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Current Role of Focal Therapy for Prostate Cancer
Published in Ayman El-Baz, Gyan Pareek, Jasjit S. Suri, Prostate Cancer Imaging, 2018
H. Abraham Chiang, George E. Haleblian
Overall, cryoablation appears to be a well-tolerated procedure with a relatively low sexual and genitourinary adverse side effect profile when compared to radical therapies. However, randomized controlled trials comparing cryoablation to standard of care therapies are needed to better assess oncologic and functional outcomes.
Focal therapy for localized cancer: a patent review
Published in Expert Review of Medical Devices, 2021
Jette Bloemberg, Luigi Van Riel, Dimitra Dodou, Paul Breedveld
Cryoablation relies on removing thermal energy from tissue to cause local freezing and consequently physical disruption due to mechanisms such as intracellular ice, ice crystals that cause shear stress, or extracellular ice crystals that remove water from cells [30]. The low temperature is achieved by the Joule-Thomson effect that describes the decrease in temperature of a fluid caused by the decrease in pressure on the fluid [31]. To illustrate, in the cryoprobe described by Surtees et al. [32] (Figure 3(b)), the tip of the cryoprobe is positioned adjacent to the target cells and is cooled by a cryogen gas to less than −50°C and subsequently heated to 5°C using both active and passive thawing in free-thaw-freeze cycles [5], causing cell destruction. The cryogen gas is throttled through a Joule-Thomson nozzle and subsequently circulated within the probe. Heat is drawn from the target cells, and a growing ice mass is formed around the tip, eventually encompassing the target cells. The instrument further includes an ultrasound component for intra-procedural monitoring. Similar cryoprobes have been proposed by a number of inventors [33–35]. Other design variations include an instrument consisting of multiple rigid probes in a grid [36] or a flexible endoscopic catheter [37].