Trajectory image-guided percutaneous renal cryoablation in a porcine model

A pilot study

David A. Rebuck, Robert B Nadler, Kent T Perry Jr*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Introduction: To assess the technical feasibility and safety of trajectory image-guided percutaneous renal cryoablation in a porcine model. Materials and methods: Six pigs (12 kidneys) were utilized. Only the posterior and lateral regions of the kidneys were considered. A bone-anchored dynamic reference frame (DRF) was inserted into the iliac crest and the O-Arm and StealthStation TREON System (OASSTS, Medtronic, CO, USA) was used to acquire 3-dimensional (3D) imaging ofthe kidneys. A hand-held pointing device was crafted from a cryoablation needle (Galil Medical, MN, USA) and an optical reference frame. The hand-held pointer/cryoablation needle ("cryoprobe") was then optically recognized by the OASSTS. The cryoprobe was then used to navigate its tip into a randomly chosen renal region of interest using 3D trajectory images. Two freeze-thaw cryoablation cycles were then performed. We assessed treatment times and effective radiationdoses. Wealso assessed concordance between projected iceball location on trajectory imaging and cryolesion location on necropsy. Results: The mean total treatment time was 24.0 minutes. The mean effective radiation dose was 23.7 mSv per kidney treated. The trajectory-guided images used to place the cryoprobe tips into the renal region of interest agreed withthe necropsy-determined location of the cryolesion in all cases. Injury to a lumbar muscle and a renal pelvis were observed in two separate cases, respectively. Conclusions: Trajectory image-guided percutaneous renal cryoablation using OASSTS is technically feasible, appears safe, and is associated with acceptable levels of radiation exposure. Comparison of trajectory imageguidance and cryolesions on necropsy demonstrated concordant needle placement.

Original languageEnglish (US)
Pages (from-to)6094-6099
Number of pages6
JournalCanadian Journal of Urology
Volume19
Issue number1
StatePublished - Dec 1 2012

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Cryosurgery
Swine
Kidney
Needles
Hand
Kidney Pelvis
Carbon Monoxide
Arm
Radiation
Safety
Bone and Bones
Equipment and Supplies
Muscles
Wounds and Injuries

Keywords

  • Cryoablation
  • Image-guided
  • Navigation
  • Percutaneous
  • Trajectory

ASJC Scopus subject areas

  • Urology

Cite this

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abstract = "Introduction: To assess the technical feasibility and safety of trajectory image-guided percutaneous renal cryoablation in a porcine model. Materials and methods: Six pigs (12 kidneys) were utilized. Only the posterior and lateral regions of the kidneys were considered. A bone-anchored dynamic reference frame (DRF) was inserted into the iliac crest and the O-Arm and StealthStation TREON System (OASSTS, Medtronic, CO, USA) was used to acquire 3-dimensional (3D) imaging ofthe kidneys. A hand-held pointing device was crafted from a cryoablation needle (Galil Medical, MN, USA) and an optical reference frame. The hand-held pointer/cryoablation needle ({"}cryoprobe{"}) was then optically recognized by the OASSTS. The cryoprobe was then used to navigate its tip into a randomly chosen renal region of interest using 3D trajectory images. Two freeze-thaw cryoablation cycles were then performed. We assessed treatment times and effective radiationdoses. Wealso assessed concordance between projected iceball location on trajectory imaging and cryolesion location on necropsy. Results: The mean total treatment time was 24.0 minutes. The mean effective radiation dose was 23.7 mSv per kidney treated. The trajectory-guided images used to place the cryoprobe tips into the renal region of interest agreed withthe necropsy-determined location of the cryolesion in all cases. Injury to a lumbar muscle and a renal pelvis were observed in two separate cases, respectively. Conclusions: Trajectory image-guided percutaneous renal cryoablation using OASSTS is technically feasible, appears safe, and is associated with acceptable levels of radiation exposure. Comparison of trajectory imageguidance and cryolesions on necropsy demonstrated concordant needle placement.",
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Trajectory image-guided percutaneous renal cryoablation in a porcine model : A pilot study. / Rebuck, David A.; Nadler, Robert B; Perry Jr, Kent T.

In: Canadian Journal of Urology, Vol. 19, No. 1, 01.12.2012, p. 6094-6099.

Research output: Contribution to journalArticle

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T1 - Trajectory image-guided percutaneous renal cryoablation in a porcine model

T2 - A pilot study

AU - Rebuck, David A.

AU - Nadler, Robert B

AU - Perry Jr, Kent T

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