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DOI QR Code

Evaluation of cryoablation using a prototype cryoablation needle in swine liver

  • Hyunjoon Son (Department of Mechanical Engineering, Ulsan National Institute of Science and Technology) ;
  • Jonghyun Lee (Division of Gastroenterology, Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital) ;
  • Sung Yong Han (Division of Gastroenterology, Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital) ;
  • Tae In Kim (Division of Gastroenterology, Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital) ;
  • Dong Uk Kim (Department of Internal Medicine, CHA Gumi Medical Center, CHA University) ;
  • Daejin Kim (Department of Mechanical Engineering, Ulsan National Institute of Science and Technology) ;
  • Gun-Ho Kim (Department of Mechanical Engineering, Ulsan National Institute of Science and Technology)
  • 투고 : 2024.02.05
  • 심사 : 2024.04.21
  • 발행 : 2024.09.30

초록

Background/Aims: Pancreatic cancer poses significant challenges due to its tendency for late-stage diagnosis and high mortality rates. Cryoablation, a technique used to treat various types of cancer, has shown potential in enhancing the prognosis of pancreatic cancer when combined with other therapies. However, its implementation is often limited by the need for lengthy procedures and specialized equipment. This study aims to develop a cryoablation needle optimized for endoscopic ultrasonography to simplify its application in treating pancreatic cancer. Methods: The study involved conducting cryoablation experiments on swine liver tissue. It utilized cryo-needles to evaluate the extent of cell death across various temperatures and durations of cryoablation. Results: The cryoablation system, which employed liquid carbon dioxide, achieved rapid cooling, reaching temperatures below -60 ℃ within 30 seconds and maintained the cryoablation process for 200 seconds. These conditions resulted in necrosis of the liver tissue. Notable cellular changes were observed up to 15 mm away from the cryoablation needle. Conclusions: This experimental study successfully demonstrated the efficacy of using a cryo-needle for cryoablation in swine liver tissue. Further trials involving pancreatic tissue are expected to verify its effectiveness, underscoring the importance of continued research to establish its role as a complementary therapy in pancreatic cancer treatment.

키워드

과제정보

This study was supported by a 2022 Weolbong grant from the Korean Gastrointestinal Endoscopy Research Foundation.

참고문헌

  1. Siegel RL, Miller KD, Wagle NS, et al. Cancer statistics, 2023. CA Cancer J Clin 2023;73:17-48.  https://doi.org/10.3322/caac.21763
  2. De Grandis MC, Ascenti V, Lanza C, et al. Locoregional therapies and remodeling of tumor microenvironment in pancreatic cancer. Int J Mol Sci 2023;24:12681. 
  3. Carrafiello G, Ierardi AM, Fontana F, et al. Microwave ablation of pancreatic head cancer: safety and efficacy. J Vasc Interv Radiol 2013;24:1513-1520.  https://doi.org/10.1016/j.jvir.2013.07.005
  4. Gajewska-Naryniecka A, Szwedowicz U, Lapinska Z, et al. Irreversible electroporation in pancreatic cancer: an evolving experimental and clinical method. Int J Mol Sci 2023;24:4381. 
  5. Xu KC, Niu LZ, Hu YZ, et al. A pilot study on combination of cryosurgery and (125)iodine seed implantation for treatment of locally advanced pancreatic cancer. World J Gastroenterol 2008;14:1603-1611.  https://doi.org/10.3748/wjg.14.1603
  6. Niu L, Chen J, He L, et al. Combination treatment with comprehensive cryoablation and immunotherapy in metastatic pancreatic cancer. Pancreas 2013;42:1143-1149.  https://doi.org/10.1097/MPA.0b013e3182965dde
  7. He L, Niu L, Korpan NN, et al. Clinical practice guidelines for cryosurgery of pancreatic cancer: a consensus statement from the China Cooperative Group of Cryosurgery on Pancreatic Cancer, International Society of Cryosurgery, and Asian Society of Cryosurgery. Pancreas 2017;46:967-972.  https://doi.org/10.1097/MPA.0000000000000878
  8. Luo XM, Niu LZ, Chen JB, et al. Advances in cryoablation for pancreatic cancer. World J Gastroenterol 2016;22:790-800.  https://doi.org/10.3748/wjg.v22.i2.790
  9. Kovach SJ, Hendrickson RJ, Cappadona CR, et al. Cryoablation of unresectable pancreatic cancer. Surgery 2002;131:463-464.  https://doi.org/10.1067/msy.2002.121231
  10. Krishna M. Patterns of necrosis in liver disease. Clin Liver Dis (Hoboken) 2017;10:53-56.  https://doi.org/10.1002/cld.653
  11. Batts KP, Ludwig J. Chronic hepatitis: an update on terminology and reporting. Am J Surg Pathol 1995;19:1409-1417.  https://doi.org/10.1097/00000478-199512000-00007
  12. Chowdhury AB, Mehta KJ. Liver biopsy for assessment of chronic liver diseases: a synopsis. Clin Exp Med 2023;23:273-285.  https://doi.org/10.1007/s10238-022-00799-z
  13. Shinde RS, Bhandare M, Chaudhari V, et al. Cutting-edge strategies for borderline resectable pancreatic cancer. Ann Gastroenterol Surg 2019;3:368-372.  https://doi.org/10.1002/ags3.12254
  14. Quinonero F, Mesas C, Doello Ket al. The challenge of drug resistance in pancreatic ductal adenocarcinoma: a current overview. Cancer Biol Med 2019;16:688-699.  https://doi.org/10.20892/j.issn.2095-3941.2019.0252
  15. Thomas D, Radhakrishnan P. Tumor-stromal crosstalk in pancreatic cancer and tissue fibrosis. Mol Cancer 2019;18:14. 
  16. Katsuta E, Qi Q, Peng X, et al. Pancreatic adenocarcinomas with mature blood vessels have better overall survival. Sci Rep 2019;9:1310. 
  17. Peng H, Shen J, Long X, et al. Local release of TGF-β inhibitor modulates tumor-associated neutrophils and enhances pancreatic cancer response to combined irreversible electroporation and immunotherapy. Adv Sci (Weinh) 2022;9:e2105240. 
  18. Yousaf MN, Ehsan H, Muneeb A, et al. Role of radiofrequency ablation in the management of unresectable pancreatic cancer. Front Med (Lausanne) 2021;7:624997. 
  19. Erinjeri JP, Clark TW. Cryoablation: mechanism of action and devices. J Vasc Interv Radiol 2010;21(8 Suppl):S187-S191.  https://doi.org/10.1016/j.jvir.2009.12.403
  20. Testoni SG, Petrone MC, Reni M, et al. EUS-guided ablation with the HybridTherm Probe as second-line treatment in patients with locally advanced pancreatic ductal adenocarcinoma: a case-control study. Endosc Ultrasound 2022;11:383-392.  https://doi.org/10.4103/EUS-D-21-00200
  21. Testoni SG, Petrone MC, Reni M, et al. Efficacy of endoscopic ultrasound-guided ablation with the HybridTherm probe in locally advanced or borderline resectable pancreatic cancer: a phase II randomized controlled trial. Cancers (Basel) 2021;13:4512. 
  22. Baust JM, Robilotto A, Raijman I, et al. The assessment of a novel endoscopic ultrasound-compatible cryocatheter to ablate pancreatic cancer. Biomedicines 2024;12:507. 
  23. Baust JM, Santucci KL, Van Buskirk RG, et al. An in vitro investigation into cryoablation and adjunctive cryoablation/chemotherapy combination therapy for the treatment of pancreatic cancer using the PANC-1 cell line. Biomedicines 2022;10:450. 
  24. Baumann KW, Baust JM, Snyder KK, et al. Characterization of pancreatic cancer cell thermal response to heat ablation or cryoablation. Technol Cancer Res Treat 2017;16:393-405.  https://doi.org/10.1177/1533034616655658
  25. Som A, Rosenboom JG, Wehrenberg-Klee E, et al. Percutaneous intratumoral immunoadjuvant gel increases the abscopal effect of cryoablation for checkpoint inhibitor resistant cancer. Adv Healthc Mater 2024;13:e2301848.