Bodard Sylvain, Geevarghese Ruben, Razakamanantsoa Leo, Frandon Julien, Petre Elena N, Marcelin Clement, Cornelis François H
Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA.
Insights Imaging. 2024 Nov 18;15(1):278. doi: 10.1186/s13244-024-01822-5.
Percutaneous cryoablation (PCA), having shown effectiveness in treating liver, lung, prostate, breast, and kidney tumors, is now gaining attention for the treatment of soft tissue tumors. PCA functions by freezing tissue, which induces ice crystal formation and cell death without damaging collagen structures. Technical considerations include the selection and handling of cryoprobes and cryogenic agents, procedural duration, and choice of image guidance for precision. This review aims to synthesize the mechanisms, applications, and technical aspects of PCA in the treatment of soft tissue tumors.
Adhering to PRISMA 2020 guidelines, a review was conducted of studies published prior to March 2024 that investigated PCA of soft tissue tumors. The review focused on technical and procedural aspects of cryoablation, cryobiological principles, cellular and tissue responses to extreme cold, intra- and post-procedure physiological mechanisms during and post-procedure, and main clinical applications.
PCA is efficient in treating soft tissue tumors, including desmoid tumors, vascular malformations, and abdominal wall endometriosis. Several cryobiological mechanisms are involved, notably ice crystal formation, cellular dehydration, osmotic effects, and the inflammatory response, all of which contribute to its efficacy. Key technical aspects include the choice of cryoprobes, cryogenic agents (argon gas or liquid nitrogen), and the duration and control of freezing/thawing cycles. PCA also frequently outperformed traditional treatments like surgery and radiotherapy in terms of pain reduction, tumor size reduction, and patient outcomes. Moreover, its nerve sideration properties make it effective under local anesthesia.
Demonstrating substantial pain reduction, tumor size decrease, and high technical success rates, PCA offers a promising and minimally invasive alternative for soft tissue tumor treatment.
Percutaneous cryoablation provides a minimally invasive, precise alternative for soft tissue tumor management, advancing clinical radiology by offering effective treatment with reduced patient risk and enhanced outcomes through image-guided procedures.
Percutaneous cryoablation (PCA) offers a promising, minimally invasive alternative for managing soft tissue tumors. PCA employs image-guided techniques to accurately target and treat tumors, ensuring high precision and control. PCA preserves structures like collagen, reduces pain, decreases tumor size, and generally enhances patient outcomes.
经皮冷冻消融术（PCA）在治疗肝脏、肺部、前列腺、乳腺和肾脏肿瘤方面已显示出有效性，目前在软组织肿瘤治疗中也日益受到关注。PCA通过冷冻组织发挥作用，可诱导冰晶形成并导致细胞死亡，同时不损伤胶原蛋白结构。技术要点包括冷冻探针和冷冻剂的选择与操作、手术持续时间以及用于精准定位的影像引导方式的选择。本综述旨在综合阐述PCA在软组织肿瘤治疗中的机制、应用及技术方面。
遵循PRISMA 2020指南，对2024年3月之前发表的有关软组织肿瘤PCA的研究进行综述。该综述聚焦于冷冻消融术的技术和操作方面、低温生物学原理、细胞和组织对极度寒冷的反应、术中及术后的生理机制以及主要临床应用。
PCA在治疗软组织肿瘤方面很有效，包括硬纤维瘤、血管畸形和腹壁子宫内膜异位症。涉及多种低温生物学机制，尤其是冰晶形成、细胞脱水、渗透效应和炎症反应，所有这些都有助于其疗效。关键技术方面包括冷冻探针的选择、冷冻剂（氩气或液氮）、冷冻/解冻周期的持续时间和控制。在减轻疼痛、缩小肿瘤大小和患者预后方面，PCA通常也优于手术和放疗等传统治疗方法。此外，其对神经的影响特性使其在局部麻醉下也有效。
PCA在减轻疼痛、缩小肿瘤大小和实现高技术成功率方面表现显著，为软组织肿瘤治疗提供了一种有前景的微创替代方案。
经皮冷冻消融术为软组织肿瘤管理提供了一种微创、精准的替代方案，通过影像引导手术提供有效治疗，降低患者风险并改善预后，推动了临床放射学发展。
经皮冷冻消融术（PCA）为软组织肿瘤管理提供了一种有前景的微创替代方案。PCA采用影像引导技术精确靶向和治疗肿瘤，确保高精度和控制。PCA可保留胶原蛋白等结构，减轻疼痛，缩小肿瘤大小，并总体改善患者预后。
