Microwave Thermal Ablation of Spinal Metastatic Bone Tumors |
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| Institution: | 1. Neuroradiology and MRI Unit, Grenoble University Hospital, Grenoble, France;2. I4S Laboratory, EA 4268, IFR 133, Franche Comté University, Besançon;3. Radiology and Interventional Pain Unit, Besançon University Hospital, Besançon, France;1. Department of Radiology, National Hospital Organization Beppu Medical Center, Oita, Japan;2. Department of Radiology, Kyushu University Beppu Hospital, 4546 Tsurumihara, Beppu 874-0838, Japan;3. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University Hospital, Fukuoka, Japan;1. Musculoskeletal Oncology Service, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashiknari, Osaka, 537-8511, Japan;2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan;1. Department of Diagnostic Radiology (U.P.) and Pathology (B.C.S.H.) Tan Tock Seng Hospital 11 Jalan Tan Tock Seng Singapore 308433;1. Musculoskeletal Imaging, Department of Diagnostic Imaging, Moffitt Cancer Center, 12902 Magnolia Drive, WCB-RAD MD/OPI, Tampa, FL 33612, USA;2. Department of Radiology, University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA;3. Department of Orthopedics/Sports Medicine, University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA;4. Moffitt Cancer Center, Tampa, FL, USA;5. Department of Surgery, University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA;1. Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, No. 600 Yi Shan Road, Shanghai 200233, China.;2. Department of Diagnostic and Interventional Radiology, The Chinese People’s Liberation Army Affiliated The 85th Hospital, Shanghai 200233, China. |
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| Abstract: | PurposeTo assess feasibility, safety, and efficacy of microwave ablation of spinal metastatic bone tumors.Materials and MethodsRetrospective study of 17 patients with 20 spinal metastatic tumors treated with microwave ablation under computed tomographic guidance between March 2011 and August 2013 was performed. Ablations were performed under local anesthesia and nitrous oxide ventilation. Lesions were lumbar (n = 10), sacral (n = 7), and thoracic (n = 3) in location. Primary neoplastic sites were lung (n = 9), prostate (n = 4), kidney (n = 6), and uterus (n = 1). Adjunct cementoplasty was performed in nine cases, and a temperature-monitoring device was used in four cases. Procedure effectiveness was evaluated by visual analog scale (VAS) during a 6-month follow-up. Patient medical records were reviewed, and demographic and clinical data, tumor characteristics, and information on pain were assessed.ResultsMean ablation time was 4.4 minutes ± 2.7 (range, 1–8 min), with an average of 3.8 cycles per ablation at 60 W (range, 30–70 W). The preprocedure mean VAS score was 7.4 ± 1.2 (range, 6–9). Pain relief was achieved in all but one patient. Follow-up VAS scores were as follows: day 0, 1.3 ± 1.8 (P < .001); day 7, 1.6 ± 1.7 (P < .001); month 1, 1.9 ± 1.6 (P < .001); month 3, 2.2 ± 1.5 (P < .001); and month 6, 2.3 ± 1.4 (P < .01). No complications were noted.ConclusionsMicrowave ablation appears to be feasible, safe, and an effective treatment of painful refractory spinal metastases and may be considered as a potential alternative percutaneous technique in the management of spinal metastases. |
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