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

PLoS One. 2019 Jul 3;14(7):e0207107. doi: 10.1371/journal.pone.0207107. eCollection 2019.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Carbon Dioxide / therapeutic use*
  • Catheter Ablation* / instrumentation
  • Catheter Ablation* / methods
  • Cryosurgery* / instrumentation
  • Cryosurgery* / methods
  • Female
  • Mammary Neoplasms, Experimental / pathology
  • Mammary Neoplasms, Experimental / surgery*
  • Rats
  • Rats, Sprague-Dawley
  • Swine

Substances

  • Carbon Dioxide

Grants and funding

This work was funded by an Under Armour Women’s Health & Breast Cancer Innovation Grant through the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins and was awarded to ND with grant detailed below: https://ictr.johnshopkins.edu/wp-content/uploads/2017/06/UA-Innovation-RFA-Sept-2017_kws.pdf. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.