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.
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.
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.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Zargar H, Atwell TD, Cadeddu JA, et al. Cryoablation for small renal masses: selection criteria, complications, and functional and oncologic results. Eur Urol. 2016;69(1):116–28.
Valerio M, Ahmed HU, Emberton M, et al. The role of focal therapy in the management of localised prostate cancer: a systematic review. Eur Urol. 2014;66(4):732–51.
Littrup PJ, Aoun HD, Adam B, Krycia M, Prus M, Shields A. Percutaneous cryoablation of hepatic tumors: long-term experience of a large US series. Abdom Radiol. 2016;41(4):767–80.
de Baere T, Tselikas L, Woodrum D, et al. Evaluating cryoablation of metastatic lung tumors in patients-safety and efficacy: the ECLIPSE trial-interim analysis at 1 year. J Thorac Oncol. 2015;10(10):1468–74.
Simmons RM, Ballman KV, Cox C, et al. A phase II trial exploring the success of cryoablation therapy in the treatment of invasive breast carcinoma: results from ACOSOG (Alliance) Z1072. Ann Surg Oncol. 2016;23(8):2438–45.
Maybody M, Tang PQ, Moskowitz CS, Hsu M, Yarmohammadi H, Boas FE. Pneumodissection for skin protection in image-guided cryoablation of superficial musculoskeletal tumours. Eur Radiol. 2016. doi:10.1007/s00330-016-4456-6.
Callstrom MR, Dupuy DE, Solomon SB, et al. Percutaneous image-guided cryoablation of painful metastases involving bone: multicenter trial. Cancer. 2013;119(5):1033–41.
Hinshaw JL, Lubner MG, Ziemlewicz TJ, Lee FT Jr, Brace CL. Percutaneous tumor ablation tools: microwave, radiofrequency, or cryoablation—what should you use and why? Radiographics. 2014;34(5):1344–62.
Erinjeri JP, Clark TW. Cryoablation: mechanism of action and devices. J Vasc Interv Radiol. 2010;21(8 Suppl):S187–91.
Chu KF, Dupuy DE. Thermal ablation of tumours: biological mechanisms and advances in therapy. Nat Rev Cancer. 2014;14(3):199–208.
http://www.galilmedical.com/cryoablation-products/ifus/. Accessed 10 Feb 2015.
Young JL, McCormick DW, Kolla SB, et al. Are multiple cryoprobes additive or synergistic in renal cryotherapy? Urology. 2012;79(2):484.
Littrup PJ, Jallad B, Vorugu V, et al. Lethal isotherms of cryoablation in a phantom study: effects of heat load, probe size, and number. J Vasc Interv Radiol. 2009;20(10):1343–51.
Kim C, O’Rourke AP, Mahvi DM, Webster JG. Finite-element analysis of ex vivo and in vivo hepatic cryoablation. IEEE Trans Bio-Med Eng. 2007;54(7):1177–85.
Shah TT, Arbel U, Foss S, et al. Modeling cryotherapy ice-ball dimensions and isotherms in a novel gel based model to determine optimal cryo-needle configurations and settings for potential use in clinical practice. Urology. 2016;91:234–40.
Shyn PB, Mauri G, Alencar RO, et al. Percutaneous imaging-guided cryoablation of liver tumors: predicting local progression on 24-hour MRI. Am J Roentgenol. 2014;203(2):W181–91.
Poon RT, Ng KK, Lam CM, et al. Learning curve for radiofrequency ablation of liver tumors: prospective analysis of initial 100 patients in a tertiary institution. Ann Surg. 2004;239(4):441–9.
Lee TY, Lin JT, Ho HJ, Wu MS, Wu CY. Evaluation of the effect of cumulative operator experience on hepatocellular carcinoma recurrence after primary treatment with radiofrequency ablation. Radiology. 2015;276(1):294–301.
Schmit GD, Atwell TD, Callstrom MR, et al. Percutaneous cryoablation of renal masses ≥ 3 cm: efficacy and safety in treatment of 108 patients. J Endourol. 2010;24(8):1255–62.
Chen MM, Holmes KR. Microvascular contributions in tissue heat transfer. Ann N. Y. Acad Sci. 1980;335:137–50.
Hasgall PA, Di Gennaro F, Baumgartner C, et al. IT’IS database for thermal and electromagnetic parameters of biological tissues. 2015. http://www.itis.ethz.ch/itis-for-health/tissue-properties/downloads/. Accessed 01 Sept 2015.
Kreith F, Goswami DY. The CRC handbook of mechanical engineering. Boca Raton: CRC Press; 2005.
Lide DR. CRC handbook of chemistry and physics. Boca Raton: CRC Press; 2000.
WolframAlpha. http://www.wolframalpha.com. Accessed 2015.
Snyder WS, Cook MJ, Nasset ES, Karhausen LR, Howells GP, Tipton IH. Report of the task group on reference man. Ann ICRP. 1975;23:1–480.
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).
Conflict of interest
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.
About this article
Cite this article
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