and Thermal Management Research Group, College of Engineering, Design and Physical Sciences, Brunel University, London, U.K.;
- Vytautas Magnus University, Kaunas, Lithuania
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3
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Ayana G, Ryu J, Choe SW. Ultrasound-Responsive Nanocarriers for Breast Cancer Chemotherapy. MICROMACHINES 2022; 13:mi13091508. [PMID: 36144131 PMCID: PMC9503784 DOI: 10.3390/mi13091508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 05/13/2023]
Abstract
Breast cancer is the most common type of cancer and it is treated with surgical intervention, radiotherapy, chemotherapy, or a combination of these regimens. Despite chemotherapy's ample use, it has limitations such as bioavailability, adverse side effects, high-dose requirements, low therapeutic indices, multiple drug resistance development, and non-specific targeting. Drug delivery vehicles or carriers, of which nanocarriers are prominent, have been introduced to overcome chemotherapy limitations. Nanocarriers have been preferentially used in breast cancer chemotherapy because of their role in protecting therapeutic agents from degradation, enabling efficient drug concentration in target cells or tissues, overcoming drug resistance, and their relatively small size. However, nanocarriers are affected by physiological barriers, bioavailability of transported drugs, and other factors. To resolve these issues, the use of external stimuli has been introduced, such as ultrasound, infrared light, thermal stimulation, microwaves, and X-rays. Recently, ultrasound-responsive nanocarriers have become popular because they are cost-effective, non-invasive, specific, tissue-penetrating, and deliver high drug concentrations to their target. In this paper, we review recent developments in ultrasound-guided nanocarriers for breast cancer chemotherapy, discuss the relevant challenges, and provide insights into future directions.
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Affiliation(s)
- Gelan Ayana
- Department of Medical IT Convergence Engineering, Kumoh National Institute of Technology, Gumi 39253, Korea
| | - Jaemyung Ryu
- Department of Optical Engineering, Kumoh National Institute of Technology, Gumi 39253, Korea
- Correspondence: (J.R.); (S.-w.C.); Tel.: +82-54-478-7781 (S.-w.C.); Fax: +82-54-462-1049 (S.-w.C.)
| | - Se-woon Choe
- Department of Medical IT Convergence Engineering, Kumoh National Institute of Technology, Gumi 39253, Korea
- Department of IT Convergence Engineering, Kumoh National Institute of Technology, Gumi 39253, Korea
- Correspondence: (J.R.); (S.-w.C.); Tel.: +82-54-478-7781 (S.-w.C.); Fax: +82-54-462-1049 (S.-w.C.)
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4
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Pusceddu C, Paliogiannis P, Nigri G, Fancellu A. Cryoablation In The Management Of Breast Cancer: Evidence To Date. BREAST CANCER-TARGETS AND THERAPY 2019; 11:283-292. [PMID: 31632134 PMCID: PMC6791835 DOI: 10.2147/bctt.s197406] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/27/2019] [Indexed: 02/05/2023]
Abstract
Cryoablation has been successfully used to treat various type of solid tumors, including breast carcinomas. This ablation method has the advantage of being a minimally invasive procedure useful in various clinical situations, including early breast cancer and metastatic breast cancer, when co-morbidities preclude the use of surgical treatment. However, due to the small sample size of the available studies, reliable and definitive conclusions on the usefulness of cryoablation in patients with breast cancer could not be drawn. In fact, many aspects necessitate to be elucidated, regarding technical issues, indications, efficacy, imaging follow-up, and possible advantages over other percutaneous ablative methods. This review article has the aim to clarify the current evidence supporting cryoablation of breast cancer, and discuss the future perspectives, including those arising from the new studies on immunological effects related to cryoablation.
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Affiliation(s)
- Claudio Pusceddu
- Division of Interventional Radiology, Department of Oncologic Radiology, Businco Hospital, Cagliari, Italy
| | - Panagiotis Paliogiannis
- Unit of Experimental Pathology and Oncology, Department of Medical Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giuseppe Nigri
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, St. Andrea University Hospital, Rome, Italy
| | - Alessandro Fancellu
- Unit of General Surgery 2 - Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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5
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Digital Breast Tomosynthesis as a Tool in Confirming Negative Surgical Margins in Non-palpable Breast Lesions. Indian J Surg Oncol 2019; 10:624-628. [PMID: 31857754 DOI: 10.1007/s13193-019-00956-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 07/23/2019] [Indexed: 10/26/2022] Open
Abstract
Breast cancer is one of the leading killers among women the world over. Widespread mammographic screening programs have led to almost 20% of breast cancers being detected when they are radiologically visible but clinically impalpable. For the localization of these cancers before surgical excision, the Kopan hook wire is the standard technique, but the extent of margins excised still needs to be determined. In this study, we have evaluated the accuracy of specimen mammogram (SM) with digital breast tomosynthesis (DBT) for margin assessment by comparing it to the excised margins as measured in final histopathology. This is a prospective observational study of patients with radiologically suspicious impalpable breast lesions. The patients underwent ultrasound-guided hook wire placement followed by excision of the lesion, subjected to digital tomosynthesis mammogram, and margins were revised on table when indicated. These findings were correlated with final histopathological margin. Our study included 30 patients and out of the 6 lesions, which showed positive margins on specimen mammography, 4 were histologically confirmed to have tumour at the surgical margin and 2 were confirmed to be tumour free. All DBT-positive margins were re-excised at the time of primary surgery. Individual comparison of the margins revealed a good agreement and high level of correlation between DBT and histopathology margins. None of the cases required a second surgery for margin revision. It can be concluded that specimen mammogram with DBT can be used as a reliable tool for intraoperative surgical margin assessment in non-palpable breast lesions to reduce rate of margin revision as well as reduce the volume of breast excised without compromising the oncological safety of the procedure.
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Korpan NN, Xu K, Schwarzinger P, Watanabe M, Breitenecker G, Patrick LP. Cryo-Assisted Resection En Bloc, and Cryoablation In Situ, of Primary Breast Cancer Coupled With Intraoperative Ultrasound-Guided Tracer Injection: A Preliminary Clinical Study. Technol Cancer Res Treat 2019; 17:1533034617746294. [PMID: 29347887 PMCID: PMC5784566 DOI: 10.1177/1533034617746294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of the study was to perform cryosurgery on a primary breast tumor, coupled with simultaneous peritumoral and intratumoral tracer injection of a blue dye, to evaluate lymphatic mapping. We explored the ability of our strategy to prevent tumor cells, but not that of injected tracers, to migrate to the lymphovascular drainage during conventional resection of frozen breast malignancies. Seventeen patients aged 51 (14) years (mean [standard deviation]), presenting primary breast cancer with stage I to IV, were randomly selected and treated in The Rudolfinerhaus Private Clinic in Vienna, Austria, and included in this preliminary clinical study. Under intraoperative ultrasound, 14 patients underwent curative cryo-assisted tumor resection en bloc, coupled with peritumoral tracer injection, which consisted of complete tumor freezing and concomitant peritumor injection with a blue dye, before resection and sentinel lymph node dissection (group A). Group B consists of 3 patients previously refused any standard therapy and had palliative tumor cryoablation in situ combined with intratumoral tracer injection. The intraoperative ultrasound facilitated needle positioning and dye injection timing. In group A, the frozen site extruded the dye that was distributed through the unfrozen tumor, the breast tissue, and the resection cavity for 12 patients. One to 4 lymph nodes were stained for 10 of 14 patients. The resection margin was evaluable. Our intraoperative ultrasound-guided performance revealed the injection and migration of a blue dye during the frozen resection en bloc and cryoablation in situ of primary breast tumors. Sentinel lymph node mapping, pathological determination of the tumor, and resection margins were achievable. The study paves the way for intraoperative cryo-assisted therapeutic strategies for breast cancer.
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Affiliation(s)
- Nikolai N Korpan
- 1 International Institute of Cryosurgery, The Rudolfinerhaus Private Clinic, Vienna, Austria.,2 1st Department of Surgery, National Medical University, Kyiv, Ukraine
| | - Kecheng Xu
- 2 1st Department of Surgery, National Medical University, Kyiv, Ukraine.,3 Jinan University School of Medicine, Fuda Cancer Hospital, Guangzhou, China
| | | | | | - Gerhard Breitenecker
- 6 Pathologic-Histological Central Laboratory, The Rudolfinerhaus Private Clinic, Vienna, Austria
| | - Le Pivert Patrick
- 7 Interventional Drug Delivery Systems and Strategies, Jupiter, FL, USA
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7
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Falk M, Falková I, Kopečná O, Bačíková A, Pagáčová E, Šimek D, Golan M, Kozubek S, Pekarová M, Follett SE, Klejdus B, Elliott KW, Varga K, Teplá O, Kratochvílová I. Chromatin architecture changes and DNA replication fork collapse are critical features in cryopreserved cells that are differentially controlled by cryoprotectants. Sci Rep 2018; 8:14694. [PMID: 30279538 PMCID: PMC6168476 DOI: 10.1038/s41598-018-32939-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 09/17/2018] [Indexed: 11/22/2022] Open
Abstract
In this work, we shed new light on the highly debated issue of chromatin fragmentation in cryopreserved cells. Moreover, for the first time, we describe replicating cell-specific DNA damage and higher-order chromatin alterations after freezing and thawing. We identified DNA structural changes associated with the freeze-thaw process and correlated them with the viability of frozen and thawed cells. We simultaneously evaluated DNA defects and the higher-order chromatin structure of frozen and thawed cells with and without cryoprotectant treatment. We found that in replicating (S phase) cells, DNA was preferentially damaged by replication fork collapse, potentially leading to DNA double strand breaks (DSBs), which represent an important source of both genome instability and defects in epigenome maintenance. This induction of DNA defects by the freeze-thaw process was not prevented by any cryoprotectant studied. Both in replicating and non-replicating cells, freezing and thawing altered the chromatin structure in a cryoprotectant-dependent manner. Interestingly, cells with condensed chromatin, which was strongly stimulated by dimethyl sulfoxide (DMSO) prior to freezing had the highest rate of survival after thawing. Our results will facilitate the design of compounds and procedures to decrease injury to cryopreserved cells.
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Affiliation(s)
- Martin Falk
- The Czech Academy of Sciences, Institute of Biophysics, Královopolská 135, CZ-612 65, Brno, Czech Republic.
| | - Iva Falková
- The Czech Academy of Sciences, Institute of Biophysics, Královopolská 135, CZ-612 65, Brno, Czech Republic
| | - Olga Kopečná
- The Czech Academy of Sciences, Institute of Biophysics, Královopolská 135, CZ-612 65, Brno, Czech Republic
| | - Alena Bačíková
- The Czech Academy of Sciences, Institute of Biophysics, Královopolská 135, CZ-612 65, Brno, Czech Republic
| | - Eva Pagáčová
- The Czech Academy of Sciences, Institute of Biophysics, Královopolská 135, CZ-612 65, Brno, Czech Republic
| | - Daniel Šimek
- The Czech Academy of Sciences, Institute of Physics, Na Slovance 2, CZ-182 21, Prague 8, Czech Republic
| | - Martin Golan
- The Czech Academy of Sciences, Institute of Physics, Na Slovance 2, CZ-182 21, Prague 8, Czech Republic
- Faculty of Mathematics and Physics, Charles University in Prague, Ke Karlovu 5, Prague 2, CZ-121 16, Czech Republic
| | - Stanislav Kozubek
- The Czech Academy of Sciences, Institute of Biophysics, Královopolská 135, CZ-612 65, Brno, Czech Republic
| | - Michaela Pekarová
- The Czech Academy of Sciences, Institute of Biophysics, Královopolská 135, CZ-612 65, Brno, Czech Republic
| | - Shelby E Follett
- Department of Chemistry, University of Wyoming, 1000 E. University Ave, WY 82071, Laramie, USA
| | - Bořivoj Klejdus
- Institute of Chemistry and Biochemistry, Faculty of Agronomy, Mendel University in Brno, Zemědělská 1, CZ-613 00, Czech Republic
- CEITEC-Central European Institute of Technology, Mendel University in Brno, Zemědělská 1, CZ-613 00, Brno, Czech Republic
| | - K Wade Elliott
- Department of Molecular, Cellular, and Biomedical Sciences, University of New Hampshire, 46 College Road, Durham, NH, 03824, USA
| | - Krisztina Varga
- Department of Molecular, Cellular, and Biomedical Sciences, University of New Hampshire, 46 College Road, Durham, NH, 03824, USA
| | - Olga Teplá
- ISCARE IVF a.s, Jankovcova 1692, CZ-160 00, Praha 6, Czech Republic
- VFN Gynekologicko-porodnická klinika, Apolinářská 18, CZ-120 00, Czech Republic
| | - Irena Kratochvílová
- The Czech Academy of Sciences, Institute of Physics, Na Slovance 2, CZ-182 21, Prague 8, Czech Republic.
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Yang X, Guo Y, Guo Z, Si T, Xing W, Yu W, Wang Y. Cryoablation inhibition of distant untreated tumors (abscopal effect) is immune mediated. Oncotarget 2018; 10:4180-4191. [PMID: 31289616 PMCID: PMC6609244 DOI: 10.18632/oncotarget.24105] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 01/03/2018] [Indexed: 11/25/2022] Open
Abstract
Cryoablation is moderately effective against prostate cancer. Of note, the off-target or enlarged therapeutic effect after cryoablation is reported in routine clinical practice. To uncover it, we constructed a bilateral inguinal transplantation model of prostate cancer. All the mice were randomly subdivided into three groups: Group A (Control group), Group B (Surgery group), and Group C (Cryoablation group). All the procedures in three groups were conducted only for tumors in the target region (right groin). The tumors in untargeted region (left groin) received no treatment. We measured the growth of untargeted tumors and lung metastasis rate, and then explored the changes in a series of immune cells and danger signals. First, our results revealed the protective effect of cryoablation treatment against the abscopal tumor. The possible mechanism was mediated by an increase in the number of CD4+ T cells, CD8+ T cells, ratio T helper 1 (Th1)/Th2, the killing activity of cytotoxic T lymphocytes and NK cells. Hsp70 may be involved in the modulation of the immune response. The combination of weakened Ki67 activity and activated immune response delayed spectator tumor growth, decreased the pulmonary metastasis rate, and prolonged animal survival, with an inducible abscopal effect.
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Affiliation(s)
- Xueling Yang
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.,National Clinical Research Center of Cancer, Tianjin 300060, China.,Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Yongfei Guo
- Department of Interventional Radiology, Tianjin Hospital of ITCWM Nankai Hospital, Tianjin 100020, China
| | - Zhi Guo
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.,National Clinical Research Center of Cancer, Tianjin 300060, China.,Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Tongguo Si
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.,National Clinical Research Center of Cancer, Tianjin 300060, China.,Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Wenge Xing
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.,National Clinical Research Center of Cancer, Tianjin 300060, China.,Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Wenwen Yu
- National Clinical Research Center of Cancer, Tianjin 300060, China.,Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China.,Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
| | - Yan Wang
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.,National Clinical Research Center of Cancer, Tianjin 300060, China.,Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
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Trupe LA, Rositch A, Dickerson L, Lucas S, Harvey SC. Knowledge and Attitudes About Breast Cancer in Limpopo, South Africa. J Glob Oncol 2017; 3:509-514. [PMID: 29094090 PMCID: PMC5646900 DOI: 10.1200/jgo.2016.008102] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Purpose Breast cancer survival is unacceptably low in many low-resource settings, including rural South Africa, where access to screening and treatment services is limited. To describe the context for implementing an early detection program, we assessed knowledge and attitudes toward breast cancer risk, early detection, and treatment. Methods We conducted a cross-sectional survey among 243 women presenting to Hlokomela Clinic in Hoedspruit, South Africa, during April and May 2016. We used quantitative and qualitative analyses to determine levels of knowledge of risk factors, symptoms, and treatment of breast cancer, as well as experience with and attitudes toward detection and treatment methods. Results Thirty-one percent of women correctly identified at least six of 12 risk factors for breast cancer, and 53.1% identified breast lumps as an important symptom. Although > 97% of women stated that self–breast examination and early detection were highly important and that they would seek care for changes in their breasts, only 33.3% of women reported performing self–breast examination, and only 24.3% reported receiving a clinical breast examination. Age and education were not associated with knowledge, and level of knowledge did not predict care-seeking behaviors or attitudes. Conclusion Although women demonstrated moderate levels of knowledge of breast cancer symptoms and risk factors and the importance of early detection, few women reported seeking services. These data demonstrate sufficient levels of knowledge and positive attitudes toward care seeking and suggest both a need and readiness for increased access to cost-effective services to facilitate early diagnosis and improved outcomes.
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Affiliation(s)
- Lydia A Trupe
- , University of Cape Town School of Public Health and Family Medicine, Cape Town; , University of Witwatersrand School of Medicine and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; , Johns Hopkins Bloomberg School of Public Health; and , Johns Hopkins University School of Medicine; and , Johns Hopkins Hospital, Baltimore, MD
| | - Anne Rositch
- , University of Cape Town School of Public Health and Family Medicine, Cape Town; , University of Witwatersrand School of Medicine and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; , Johns Hopkins Bloomberg School of Public Health; and , Johns Hopkins University School of Medicine; and , Johns Hopkins Hospital, Baltimore, MD
| | - Lindsay Dickerson
- , University of Cape Town School of Public Health and Family Medicine, Cape Town; , University of Witwatersrand School of Medicine and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; , Johns Hopkins Bloomberg School of Public Health; and , Johns Hopkins University School of Medicine; and , Johns Hopkins Hospital, Baltimore, MD
| | - Su Lucas
- , University of Cape Town School of Public Health and Family Medicine, Cape Town; , University of Witwatersrand School of Medicine and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; , Johns Hopkins Bloomberg School of Public Health; and , Johns Hopkins University School of Medicine; and , Johns Hopkins Hospital, Baltimore, MD
| | - Susan C Harvey
- , University of Cape Town School of Public Health and Family Medicine, Cape Town; , University of Witwatersrand School of Medicine and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; , Johns Hopkins Bloomberg School of Public Health; and , Johns Hopkins University School of Medicine; and , Johns Hopkins Hospital, Baltimore, MD
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10
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Yılmaz S, Özdoğan M, Cevener M, Ozluk A, Kargi A, Kendiroglu F, Ogretmen I, Yildiz A. Use of cryoablation beyond the prostate. Insights Imaging 2016; 7:223-32. [PMID: 26762141 PMCID: PMC4805614 DOI: 10.1007/s13244-015-0460-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 12/04/2015] [Accepted: 12/11/2015] [Indexed: 12/19/2022] Open
Abstract
UNLABELLED 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.
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Affiliation(s)
- Saim Yılmaz
- MIIO Group, Radiology Division, Memorial-MedStar Hospitals, Antalya, Turkey.
- MIIO: Mediterranean Integrative and Innovative Oncology, Antalya, Turkey.
| | - Mustafa Özdoğan
- MIIO Group, Medical Oncology Division, Memorial-MedStar Hospitals, Antalya, Turkey
| | - Metin Cevener
- MIIO Group, Radiology Division, Memorial-MedStar Hospitals, Antalya, Turkey
| | - Ali Ozluk
- MIIO Group, General Surgery Division, Memorial-MedStar Hospitals, Antalya, Turkey
| | - Aysegul Kargi
- MIIO Group, Medical Oncology Division, Memorial-MedStar Hospitals, Antalya, Turkey
| | - Feride Kendiroglu
- MIIO Group, Radiology Division, Memorial-MedStar Hospitals, Antalya, Turkey
| | - Irfan Ogretmen
- MIIO Group, Medical Oncology Division, Memorial-MedStar Hospitals, Antalya, Turkey
| | - Akin Yildiz
- MIIO Group, Nuclear Medicine Division, Memorial-MedStar Hospitals, Antalya, Turkey
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