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

Surtees, B.; Young, S.; Hu, Y.; Wang, G.; McChesney, E.; Kuroki, G.; Acree, P.; Thomas, S.; Blair, T.; Rastogi, S.; Kraitchman, D. L.; Weiss, C.; Sukumar, S.; Harvey, S. C.; Durr, N. J.

doi:10.1101/454413

bioRxiv · 10.1101/454413

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

Surtees, B.·Young, S.·Hu, Y.·Wang, G.·McChesney, E.·Kuroki, G.·Acree, P.·Thomas, S.·Blair, T.·Rastogi, S.·Kraitchman, D. L.·Weiss, C.·Sukumar, S.·Harvey, S. C.·Durr, N. J.

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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.

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Surtees, B., Young, S., Hu, Y., Wang, G., McChesney, E., Kuroki, G., Acree, P., Thomas, S., Blair, T., Rastogi, S., Kraitchman, D. L., Weiss, C., Sukumar, S., Harvey, S. C., Durr, N. J.. 2018-10-26. Validation of a low-cost, carbon dioxide-based cryoablation system for percutaneous tumor ablation. https://doi.org/10.1101/454413

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