Tumor and Ablation Margin Visibility during Cryoablation of Musculoskeletal Tumors: Comparing Intraprocedural PET/CT Images with CT-Only Images |
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| Affiliation: | 1. Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts;2. Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts;1. Institute of Biomedical Technology, State University of New York at Binghamton, Binghamton, NY 13902, United States;2. Department of Biological Sciences, Binghamton University, Binghamton, NY 13902, United States;3. Department of Surgery, State University of New York at Buffalo, Medical School, Buffalo, NY 14214, United States;4. Urology Department, Cancer and Surgery Clinic, Oslo University Hospital, Oslo, Norway;5. CPSI Biotech, Owego, NY 13827, United States;1. Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania;2. Department of Bioethics, Columbia University, New York, New York;3. Frank Netter School of Medicine at Quinnipiac University, New Haven, Connecticut;4. Department of Vascular and Interventional Radiology, ChristianaCare, Newark, Delaware;5. Department of Diagnostic and Interventional Radiology, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas;1. Michigan State University College of Osteopathic Medicine, East Lancing, Michigan;2. University of New Mexico, Albuquerque, New Mexico;3. Department of Interventional Radiology, Advanced Radiology Services PC, Spectrum Health Medical Group, Michigan State University College of Human Medicine, 100 Michigan St. NE, Grand Rapids, MI 49503;4. Spectrum Health Medical Group Cardiovascular Medicine, Grand Rapids, Michigan;1. Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong;2. Department of Radiology, 2/F, Block B, Hong Kong Children’s Hospital, 1 Shing Cheong Rd, Kowloon Bay, Hong Kong;3. Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong;1. Department of Radiology, University of California, Davis Medical Center, 4860 Y St, Suite 3100, Sacramento, CA 95817;2. Department of Interventional Radiology, Oregon Health & Science University, Portland, OR;3. Mercy Radiology Group, Department of Radiology, Sacramento, CA;4. Department of Surgery, Division of Pediatric Cardiothoracic Surgery, Sacramento, CA |
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| Abstract: | PurposeTo compare tumor and ice-ball margin visibility on intraprocedural positron emission tomography (PET)/computed tomography (CT) and CT-only images and report technical success, local tumor progression, and adverse event rates for PET/CT-guided cryoablation procedures for musculoskeletal tumors.Materials and MethodsThis Health Insurance Portability and Accountability Act (HIPAA)–compliant and institutional review board–approved retrospective study evaluated 20 PET/CT-guided cryoablation procedures performed with palliative and/or curative intent to treat 15 musculoskeletal tumors in 15 patients from 2012 to 2021. Cryoablation was performed using general anesthesia and PET/CT guidance. Procedural images were reviewed to determine the following: (a) whether the tumor borders could be fully assessed on PET/CT or CT-only images; and (b) whether tumor ice-ball margins could be fully assessed on PET/CT or CT-only images. The ability to visualize tumor borders and ice-ball margins on PET/CT images was compared with that on CT-only images.ResultsTumor borders were fully assessable for 100% (20 of 20; 95% CI, 0.83–1) of procedures on PET/CT versus 20% (4 of 20; 95 CI, 0.057–0.44) of procedures on CT only (P < .001). The tumor ice-ball margin was fully assessable in 80% (16 of 20; 95% CI, 0.56–0.94) of procedures using PET/CT versus 5% (1 of 20; 95% CI, 0.0013–0.25) of procedures using CT only (P < .001). Primary technical success was achieved in 75% (15 of 20; 95% CI, 0.51–0.91) of procedures. There was local tumor progression in 23% (3/13; 95% CI, 0.050–0.54) of the treated tumors with at least 6 months of follow-up. There were 3 adverse events (1 Grade 3, 1 Grade 2, and 1 Grade 1).ConclusionsPET/CT-guided cryoablation of musculoskeletal tumors can provide superior intraprocedural visualization of the tumor and ice-ball margins compared with that provided by CT alone. Further studies are warranted to confirm the long-term efficacy and safety of this approach. |
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