Cryoablation is a procedure used to treat some tumors in certain parts of the body. During cryoablation special needles are placed through the skin into the tumor. A generator sends super-cooled gases through the needle, freezing and killing the tumor cells in the area. Radiofrequency ablation is a similar procedure in which a needle is inserted to kill tissue by heating.

Cryoablation is most commonly used to treat the following tumors:

• Kidney tumors: Renal cell cancer, which is a malignant tumor that arises in the kidney.
• Bone tumors: Most commonly metastases to bone from cancers of other organs. Cryoablation can be used to treat bone tumors that are causing significant pain that does not respond to pain medications.
• Liver tumors: Metastases from colon and rectal cancer. Hepatocellular carcinoma, which is a tumor that originates from liver cells.
• Lung tumors: Tumors that arise from the lung and some metastases to the lung from tumors beginning in other organs.

Cryoablation is appropriate for a small percentage of patients with cancer. When tumors are potentially curable, surgical resection of the tumor is generally the preferred method of treatment. However, some patients may not be candidates for surgery due to illnesses that make surgery too risky or due to tumor locations. In these cases, cryoablation may be an appropriate option for treatment of the tumor. For kidney tumors, cryoablation may be an alternative to removing the entire kidney or a large part of the kidney; this approach allows preservation of kidney tissue and function. Tumors that cause pain may be treated with surgery, radiation therapy or chemotherapy. Cryoablation may be used to rapidly shrink the tumor and reduce pain caused by the tumor.

Clinical Radiologists has been performing percutaneous ablation procedures at Memorial Medical Center since 1999. We have physicians with advanced training in imaging guided procedures who can evaluate patients prior to the procedure, perform the procedure and help to follow patients after the procedure.

How do I know if I am a candidate for cryoablation?

Your oncologist, surgeon or primary physician should know whether cryoablation may be an appropriate treatment option for your tumor or condition. If so, you will receive an appointment to meet with a radiologist to discuss the procedure and answer any questions you have. Together you can decide whether cryoablation is appropriate and whether to proceed with the procedure.

How is the cryoablation procedure performed?

Cryoablation will be performed either under general anesthesia or a combination of local anesthesia and conscious sedation (anti-anxiety medications and narcotic pain relievers given through an intravenous line). Using either CAT scan (CT) or a combination of CT and ultrasound, the radiologist will advance a special needle or needles into the tumor. Once the needles have been positioned, the tissue will be frozen. The radiologist will monitor the area being frozen with intermittent CAT scan pictures. Depending upon the size of the tumor, one needle or several needles may be placed to perform the procedure. In some cases more than one tumor may be treated during a single session.

What happens the day of the procedure?

Cryoablation is often performed as an outpatient procedure. You will report to the hospital early in the morning, a couple hours prior to the procedure. You will be checked into the hospital, have an IV line started and prepared for the procedure. Some blood tests may be obtained if needed. After the procedure you will return to the same day care ward and be observed for the remainder of the day. (If the procedure is performed with general anesthesia, you will go to the recovery room first, then back to the same day care area.) You will be at bed rest for several hours while being observed and having vital signs monitored. Most patients will be discharged to home late in the afternoon. Some patients will be admitted over night if they have significant pain, complications or any other medical problems.

Are there potential complications from cryoablation?

Cryoablation is a generally safe and minimally invasive way of treating appropriate tumors. However, like any invasive procedure, it does carry some risks.
There is a risk of pain from the procedure and some patients could be admitted overnight for pain control.

There is a risk of bleeding. Bleeding that requires hospitalization, blood transfusion or that is life-threatening is quite rare.
Depending upon tumor location, there may be a risk of damage to the organ being treated or to adjacent organs. This will vary from patient to patient.
The tissue that is frozen remains in the body. The body’s natural response to this dead tissue can leave you feeling “punky” and with a low-grade fever for several days. Rarely the tissue can become infected and result in an abscess or “pus pocket” that may need to be drained.
Although the needle is placed into the tumor and then withdrawn, the chance of spreading tumor cells with the needle is extremely low since the heat should kill tumor cells near the needle.

How will I know whether the procedure was successful?

The goal of cryoablation will vary from patient to patient. If the procedure is performed to treat a painful lesion, we will know within several days whether the procedure was a success. In some cases the goal will be to completely eliminate a tumor, as though it had been removed surgically. This can be difficult to accomplish, and unfortunately, it is usually not possible to know at the time of the procedure whether a particular tumor has been completely eradicated. We generally recommend that a patient have a follow up CAT scan or MRI about a month after the procedure. This scan will usually allow us to determine whether the procedure was successful. In some cases a portion of the tumor that was not successfully ablated with the original procedure can be retreated.