Lung Cryoablation: Patient Selection, Techniques, and Postablation Imaging.

Fecha de publicación: 01/06/2025

Autores de IIS La Fe

Fernando Gómez Muñoz

Autor

Participantes ajenos a IIS La Fe

Castillo-Fortuño À
Páez-Carpio A
Matute-González M
Odisio EG
Vollmer I
Baetens T
Palussière J

Grupos

Investigacion Biomédica en Imagen (GIBI 2-30)

Abstract

Image-guided percutaneous lung ablation has become increasingly common in the treatment of non-small cell lung cancer (NSCLC) and oligometastatic disease in recent years. Among the available techniques are well-described heat-based techniques, such as lung radiofrequency or microwave ablation, and lung cryoablation (LCA), based on the use of extreme cold to cause tissue necrosis. Although it is the least used of the three ablative techniques available for lung ablation, LCA has inherent characteristics that render it the preferred technique in certain situations. Due to the nature of cryoablation, the collagen extracellular matrix of the tissue adjacent to the ablation site is preserved during the intervention. Additionally, cryoablation may allow more precise imaging monitoring of the ablation zone compared with heat-based techniques. These intrinsic advantages potentially establish LCA as the preferred ablative technique for treating lung tumors located near sensitive vital structures, such as the heart, pulmonary hilum, pulmonary arteries, aorta, main bronchi, and pleura. The authors discuss the basic principles of LCA; the indications and contraindications of the technique; and the technical details of the treatment, including the expected findings and periprocedural complications. A standardized scheme for post-cryoablation imaging follow-up is proposed, detailing the expected findings of complete response and signs of tumor persistence and recurrence and specifying the differences seen with heat-based ablative techniques. (©)RSNA, 2025 Supplemental material is available for this article. See the invited commentary by Parvinian and Eiken in this issue.

Datos de la publicación

ISSN/ISSNe:: 0271-5333, 1527-1323
Tipo:: Article
Páginas:: 240157-240157
DOI:: 10.1148/rg.240157
PubMed:: 40402927
Enlace a otro recurso:: www.scopus.com
Factor de Impacto:: 1,477 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Filiaciones

Castillo-Fortuño À:: Department of Medical Imaging, University of Toronto, 263 McCaul St, 4th Fl, Toronto, ON, Canada M5T 1W7 (A.P.C.)

Department of Radiology, Bergonié Institute Comprehensive Cancer Center, Bordeaux, France (J.P.)

and Department of Radiology, Hospital Universitari i Politècnic La Fe, València, Spain (F.M.G.)
Páez-Carpio A:: Department of Medical Imaging, University of Toronto, 263 McCaul St, 4th Fl, Toronto, ON, Canada M5T 1W7 (A.P.C.)

Department of Radiology, Bergonié Institute Comprehensive Cancer Center, Bordeaux, France (J.P.)

and Department of Radiology, Hospital Universitari i Politècnic La Fe, València, Spain (F.M.G.)
Matute-González M:: Department of Medical Imaging, University of Toronto, 263 McCaul St, 4th Fl, Toronto, ON, Canada M5T 1W7 (A.P.C.)

Department of Radiology, Bergonié Institute Comprehensive Cancer Center, Bordeaux, France (J.P.)

and Department of Radiology, Hospital Universitari i Politècnic La Fe, València, Spain (F.M.G.)
Odisio EG:: Department of Medical Imaging, University of Toronto, 263 McCaul St, 4th Fl, Toronto, ON, Canada M5T 1W7 (A.P.C.)

Department of Radiology, Bergonié Institute Comprehensive Cancer Center, Bordeaux, France (J.P.)

and Department of Radiology, Hospital Universitari i Politècnic La Fe, València, Spain (F.M.G.)
Vollmer I:: Department of Medical Imaging, University of Toronto, 263 McCaul St, 4th Fl, Toronto, ON, Canada M5T 1W7 (A.P.C.)

Department of Radiology, Bergonié Institute Comprehensive Cancer Center, Bordeaux, France (J.P.)

and Department of Radiology, Hospital Universitari i Politècnic La Fe, València, Spain (F.M.G.)
Baetens T:: Department of Medical Imaging, University of Toronto, 263 McCaul St, 4th Fl, Toronto, ON, Canada M5T 1W7 (A.P.C.)

Department of Radiology, Bergonié Institute Comprehensive Cancer Center, Bordeaux, France (J.P.)

and Department of Radiology, Hospital Universitari i Politècnic La Fe, València, Spain (F.M.G.)
Palussière J:: Department of Medical Imaging, University of Toronto, 263 McCaul St, 4th Fl, Toronto, ON, Canada M5T 1W7 (A.P.C.)

Department of Radiology, Bergonié Institute Comprehensive Cancer Center, Bordeaux, France (J.P.)

and Department of Radiology, Hospital Universitari i Politècnic La Fe, València, Spain (F.M.G.)
GÓMEZ, F.:: Department of Medical Imaging, University of Toronto, 263 McCaul St, 4th Fl, Toronto, ON, Canada M5T 1W7 (A.P.C.)

Department of Radiology, Bergonié Institute Comprehensive Cancer Center, Bordeaux, France (J.P.)

and Department of Radiology, Hospital Universitari i Politècnic La Fe, València, Spain (F.M.G.)

Keywords

PERCUTANEOUS THERMAL ABLATION; PULMONARY CRYOABLATION; TUMORS; CRYOTHERAPY; CT; CANCER; EFFICACY; RADIOFREQUENCY; RECURRENCE; MICROWAVE

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