Prediction of the critical thermal zone during pulmonary cryoablation on computed tomography from correlated experimental and clinical findings

Kohei Hashimoto, Yotaro Izumi, Yoshikane Yamauchi, Hideki Yashiro, Masanori Inoue, Seishi Nakatsuka, Hiroaki Nomori

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective: During cryoablation, cells are destroyed at temperatures less than -20°C. The determining factors for local cancer control in pulmonary cryoablation were assessed using computed tomography (CT), isothermal curves, and histologic findings in pigs. Experimental findings were compared with clinical CT findings and were extrapolated to local cancer control outcomes. Methods: Cryoablation was performed with thermal monitoring, and the ablated areas were divided into 3 zones: less than -20°C, -20°C to 0°C, and greater than 0°C and were compared with histologic findings. CT findings with multiplanar reconstruction in 36 nodules were compared with the porcine histologic findings. The relationship between CT findings and 3-year local cancer control was evaluated in 98 nodules. Results: The 3 concentric thermal zones correlated with histologic findings as follows: less than -20°C zone, complete tissue destruction (zone D); -20°C to 0°C zone (which surrounded zone D), hemorrhage with air trapping and maintenance of alveolar structures (zone H); and greater than 0°C zone (outermost), edema with sustained alveolar structures (zone E). The CT findings in 36 nodules showed a central solid zone, a surrounding air-containing zone, and an outside solid zone, corresponding to zones D, H, and E, respectively. Local cancer control at 3 years in 80 nodules contained within the central solid zone was significantly greater compared with the 18 nodules that were not (82% vs 33%, P = .0002). Conclusions: Pulmonary cryoablation should be performed such that tumors are contained within the central solid zone on CT, which represents the less than -20°C zone.

Original languageEnglish
Pages (from-to)832-838
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume145
Issue number3
DOIs
Publication statusPublished - 2013 Mar

Fingerprint

Cryosurgery
Hot Temperature
Tomography
Lung
Neoplasms
Swine
Air
Edema
Maintenance
Hemorrhage
Temperature

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Prediction of the critical thermal zone during pulmonary cryoablation on computed tomography from correlated experimental and clinical findings. / Hashimoto, Kohei; Izumi, Yotaro; Yamauchi, Yoshikane; Yashiro, Hideki; Inoue, Masanori; Nakatsuka, Seishi; Nomori, Hiroaki.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 145, No. 3, 03.2013, p. 832-838.

Research output: Contribution to journalArticle

@article{fc5ace73a2de48388311c827c0ce28d9,
title = "Prediction of the critical thermal zone during pulmonary cryoablation on computed tomography from correlated experimental and clinical findings",
abstract = "Objective: During cryoablation, cells are destroyed at temperatures less than -20°C. The determining factors for local cancer control in pulmonary cryoablation were assessed using computed tomography (CT), isothermal curves, and histologic findings in pigs. Experimental findings were compared with clinical CT findings and were extrapolated to local cancer control outcomes. Methods: Cryoablation was performed with thermal monitoring, and the ablated areas were divided into 3 zones: less than -20°C, -20°C to 0°C, and greater than 0°C and were compared with histologic findings. CT findings with multiplanar reconstruction in 36 nodules were compared with the porcine histologic findings. The relationship between CT findings and 3-year local cancer control was evaluated in 98 nodules. Results: The 3 concentric thermal zones correlated with histologic findings as follows: less than -20°C zone, complete tissue destruction (zone D); -20°C to 0°C zone (which surrounded zone D), hemorrhage with air trapping and maintenance of alveolar structures (zone H); and greater than 0°C zone (outermost), edema with sustained alveolar structures (zone E). The CT findings in 36 nodules showed a central solid zone, a surrounding air-containing zone, and an outside solid zone, corresponding to zones D, H, and E, respectively. Local cancer control at 3 years in 80 nodules contained within the central solid zone was significantly greater compared with the 18 nodules that were not (82{\%} vs 33{\%}, P = .0002). Conclusions: Pulmonary cryoablation should be performed such that tumors are contained within the central solid zone on CT, which represents the less than -20°C zone.",
author = "Kohei Hashimoto and Yotaro Izumi and Yoshikane Yamauchi and Hideki Yashiro and Masanori Inoue and Seishi Nakatsuka and Hiroaki Nomori",
year = "2013",
month = "3",
doi = "10.1016/j.jtcvs.2012.03.029",
language = "English",
volume = "145",
pages = "832--838",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Prediction of the critical thermal zone during pulmonary cryoablation on computed tomography from correlated experimental and clinical findings

AU - Hashimoto, Kohei

AU - Izumi, Yotaro

AU - Yamauchi, Yoshikane

AU - Yashiro, Hideki

AU - Inoue, Masanori

AU - Nakatsuka, Seishi

AU - Nomori, Hiroaki

PY - 2013/3

Y1 - 2013/3

N2 - Objective: During cryoablation, cells are destroyed at temperatures less than -20°C. The determining factors for local cancer control in pulmonary cryoablation were assessed using computed tomography (CT), isothermal curves, and histologic findings in pigs. Experimental findings were compared with clinical CT findings and were extrapolated to local cancer control outcomes. Methods: Cryoablation was performed with thermal monitoring, and the ablated areas were divided into 3 zones: less than -20°C, -20°C to 0°C, and greater than 0°C and were compared with histologic findings. CT findings with multiplanar reconstruction in 36 nodules were compared with the porcine histologic findings. The relationship between CT findings and 3-year local cancer control was evaluated in 98 nodules. Results: The 3 concentric thermal zones correlated with histologic findings as follows: less than -20°C zone, complete tissue destruction (zone D); -20°C to 0°C zone (which surrounded zone D), hemorrhage with air trapping and maintenance of alveolar structures (zone H); and greater than 0°C zone (outermost), edema with sustained alveolar structures (zone E). The CT findings in 36 nodules showed a central solid zone, a surrounding air-containing zone, and an outside solid zone, corresponding to zones D, H, and E, respectively. Local cancer control at 3 years in 80 nodules contained within the central solid zone was significantly greater compared with the 18 nodules that were not (82% vs 33%, P = .0002). Conclusions: Pulmonary cryoablation should be performed such that tumors are contained within the central solid zone on CT, which represents the less than -20°C zone.

AB - Objective: During cryoablation, cells are destroyed at temperatures less than -20°C. The determining factors for local cancer control in pulmonary cryoablation were assessed using computed tomography (CT), isothermal curves, and histologic findings in pigs. Experimental findings were compared with clinical CT findings and were extrapolated to local cancer control outcomes. Methods: Cryoablation was performed with thermal monitoring, and the ablated areas were divided into 3 zones: less than -20°C, -20°C to 0°C, and greater than 0°C and were compared with histologic findings. CT findings with multiplanar reconstruction in 36 nodules were compared with the porcine histologic findings. The relationship between CT findings and 3-year local cancer control was evaluated in 98 nodules. Results: The 3 concentric thermal zones correlated with histologic findings as follows: less than -20°C zone, complete tissue destruction (zone D); -20°C to 0°C zone (which surrounded zone D), hemorrhage with air trapping and maintenance of alveolar structures (zone H); and greater than 0°C zone (outermost), edema with sustained alveolar structures (zone E). The CT findings in 36 nodules showed a central solid zone, a surrounding air-containing zone, and an outside solid zone, corresponding to zones D, H, and E, respectively. Local cancer control at 3 years in 80 nodules contained within the central solid zone was significantly greater compared with the 18 nodules that were not (82% vs 33%, P = .0002). Conclusions: Pulmonary cryoablation should be performed such that tumors are contained within the central solid zone on CT, which represents the less than -20°C zone.

UR - http://www.scopus.com/inward/record.url?scp=84873987237&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84873987237&partnerID=8YFLogxK

U2 - 10.1016/j.jtcvs.2012.03.029

DO - 10.1016/j.jtcvs.2012.03.029

M3 - Article

C2 - 22503202

AN - SCOPUS:84873987237

VL - 145

SP - 832

EP - 838

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 3

ER -