Abstract
Breast cancer rates are rising in low- and middle-income countries (LMICs), yet there is a lack of accessible and cost-effective treatment. As a result, the cancer burden and death rates are highest in LMICs. In an effort to meet this need, our work presents the design and feasibility of a low-cost cryoablation system using widely-available carbon dioxide as the only consumable. This system uses an 8-gauge outer-diameter needle and Joule-Thomson expansion to percutaneously necrose tissue with cryoablation. Bench top experiments characterized temperature dynamics in ultrasound gel demonstrated that isotherms greater than 2 cm were formed. Further, this system was applied to mammary tumors in an in vivo rat model and necrosis was verified by histopathology. Finally, freezing capacity under a large heat load was assessed with an in vivo porcine study, where volumes of necrosis greater than 1.5 cm in diameter confirmed by histopathology were induced in a highly perfused liver after two 7-minute freeze cycles. These results demonstrate the feasibility of a carbon-dioxide based cryoablation system for improving solid tumor treatment options in resource-constrained environments.
Highlights
Over 8 million cancer deaths occurred worldwide in 2012, with breast cancer being the largest cause of cancer-related mortality for women with almost 500,000 reported deaths [1]
We report our results from three stages of experimental evaluation: bench top experiment in an ultrasound gel tissue phantom, in vivo testing on mammary tumors in a rat model with necrosis verified via histopathology, and assessment of freezing capacity under a large heat load with an in vivo experiment in a porcine model
This study evaluated the use of a cryoablation device that utilizes CO2 as the cryogen in a variety of experimental settings, exploring its potential as a breast cancer treatment in low- and middle-income countries (LMICs)
Summary
Over 8 million cancer deaths occurred worldwide in 2012, with breast cancer being the largest cause of cancer-related mortality for women with almost 500,000 reported deaths [1]. Validation of a low-cost, carbon dioxide-based cryoablation system. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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