@article{0877057a8d914560b0d2a62c62b0d8a2,
title = "Validation of a low-cost, carbon dioxide-based cryoablation system for percutaneous tumor ablation",
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.",
author = "Bailey Surtees and Sean Young and Yixin Hu and Guannan Wang and Evelyn McChesney and Grace Kuroki and Pascal Acree and Serena Thomas and Tara Blair and Shivam Rastogi and Kraitchman, {Dara L.} and Clifford Weiss and Saraswati Sukumar and Harvey, {Susan C.} and Durr, {Nicholas J.}",
note = "Funding Information: This work was funded by an Under Armour Women{\textquoteright}s Health & Breast Cancer Innovation Grant through the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins and was awarded to ND with grant detailed below: https://ictr.johnshopkins.edu/wp-content/uploads/ 2017/06/UA-Innovation-RFA-Sept-2017_kws.pdf. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We would like to thank the Center for Bioengineering Innovation and Design and the Biomedical Engineering Department at Johns Hopkins University for research support, as well as: Monica Rex, Yechan Kang, Nikhil Jois, Alwin Hui, Sonia Trakru, Sarah Lee, Sanjay Elangovan, Ben Lee, Marton Varady, and Sue Lucas. Publisher Copyright: {\textcopyright} 2019 Surtees et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",
year = "2019",
month = jul,
day = "1",
doi = "10.1371/journal.pone.0207107",
language = "English (US)",
volume = "14",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "7",
}