A study of prostate multiprobe cryoablation near urethra for precision treatment planning

Пушкарев, А. В.; Ryabikin, S.S.; Saakyan, N.Yu; Tsiganov, D. I.; Burkov, Ivan A.; Vasilyev, A. O.

doi:10.1016/j.cryobiol.2022.10.002

Cited by 7 publications

(3 citation statements)

References 35 publications

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“…This assumption represents the rationale behind all organ-sparing therapies that aim for adequate oncological control through the sole treatment of the dominant lesion, minimizing undesired effects related to radical therapeutic options. Recent scientific evidence suggests that the treatment of the index lesion is feasible, oncologically safe and characterized by excellent functional results [ 35 , 36 , 37 ]. Ahmed et al [ 38 ] showed that focal therapy of the index lesion is a feasible, safe and well-tolerated treatment, with high rates of genitourinary functional preservation.…”

Section: Discussionmentioning

confidence: 99%

Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study

Misuraca

Lugnani²,

Brassetti

et al. 2023

JPM

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Our study explored frozen section reliability in prostate cancer (PCa) diagnoses and described surgical steps of a 3D magnetic resonance imaging (MRI)–ultrasound (US)-guided prostate biopsy (PB) and focal cryoablation of the index lesion (IL) in a single-setting procedure. Patients with a suspicious prostatic specific antigen (PSA) value, with a PIRADS 4 or 5 single lesion, were enrolled for trans perineal 3D MRI–US-guided PB and TRUS-guided focal cryoablation. Three cores were taken from the IL, three cores from the surrounding area, while systematic sampling was performed for the rest of the gland. After confirmation of PCa in frozen sections, focal cryoablation was performed. The 1st-year follow-up schedule included a PSA test at a 3-month interval, MRI 3 months and 1 year postoperatively and PB of the treated area at 1 year. Following the follow-up schedule, an involved PSA test at a 3-month interval and yearly MRI were performed. The PCa diagnosis was histologically confirmed in all three patients with frozen sections. At final histology, a single Gleason score upgrade from 6 (3 + 3) to 7 (3 + 4) was observed. All patients were discharged on postoperative day 1. At the 3-month evaluation, mean PSA values decreased from 12.54 (baseline) to 1.73 ng/mL and MRI images showed complete ablation of the IL in all patients. Urinary continence and potency were preserved in all patients. At the 1-year follow-up, one patient had suspicious ipsilateral recurrence on MRI and underwent a new analogous procedure. Post follow-up was uneventful and PSA remained stable in all patients. Three-dimensional MRI–US-guided frozen sectioning and focal cryoablation of the IL is a step forward towards a “patient-tailored” minimally invasive approach to the diagnosis and cure of PCa.

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Section: Discussionmentioning

confidence: 99%

Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study

Misuraca

Lugnani²,

Brassetti

et al. 2023

JPM

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“…There is a problem of correctly positioning cryoprobes to achieve maximum necrosis and prevent damage to the urethral canal and healthy surrounding tissue. As a result, both experimental data and results using thermophysical modeling were obtained [7].…”

Section: Destructionmentioning

confidence: 99%

Study of local low-temperature effect on biotissues

Pushkarev,

Zhidkov

2023

E3S Web Conf.

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Local low-temperature exposure on biological tissues consists in the removal of heat and, accordingly, a decrease of its temperature. Such impact may be divided into groups: (1) «destruction», for example, cryosurgery, (2) «preservation», for example, cryoconservation, (3) «therapy», for example, joint cryophysiotherapy. Obtaining different effects depends on the depth and rate of the biological tissue target region cooling. As part of the research, a concept for improving the accuracy of low-temperature exposure is proposed. The conducted studies make it possible to take a step towards the possibility of carrying out precision of local low-temperature impact on biological tissues in different directions.

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“…Several approaches have been applied to addressing this problem. The first one deals with the accurate planning of the procedure, numerical simulations and preliminary estimations [ 15 , 16 , 17 , 18 ]. The evident drawback of this approach is the absence of real-time monitoring of tissue freezing.…”

Section: Introductionmentioning

confidence: 99%

Optical Sensing of Tissue Freezing Depth by Sapphire Cryo-Applicator and Steady-State Diffuse Reflectance Analysis

Zotov,

Pushkarev,

Alekseeva

et al. 2024

Sensors

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This work describes a sapphire cryo-applicator with the ability to sense tissue freezing depth during cryosurgery by illumination of tissue and analyzing diffuse optical signals in a steady-state regime. The applicator was manufactured by the crystal growth technique and has several spatially resolved internal channels for accommodating optical fibers. The method of reconstructing freezing depth proposed in this work requires one illumination and two detection channels. The analysis of the detected intensities yields the estimation of the time evolution of the effective attenuation coefficient, which is compared with the theoretically calculated values obtained for a number of combinations of tissue parameters. The experimental test of the proposed applicator and approach for freezing depth reconstruction was performed using gelatin-based tissue phantom and rat liver tissue in vivo. It revealed the ability to estimate depth up to 8 mm. The in vivo study confirmed the feasibility of the applicator to sense the freezing depth of living tissues despite the possible diversity of their optical parameters. The results justify the potential of the described design of a sapphire instrument for cryosurgery.

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A study of prostate multiprobe cryoablation near urethra for precision treatment planning

Cited by 7 publications

References 35 publications

Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study

Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study

Study of local low-temperature effect on biotissues

Optical Sensing of Tissue Freezing Depth by Sapphire Cryo-Applicator and Steady-State Diffuse Reflectance Analysis

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