Abstract
Purpose
To create and validate a planning tool for multiple-probe cryoablation, using simulations of ice ball size and shape for various ablation probe configurations, ablation times, and types of tissue ablated.
Materials and Methods
Ice ball size and shape was simulated using the Pennes bioheat equation. Five thousand six hundred and seventy different cryoablation procedures were simulated, using 1–6 cryoablation probes and 1–2 cm spacing between probes. The resulting ice ball was measured along three perpendicular axes and recorded in a database. Simulated ice ball sizes were compared to gel experiments (26 measurements) and clinical cryoablation cases (42 measurements). The clinical cryoablation measurements were obtained from a HIPAA-compliant retrospective review of kidney and liver cryoablation procedures between January 2015 and February 2016. Finally, we created a web-based cryoablation planning tool, which uses the cryoablation simulation database to look up the probe spacing and ablation time that produces the desired ice ball shape and dimensions.
Results
Average absolute error between the simulated and experimentally measured ice balls was 1 mm in gel experiments and 4 mm in clinical cryoablation cases. The simulations accurately predicted the degree of synergy in multiple-probe ablations. The cryoablation simulation database covers a wide range of ice ball sizes and shapes up to 9.8 cm.
Conclusion
Cryoablation simulations accurately predict the ice ball size in multiple-probe ablations. The cryoablation database can be used to plan ablation procedures: given the desired ice ball size and shape, it will find the number and type of probes, probe configuration and spacing, and ablation time required.
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Acknowledgements
We thank Vineel Vallapureddy, Sonja Foss, Luan Chan, Satish Ramadhyani, and Uri Arbel at Galil for providing the experimental data on ice ball sizes. This research was funded in part through an NIH/NCI Cancer Center Support Grant (P30 CA008748).
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FEB is a co-founder of Claripacs, LLC, and has received research supplies from Bayer. JCD is on the Scientific Advisory Board and is an investor in Adient Medical. SBS is a PI and HY is a co-PI on a multicenter lung cryoablation trial sponsored by Galil. SBS receives research support from AngioDynamics and GE Healthcare.
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Boas, F.E., Srimathveeravalli, G., Durack, J.C. et al. Development of a Searchable Database of Cryoablation Simulations for Use in Treatment Planning. Cardiovasc Intervent Radiol 40, 761–768 (2017). https://doi.org/10.1007/s00270-016-1562-4
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DOI: https://doi.org/10.1007/s00270-016-1562-4