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Temperature Measurements of the Low-Attenuation Radiographic Ice Ball During CT-Guided Renal Cryoablation

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Abstract

During renal cryoablation a low-attenuation area on CT develops around the cryoprobe. Knowledge of the temperature of the growing low-attenuation area can guide therapy and ensure lethal temperatures. Herein, we report thermocouple results and correlating CT images during the development of the low-attenuation “radiographic ice ball.” Five patients who underwent percutaneous CT-guided renal cryoablation were identified who had thermocouples inserted and serial intraprocedural CT images that included images with thermocouple measurements of 0° and sub-0°C. Thermocouples had been percutaneously placed just beyond the edge of the tumors either to ensure adequate cooling or to ensure safety to adjacent critical structures. Renal cryotherapy under CT guidance produced a growing low-attenuation area corresponding to the radiographic ice ball. When the thermocouple measured 0°C, CT images showed the thermocouple tip at the edge of the low-attenuation ice ball. At lower temperatures the tip was within the low-attenuation ice ball. We conclude that knowledge of the temperature at the ice ball edge during cryoablation can be used to predict the extent of tissue necrosis and thus provide an estimate of cryotherapy effectiveness during the procedure. Further work is necessary to establish a firm relationship between the thermal conditions and the zone of damage.

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Authors and Affiliations

  1. James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA

    Sompol Permpongkosol

  2. Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

    Sompol Permpongkosol

  3. Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA

    Richard E. Link

  4. Institute for Urology, North Shore LIJ Health System, Long Island, NY, USA

    Louis R. Kavoussi

  5. Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10021, USA

    Stephen B. Solomon

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  1. Sompol Permpongkosol
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  2. Richard E. Link
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  3. Louis R. Kavoussi
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  4. Stephen B. Solomon
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Correspondence to Stephen B. Solomon.

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Permpongkosol, S., Link, R.E., Kavoussi, L.R. et al. Temperature Measurements of the Low-Attenuation Radiographic Ice Ball During CT-Guided Renal Cryoablation. Cardiovasc Intervent Radiol 31, 116–121 (2008). https://doi.org/10.1007/s00270-007-9220-5

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  • DOI: https://doi.org/10.1007/s00270-007-9220-5

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