Cryobiopsy: Physics

  • Sara Colella


Cold temperatures have been used in medicine for several decades, mainly for therapeutic purposes in several fields. The underlining physic principle is the “Joule-Thomson” effect: it is a phenomenon in which the temperature of a real gas increases or decreases following, respectively, its compression or its expansion—as a result from a pressure difference—that is carried out without extracting a work. Different cryogenic gases have been used so far.


Joule-Thomson effect Cryogenic gas Cryoprobes 


  1. 1.
    Colella S, Ravaglia C, Tomassett S, Gurioli CH, Gurioli C, Poletti V. Cryotherapy: application in the airways. In: Diaz-Jimenez JP, Rodriguez AN, editors. Interventions in pulmonary medicine. Cham: Springer; 2018.Google Scholar
  2. 2.
    Maiwand MO. Cryotherapy for advanced carcinoma of the trachea and bronchi. Br Med J (Clin Res Ed). 1986;293(6540):181–2.CrossRefGoogle Scholar
  3. 3.
    DiBardino DM, Lanfranco AR, Haas AR. Bronchoscopic cryotherapy. Clinical applications of the cryoprobe, cryospray, and cryoadhesion. Ann Am Thorac Soc. 2016;13(8):1405–15.CrossRefGoogle Scholar
  4. 4.
    Hetzel J, Eberhardt R, Herth FJ, Petermann C, Reichle G, Freitag L, Dobbertin I, Franke KJ, Stanzel F, Beyer T, Möller P, Fritz P, Ott G, Schnabel PA, Kastendieck H, Lang W, Morresi-Hauf AT, Szyrach MN, Muche R, Shah PL, Babiak A, Hetzel M. Cryobiopsy increases the diagnostic yield of endobronchial biopsy: a multicentre trial. Eur Respir J. 2012;39(3):685–90.CrossRefGoogle Scholar
  5. 5.
    Poletti V, Casoni GL, Gurioli C, Ryu JH, Tomassetti S. Lung cryobiopsies: a paradigm shift in diagnostic bronchoscopy? Respirology. 2014;19(5):645–54.CrossRefGoogle Scholar
  6. 6.
    Griff S, Ammenwerth W, Schönfeld N, Bauer TT, Mairinger T, Blum TG, Kollmeier J, Grüning W. Morphometrical analysis of transbronchial cryobiopsies. Diagn Pathol. 2011;6:53.CrossRefGoogle Scholar
  7. 7.
    Poletti V, Hetzel J. Transbronchial cryobiopsy in diffuse parenchymal lung disease: need for procedural standardization. Respiration. 2015;90(4):275–8.CrossRefGoogle Scholar
  8. 8.
    Almeida LM, Lima B, Mota PC, Melo N, Magalhães A, Pereira JM, Moura CS, Guimarães S, Morais A. Learning curve for transbronchial lung cryobiopsy in diffuse lung disease. Rev Port Pneumol (2006). 2017. pii: S2173-5115(17)30148-3. Scholar
  9. 9.
    Echevarria-Uraga JJ, Pérez-Izquierdo J, García-Garai N, Gómez-Jiménez E, Aramburu-Ojembarrena A, Tena-Tudanca L, Miguélez-Vidales JL, Capelastegui-Saiz A. Usefulness of an angioplasty balloon as selective bronchial blockade device after transbronchial cryobiopsy. Respirology. 2016;21(6):1094–9.CrossRefGoogle Scholar
  10. 10.
    Ravaglia C, Bonifazi M, Wells AU, Tomassetti S, Gurioli C, Piciucchi S, Dubini A, Tantalocco P, Sanna S, Negri E, Tramacere I, Ventura VA, Cavazza A, Rossi A, Chilosi M, La Vecchia C, Gasparini S, Poletti V. Safety and diagnostic yield of transbronchial lung cryobiopsy in diffuse parenchymal lung diseases: a comparative study versus video-assisted thoracoscopic lung biopsy and a systematic review of the literature. Respiration. 2016;91(3):215–27.CrossRefGoogle Scholar
  11. 11.
    Gershman E, Fruchter O, Benjamin F, Nader AR, Rosengarten D, Rusanov V, Fridel L, Kramer MR. Safety of cryo-transbronchial biopsy in diffuse lung diseases: analysis of three hundred cases. Respiration. 2015;90(1):40–6.CrossRefGoogle Scholar
  12. 12.
    Griff S, Schönfeld N, Ammenwerth W, Blum TG, Grah C, Bauer TT, Grüning W, Mairinger T, Wurps H. Diagnostic yield of transbronchial cryobiopsy in non-neoplastic lung disease: a retrospective case series. BMC Pulm Med. 2014;14:171.CrossRefGoogle Scholar
  13. 13.
    Casoni GL, Tomassetti S, Cavazza A, Colby TV, Dubini A, Ryu JH, Carretta E, Tantalocco P, Piciucchi S, Ravaglia C, Gurioli C, Romagnoli M, Gurioli C, Chilosi M, Poletti V. Transbronchial lung cryobiopsy in the diagnosis of fibrotic interstitial lung diseases. PLoS One. 2014;9(2):e86716.CrossRefGoogle Scholar
  14. 14.
    Seamans Y, et al. Effect of cough technique and cryogen gas on temperatures achieved during simulated cryotherapy. BMC Womens Health. 2007;7:16.CrossRefGoogle Scholar
  15. 15.
    Maiti H, Cheyne MF, Hobbs G, Jeraj HA. Cryotherapy gas—to use nitrous oxide or carbon dioxide? Int J STD AIDS. 1999;10(2):118–20.PubMedGoogle Scholar
  16. 16.
    Mariategui J, Santos C, Taxa L, Jeronimo J, Castle PE. Comparison of depth of necrosis achieved by CO2- and N2O-cryotherapy. Int J Gynaecol Obstet. 2008;100(1):24–6.CrossRefGoogle Scholar
  17. 17.
    Hetzel J, Maldonado F, Ravaglia C, Wells AU, Colby TV, Tomassetti S, Ryu JH, Fruchter O, Piciucchi S, Dubini A, Cavazza A, Chilosi M, Sverzellati N, Valeyre D, Leduc D, Walsh SLF, Gasparini S, Hetzel M, Hagmeyer L, Haentschel M, Eberhardt R, Darwiche K, Yarmus LB, Torrego A, Krishna G, Shah PL, Annema JT, Herth FJF, Poletti V. Transbronchial cryobiopsies for the diagnosis of diffuse parenchymal lung diseases: expert statement from the cryobiopsy working group on safety and utility and a call for standardization of the procedure. Respiration. 2018;95(3):188–200.CrossRefGoogle Scholar
  18. 18.
    Franke KJ, Szyrach M, Nilius G, Hetzel J, Hetzel M, Ruehle KH, Enderle MD. Experimental study on biopsy sampling using new flexible cryoprobes: influence of activation time, probe size, tissue consistency, and contact pressure of the probe on the size of the biopsy specimen. Lung. 2009;187(4):253–9.CrossRefGoogle Scholar
  19. 19.
    Ing M, Oliver RA, Oliver BG, Walsh WR, Williamson JP. Evaluation of transbronchial lung cryobiopsy size and freezing time: a prognostic animal study. Respiration. 2016;92(1):34–9.CrossRefGoogle Scholar
  20. 20.
    Chua KJ, Chou SK, Ho JC. An analytical study on the thermal effects of cryosurgery on selective cell destruction. J Biomech. 2007;40(1):100–16.CrossRefGoogle Scholar
  21. 21.
    Mazur P, Leibo SP, Farrant J, Chu EHY, Hanna MG Jr, Smith LH. Interactions of cooling rate, warming rate and protective additive on the survival of frozen mammalian cells. In: Wolstenholme GEW, O’Connor M, editors. Ciba foundation symposium on the frozen cell. London: J&A Churchill Publication; 1970. p. 69–88.Google Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sara Colella
    • 1
  1. 1.Pulmonary UnitAscoli PicenoItaly

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