Percutaneous cryoablation in soft tissue tumor management: an educational review.

Autor: Bodard S; Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. sylvain.bodard@aphp.fr.; Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA. sylvain.bodard@aphp.fr.; Department of Radiology, Necker Hospital, University of Paris Cité, 149 rue de Sèvre, 75015, Paris, France. sylvain.bodard@aphp.fr.; Laboratoire d'Imagerie Biomédicale, Sorbonne University, CNRS UMR 7371, INSERM U 1146, 75006, Paris, France. sylvain.bodard@aphp.fr., Geevarghese R; Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA., Razakamanantsoa L; Department of Interventional Radiology and Oncology, Sorbonne University, Tenon Hospital, 4 rue de la Chine, 75020, Paris, France., Frandon J; Radiology Department, Nimes University Hospital, Nimes, France., Petre EN; Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA., Marcelin C; Department of Radiology, Centre Hospitalo-Universitaire de Bordeaux, 33076, Bordeaux, France., Cornelis FH; Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. cornelif@mskcc.org.; Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA. cornelif@mskcc.org.; Department of Interventional Radiology and Oncology, Sorbonne University, Tenon Hospital, 4 rue de la Chine, 75020, Paris, France. cornelif@mskcc.org.
Jazyk: angličtina
Zdroj: Insights into imaging [Insights Imaging] 2024 Nov 18; Vol. 15 (1), pp. 278. Date of Electronic Publication: 2024 Nov 18.
DOI: 10.1186/s13244-024-01822-5
Abstrakt: Background: Percutaneous cryoablation (PCA), having shown effectiveness in treating liver, lung, prostate, breast, and kidney tumors, is now gaining attention for the treatment of soft tissue tumors. PCA functions by freezing tissue, which induces ice crystal formation and cell death without damaging collagen structures. Technical considerations include the selection and handling of cryoprobes and cryogenic agents, procedural duration, and choice of image guidance for precision. This review aims to synthesize the mechanisms, applications, and technical aspects of PCA in the treatment of soft tissue tumors.
Methods: Adhering to PRISMA 2020 guidelines, a review was conducted of studies published prior to March 2024 that investigated PCA of soft tissue tumors. The review focused on technical and procedural aspects of cryoablation, cryobiological principles, cellular and tissue responses to extreme cold, intra- and post-procedure physiological mechanisms during and post-procedure, and main clinical applications.
Results: PCA is efficient in treating soft tissue tumors, including desmoid tumors, vascular malformations, and abdominal wall endometriosis. Several cryobiological mechanisms are involved, notably ice crystal formation, cellular dehydration, osmotic effects, and the inflammatory response, all of which contribute to its efficacy. Key technical aspects include the choice of cryoprobes, cryogenic agents (argon gas or liquid nitrogen), and the duration and control of freezing/thawing cycles. PCA also frequently outperformed traditional treatments like surgery and radiotherapy in terms of pain reduction, tumor size reduction, and patient outcomes. Moreover, its nerve sideration properties make it effective under local anesthesia.
Conclusion: Demonstrating substantial pain reduction, tumor size decrease, and high technical success rates, PCA offers a promising and minimally invasive alternative for soft tissue tumor treatment.
Critical Relevance Statement: Percutaneous cryoablation provides a minimally invasive, precise alternative for soft tissue tumor management, advancing clinical radiology by offering effective treatment with reduced patient risk and enhanced outcomes through image-guided procedures.
Key Points: Percutaneous cryoablation (PCA) offers a promising, minimally invasive alternative for managing soft tissue tumors. PCA employs image-guided techniques to accurately target and treat tumors, ensuring high precision and control. PCA preserves structures like collagen, reduces pain, decreases tumor size, and generally enhances patient outcomes.
Competing Interests: Declarations Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interests F.H.C. is a Boston Scientific, Varian, and IceCure consultant. The remaining authors declare no conflicts of interest.
(© 2024. The Author(s).)
Databáze: MEDLINE
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