MRI‐guided cryotherapy

Abstract

Over the last decade the focus of published research on MRI-guided cryotherapy has switched from the study of experimental models to the clinical treatment of patients. The latter reports attest to the safety and feasibility of treating lesions in the liver, kidney, and other sites throughout the body. Further, the published images and initial results speak to the utility of MRI for the task of monitoring this specific procedure. This clinical utility is a realization of the promise of the earlier experimental work that showed the clarity with which interstitial ice is seen under MRI under various pulse sequence parameters. Early adopters have taken advantage of access to the patient that is provided by low and mid-field open scanners; the near future will test the suitability of higher field systems. It has been critical that an FDA-approved cryotherapy system and suitably thin probes were customized for the MRI environment a decade ago by which percutaneous cryotherapy could be performed. There is still work to be done to expand the role of percutaneous cryotherapy, to understand various tissue responses, and to optimize visualization of therapeutic isotherms. Also, long-term outcomes need to be assessed. Overall, in a worldwide environment in which the practice of ablation is growing and an appreciation for such therapies is on the rise, the work of these recent years provides sound footing for the advances that lay ahead for clinical MRI-guided cryotherapy.