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Renal mass cryoablation: Melting time analysis of radiographic ice-ball after 5-minute active thawing by using serial ultrasound

Authors
 Jong Yun Won  ;  Dong Kyu Kim  ;  Sung Yoon Park 
Citation
 EUROPEAN JOURNAL OF RADIOLOGY, Vol.134 : 109409, 2021-01 
Journal Title
 EUROPEAN JOURNAL OF RADIOLOGY 
ISSN
 0720-048X 
Issue Date
2021-01
MeSH
Cryosurgery* ; Freezing ; Humans ; Ice ; Kidney Neoplasms* / diagnostic imaging ; Kidney Neoplasms* / surgery ; Tomography, X-Ray Computed ; Treatment Outcome
Keywords
Bleeding ; Cryoablation ; Kidney
Abstract
Objective: Cryoneedles removal before sufficient thawing may lead to tissue damage and bleeding. We analyzed melting time of radiographic ice-ball in renal percutaneous cryoablation (PCA) using ultrasound. Materials and methods: Consecutive 27 patients who underwent PCA using cryoneedles of 2-4 for the renal mass (median size, 1.9 cm; range, 1.1-4.1 cm) were evaluated. Reconstructed CT images obtained during freezing were used to measure radiographic ice-ball volume. After completing final freezing, 5-min active thawing and following passive thawing were performed. Melting time of radiographic ice-ball during the thawing was analyzed by serial ultrasound examination. Melting time was defined as the time of complete disappearance of intrarenal posterior acoustic shadowing generated by radiographic ice-ball, which was analyzed by two independent radiologists. The relationship between total melting time and radiographic ice-ball volume was also analyzed by Spearman's rank correlation. Results: Median radiographic ice-ball volume was 30.5 cm3 (range, 26.6-37.3 cm3). After 5-min active thawing, radiographic ice-ball needed additional passive thawing of median 8-min or 9-min for complete melting in analyses of two independent radiologists, respectively (p > 0.05). The range of total melting time during active and passive thawing was 9-min-to-15-min for both radiologists, respectively. A positive correlation was found between total melting time and radiographic ice-ball volume (Spearman's rho, 0.644 and 0.479 for radiologist 1 and 2). Conclusion: In our PCA protocol, radiographic ice-ball needed approximately 10-min passive thawing after 5-min active thawing for complete melting. This may help determine safe removal time of cryoneedles.
Full Text
https://www.sciencedirect.com/science/article/pii/S0720048X20305994
DOI
10.1016/j.ejrad.2020.109409
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Kyu(김동규) ORCID logo https://orcid.org/0000-0001-7322-2550
Park, Sung Yoon(박성윤)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182425
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