Open AccessValidation of a low-cost, carbon dioxide-based cryoablation system for percutaneous tumor ablation
Author(s) -
Bailey Surtees,
Sean Young,
Yixin Hu,
Guannan Wang,
Evelyn McChesney,
Grace Kuroki,
Pascal Acree,
Serena Thomas,
Tara Blair,
Shivam Rastogi,
Dara L. Kraitchman,
Clifford R. Weiss,
Saraswati Sukumar,
Susan C. Harvey,
Nicholas J. Durr
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0207107
Subject(s) - cryoablation , cryosurgery , in vivo , histopathology , medicine , necrosis , biomedical engineering , coagulative necrosis , ablation , materials science , surgery , pathology , biology , microbiology and biotechnology
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.