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Zhang C, Zhu L, Tang S, Wang J, Li Y, Chen X, Bian C, Liu D, Ao G, Luo T. Feasibility and safety of trans-biliary cryoablation: Preclinical evaluation of a novel flexible cryoprobe. Cryobiology 2022:S0011-2240(22)00354-6. [PMID: 36414042 DOI: 10.1016/j.cryobiol.2022.11.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 11/21/2022]
Abstract
Cryoablation, as a well-characterized technology, has multifarious clinical applications in solid malignancy. However, trans-biliary cryoablation for malignant biliary obstruction has not been reported yet. Thus, this study aimed to determine the efficacy and safety of trans-biliary cryoablation with a novel CO2 gas-based flexible cryoprobe in standardized preclinical settings. For fresh porcine liver ex vivo, the freezing efficacy of cryoablation was evaluated by using fresh porcine liver. The real-time CO2 flow rate, freezing temperature and freezing range were examined and the frozen appearance was visualized. In vivo study, acute and chronical effects were investigated by using the models of canine bile duct. Histopathology and laboratory examination were performed. The lowest temperature that the electrode could deliver to the tissue was -60.7 °C. At 60s after freezing, the tissue temperature dropped to -22.6 °C and -4.3 °C at 0.1 and 0.2 cm from the electrode center, respectively. The frozen size was greater in liver tissue ex vivo than that in bile duct tissue in vivo. No biliary hemorrhage, perforation, stricture, obstruction, and adjacent organ injury were observed. With histopathologic examination, acute intercellular vacuoles were observed in the lamina propria adjacent to the lumen. Chronic changes, including uneven coagulative necrosis, fibro-proliferation, inflammatory infiltration and connective tissue thickening were observed in the lamina propria of the all biliary samples. The results demonstrated CO2 gas-based trans-biliary cryoablation is safe and efficacious. These findings may provide a potential new modality for primary malignant biliary obstruction and malignant obstruction within a biliary stent and contribute to cryoablation of clinical practice.
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Affiliation(s)
- Chao Zhang
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, PR China
| | - Linzhong Zhu
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, PR China
| | - Shousheng Tang
- CAS Key Laboratory of Cryogenics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing, 100080, 100091, PR China
| | - Jukun Wang
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, PR China
| | - Yu Li
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, PR China
| | - Xin Chen
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, PR China
| | - Chunjing Bian
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, PR China
| | - Dongbin Liu
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, PR China
| | - Guokun Ao
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, PR China
| | - Tao Luo
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, PR China.
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Yu JS, Mohammadi AM. Introduction to laser thermal therapy for brain disorders. Int J Hyperthermia 2021; 37:1-2. [PMID: 32672120 PMCID: PMC7673657 DOI: 10.1080/02656736.2020.1789764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jennifer S Yu
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.,Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Alireza M Mohammadi
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
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Rodrigues HF, Capistrano G, Bakuzis AF. In vivo magnetic nanoparticle hyperthermia: a review on preclinical studies, low-field nano-heaters, noninvasive thermometry and computer simulations for treatment planning. Int J Hyperthermia 2021; 37:76-99. [PMID: 33426989 DOI: 10.1080/02656736.2020.1800831] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Magnetic nanoparticle hyperthermia (MNH) is a promising nanotechnology-based cancer thermal therapy that has been approved for clinical use, together with radiation therapy, for treating brain tumors. Almost ten years after approval, few new clinical applications had appeared, perhaps because it cannot benefit from the gold standard noninvasive MRI thermometry technique, since static magnetic fields inhibit heat generation. This might limit its clinical use, in particular as a single therapeutic modality. In this article, we review the in vivo MNH preclinical studies, discussing results of the last two decades with emphasis on safety as a clinical criteria, the need for low-field nano-heaters and noninvasive thermal dosimetry, and the state of the art of computational modeling for treatment planning using MNH. Limitations to more effective clinical use are discussed, together with suggestions for future directions, such as the development of ultrasound-based, computed tomography-based or magnetic nanoparticle-based thermometry to achieve greater impact on clinical translation of MNH.
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Affiliation(s)
- Harley F Rodrigues
- Instituto de Física, Universidade Federal de Goiás, Goiânia, Brasil.,Curso de Licenciatura em Física, Instituto Federal de Goiás, Goiânia, Brasil
| | - Gustavo Capistrano
- Instituto de Física, Universidade Federal de Goiás, Goiânia, Brasil.,Campus Fronteira Oeste, Instituto Federal de Mato Grosso, Pontes e Lacerda, Brasil
| | - Andris F Bakuzis
- Instituto de Física, Universidade Federal de Goiás, Goiânia, Brasil
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