1
|
Parvinian A, Morris JM, Johnson-Tesch BA, Kurup AN. Thermoprotection of Neural Structures During Musculoskeletal Ablation. Cardiovasc Intervent Radiol 2023; 46:1495-1503. [PMID: 36944852 DOI: 10.1007/s00270-023-03407-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/25/2023] [Indexed: 03/23/2023]
Abstract
Percutaneous thermal ablation is widely used for local control and palliation of a variety of lesions throughout the musculoskeletal system. In this setting, safe ablation is predicated on the avoidance of unintentional injury to vulnerable neural structures that are often in proximity to ablation targets. This article highlights key periprocedural considerations in musculoskeletal ablation and reviews the array of active and passive thermoprotective measures that are critical to safe and successful treatment.
Collapse
Affiliation(s)
- Ahmad Parvinian
- Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
| | - Jonathan M Morris
- Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | | | - A Nicholas Kurup
- Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| |
Collapse
|
2
|
Sag AA, Riedel RF, Eward WC, Visgauss JD, Brigman BE. Hydropneumodissection-Assisted Cryoablation of Recurrent Sarcoma Adjacent to the Sciatic Nerve as a Limb-Sparing Alternative to Hindquarter Amputation. J Vasc Interv Radiol 2022; 34:923-926.e1. [PMID: 36584809 DOI: 10.1016/j.jvir.2022.12.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/11/2022] [Accepted: 12/15/2022] [Indexed: 12/28/2022] Open
Affiliation(s)
- Alan A Sag
- Division of Interventional Radiology, Department of Radiology, Duke University Medical Center, 2301 Erwin Road, DUMC Box 3808, Durham, NC 27710; Department of Orthopedic Surgery, Duke University Medical Center, Durham, NC; Duke Cancer Institute, Duke University Medical Center, Durham, NC.
| | - Richard F Riedel
- Duke Cancer Institute, Duke University Medical Center, Durham, NC; Division of Medical Oncology, Duke University Medical Center, Durham, NC
| | - William C Eward
- Department of Orthopedic Surgery, Duke University Medical Center, Durham, NC; Duke Cancer Institute, Duke University Medical Center, Durham, NC
| | - Julia D Visgauss
- Department of Orthopedic Surgery, Duke University Medical Center, Durham, NC; Duke Cancer Institute, Duke University Medical Center, Durham, NC
| | - Brian E Brigman
- Department of Orthopedic Surgery, Duke University Medical Center, Durham, NC; Duke Cancer Institute, Duke University Medical Center, Durham, NC
| |
Collapse
|
3
|
Parisot L, Grillet F, Verdot P, Danner A, Brumpt E, Aubry S. CT-guided microwave ablation of osteoid osteoma: Long-term outcome in 28 patients. Diagn Interv Imaging 2022; 103:427-432. [PMID: 35523700 DOI: 10.1016/j.diii.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to assess the long-term efficacy of CT-guided microwave ablation (MWA) in the treatment of osteoid osteoma. Secondary objectives were to assess early outcome and side-effects of MWA. MATERIALS AND METHODS Twenty-eight consecutive patients (18 men, 10 women) with a median age of 19.5 years (IQR: 16, 25.5) with a total of 28 non-spinal osteoid osteoma treated by CT-guided MWA were retrospectively included. The ablations were performed with a median power and duration of 60 Watt and 1 min 30 s, respectively. Pain referred to osteoid osteoma was assessed at predefined time points using a 0-10 numeric rating scale. At one month, contrast-enhanced follow-up MRI was performed to evaluate the nidus vascularization and the volume of necrosis induced by MWA. Clinical success was defined by the absence of osteoid osteoma-related pain, and technical success was defined by the presence of necrosis of the nidus on the one-month post-MWA MRI. RESULTS Long term success rate was 93% (26/28) after a follow-up of 55.5 months (IQR: 25.75, 74.5) and technical success rate was 96 % (25/26). One late failure was observed after a patient had been declared cured at one month but the formal proof of a late recurrence of osteoid osteoma could not be brought. Three minor complications were reported including mild reversible superficial radial nerve injury with a skin burn (grade 2) in one patient and moderate skin burn only in two patients. CONCLUSION Our results suggest that CT-guided MWA is an effective option for a minimally-invasive treatment of osteoid osteoma with a low rate of complication and no late recurrence.
Collapse
Affiliation(s)
- Lucie Parisot
- Department of Radiology, CHU de Besancon, 25030 Besancon, France
| | - Franck Grillet
- Department of Radiology, CHU de Besancon, 25030 Besancon, France; Department of Radiology, Centre Leon Bérard, 69008 Lyon, France
| | - Pierre Verdot
- Department of Radiology, CHU de Besancon, 25030 Besancon, France
| | - Alexis Danner
- Department of Radiology, CHU de Besancon, 25030 Besancon, France
| | - Eléonore Brumpt
- Department of Radiology, CHU de Besancon, 25030 Besancon, France; Nanomedicine laboratory EA4662. University of Franche-Comté, 25000 Besancon, France
| | - Sébastien Aubry
- Department of Radiology, CHU de Besancon, 25030 Besancon, France; Nanomedicine laboratory EA4662. University of Franche-Comté, 25000 Besancon, France.
| |
Collapse
|
4
|
Thermal Protection Strategies and Neuromonitoring during Ablation. Semin Intervent Radiol 2022; 39:157-161. [PMID: 35781991 DOI: 10.1055/s-0042-1745795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Advanced interventional pain management approaches seek to lesion neural targets to achieve desirable analgesia; however, equally important is preservation of motor and sensory function for regional bystander nerves. The topic of neuroprotection is also relevant for thermal ablation of metastatic bone tumors in the vicinity of neural structures. This report aims to provide an IR-directed framework of thermoprotective techniques available during thermal ablation.
Collapse
|
5
|
Bode AD, Heithaus RE, Prologo D. External Skin Warming Using Saline Soaked Gauze During Cryoablation with in Vivo Temperature Data: A Letter to the Editor. J Vasc Interv Radiol 2022; 33:856-857. [DOI: 10.1016/j.jvir.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/28/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022] Open
|
6
|
Haroon M, Sathiadoss P, Hibbert RM, Jeyaraj SK, Lim C, Schieda N. Imaging considerations for thermal and radiotherapy ablation of primary and metastatic renal cell carcinoma. Abdom Radiol (NY) 2021; 46:5386-5407. [PMID: 34245341 DOI: 10.1007/s00261-021-03178-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 10/20/2022]
Abstract
Ablative (percutaneous and stereotactic) thermal and radiotherapy procedures for management of both primary and metastatic renal cell carcinoma are increasing in popularity in clinical practice. Data suggest comparable efficacy with lower cost and morbidity compared to nephrectomy. Ablative therapies may be used alone or in conjunction with surgery or chemotherapy for treatment of primary tumor and metastatic disease. Imaging plays a crucial role in pre-treatment selection and planning of ablation, intra-procedural guidance, evaluation for complications, short- and long-term post-procedural surveillance of disease, and treatment response. Treatment response and disease recurrence may differ considerably after ablation, particularly for stereotactic radiotherapy, when compared to conventional surgical and chemotherapies. This article reviews the current and emerging role of imaging for ablative therapy of renal cell carcinoma.
Collapse
|
7
|
Holmes RD, Thakur Y, Mallinson P. Implications of Cone Beam CT Peripheral Edge Blurring and Signal Attenuation for Interventional Procedures. Cardiovasc Intervent Radiol 2021; 45:137-141. [PMID: 34590161 DOI: 10.1007/s00270-021-02971-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022]
Affiliation(s)
- R Davis Holmes
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Yogesh Thakur
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Lower Mainland Medical Imaging, Vancouver Coastal Health Authority, Vancouver, BC, Canada
| | - Paul Mallinson
- Musculoskeletal Section, Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada
| |
Collapse
|
8
|
Maybody M, Soliman MM, Hwang S, Gonzalez-Aguirre A, Martin EGS, Kaye E, Hsu M, Moskowitz C, Healey JH, Fabbri N. Impact of Magnetic Resonance Imaging (MRI) Findings on Management of Symptomatic Patients Following Radiofrequency Ablation (RFA) of Osteoid Osteoma (OO). ACTA ACUST UNITED AC 2020; 2:2170-2177. [PMID: 33235978 DOI: 10.1007/s42399-020-00514-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Object To assess the impact of MRI findings on management of symptomatic patients following RFA of OO. Materials & Methods Retrospective review of 43 patients with RFA for OO between June 2010 and June 2017 was performed. Patient, nidus and ablation data were reviewed. Pre- and 6-8 weeks post-procedural MRI (n=32) were compared for coverage of nidus by ablation zone, bone marrow edema, nidus hyperintensity and other findings. Baseline pain levels and analgesic use were compared with post-procedural follow-up visit at 6-8 weeks. Three groups of clinical and MRI outcomes of complete (CR), partial (PR) and no response (NR) were defined. A weighted-kappa statistic was used to assess for agreement. Results Clinical responses were CR in 34/43 (79.1%, 95%CI: 64.0-90.0%), PR in 8/43 (18.6%) and NR in 1/43 (2.3%) patients. All 19/32 patients with MRI CR experienced clinical CR. One patient with MRI NR had clinical NR. All 7/32 patients with clinical PR had MRI PR. All 4/43 complications were in MRI PR or NR groups. Substantial agreement was observed between MRI and clinical outcomes (kappa:0.69, 95%CI:0.45-0.95). MRI helped determine etiologies in all symptomatic patients and their management (n=8). Conclusions MRI is recommended for symptomatic patients after ablation.
Collapse
Affiliation(s)
- Majid Maybody
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Interventional Radiology Service, 1275 York Ave., M276C, New York, NY 10065
| | - Mohamed M Soliman
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Interventional Radiology Service, 1275 York Ave, New York, NY 10065
| | - Sinchun Hwang
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Musculoskeletal Radiology Service, 1275 York Ave, New York, NY 10065
| | - Adrian Gonzalez-Aguirre
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Interventional Radiology Service, 1275 York Ave, New York, NY 10065
| | - Ernesto G Santos Martin
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Interventional Radiology Service, 1275 York Ave, New York, NY 10065
| | - Elena Kaye
- Memorial Sloan Kettering Cancer Center, Department of Medical Physics, 1275 York Ave, New York, NY 10065
| | - Meier Hsu
- Memorial Sloan Kettering Cancer Center, Department of Biostatistics and Epidemiology, Research Biostatistician, 1275 York Ave, New York, NY 10065
| | - Chaya Moskowitz
- Memorial Sloan Kettering Cancer Center, Department of Biostatistics and Epidemiology, Associate Attending, 1275 York Ave, New York, NY 10065
| | - John H Healey
- Memorial Sloan Kettering Cancer Center, Department of Surgery, Orthopedic Oncology Service, 1275 York Ave, New York, NY 10065
| | - Nicola Fabbri
- Memorial Sloan Kettering Cancer Center, Department of Surgery, Orthopedic Oncology Service, 1275 York Ave, New York, NY 10065
| |
Collapse
|
9
|
Maybody M, Soliman MM, Yamada Y, Tahour D, Hsu M, Moskowitz CS, Katsoulakis E, Solomon SB. Temporary Organ Displacement to Escalate Radiation Dose to Retroperitoneal Tumors and Decrease Toxicity to Organs at Risk. J Vasc Interv Radiol 2020; 31:1578-1586. [PMID: 32861570 DOI: 10.1016/j.jvir.2020.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/20/2019] [Accepted: 01/13/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To demonstrate that temporary organ displacement (TOD) by drainage catheter placement and hydrodissection is feasible and reproducible for simulation (SIM) and stereotactic body radiation treatment (SBRT). MATERIALS AND METHODS Between February 2010 and December 2018, 31 consecutive patients (20 men and 11 women; median age, 59 years; range 20-80 years) received both SIM and SBRT with TOD. The minimum required displacement was 10 mm between the gross tumor volume (GTV) and the organ at risk (OAR). Complete displacement was defined as the ability to displace the OAR from the GTV a minimum of 10 mm across the entire boundary. SIM was performed with hydrodissection on the same day. On the day of SBRT, displacement was reproduced by hydrodissection. Displacement was measured on computed tomography images of TOD, SIM, and SBRT. The drain was removed after SBRT. RESULTS TOD (hydrodissection) was significantly associated with successful displacement of the OAR from a GTV greater than 10 mm (median, 20 mm vs 4.1 mm, P < .001) and maintained displacement at SIM and SBRT (SIM: 29.4 mm vs 4.1 mm, P < .001; SBRT: 32.4 mm vs 4.1 mm, P < .001). The OAR-GTV boundary showed a median reduction of 35 mm (95% confidence interval, 27.5-37.5 mm) after TOD. TOD achieved complete displacement in 22 of 31 (71%) patients, and 25 of 31 (81%) patients were able to undergo single-fraction ablative SBRT. No patients developed procedure-related complications within 30 days. SIM and SBRT were successful without OAR toxicities within a median of 33 months (range, 3-92 months). CONCLUSIONS TOD with placement of drain and hydrodissection is technically feasible and safe and maintains displacement for SIM and SBRT.
Collapse
Affiliation(s)
- Majid Maybody
- Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Mohamed M Soliman
- Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yoshiya Yamada
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David Tahour
- Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Meier Hsu
- Department of Biostatistics and Epidemiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Chaya S Moskowitz
- Department of Biostatistics and Epidemiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Evangelia Katsoulakis
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Stephen B Solomon
- Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|
10
|
Sandberg JK, Shoaf KR, Lungren MP, Young VA, Josephs S, Thakor AS. Dynamic Hydrodissection for Skin Protection during Cryoablation of Superficial Lesions. J Vasc Interv Radiol 2020; 31:1942-1945. [PMID: 32418774 DOI: 10.1016/j.jvir.2020.01.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jesse K Sandberg
- Department of Pediatric Interventional Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine 3155 Porter Drive, Stanford, CA 94034
| | - Kevin R Shoaf
- Department of Pediatric Interventional Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine 3155 Porter Drive, Stanford, CA 94034
| | - Matthew P Lungren
- Department of Pediatric Interventional Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine 3155 Porter Drive, Stanford, CA 94034
| | - Victoria A Young
- Department of Pediatric Interventional Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine 3155 Porter Drive, Stanford, CA 94034
| | - Shellie Josephs
- Department of Pediatric Interventional Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine 3155 Porter Drive, Stanford, CA 94034
| | - Avnesh S Thakor
- Department of Pediatric Interventional Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine 3155 Porter Drive, Stanford, CA 94034
| |
Collapse
|
11
|
Yang Y, Li Y, Wu Y, Qiu S, Liu C, Wang Q, Hong Y, Lyu J, Zhang Y, Du D. Retrospective analysis of CT-guided percutaneous cryoablation for treatment of painful osteolytic bone metastasis. Cryobiology 2020; 92:203-207. [PMID: 31958427 DOI: 10.1016/j.cryobiol.2020.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 01/10/2023]
Abstract
This study aimed to evaluate the safety and effectiveness of CT-guided percutaneous cryoablation for treatment of painful osteolytic bone metastases. A total of 26 patients (36 bone metastases) treated with CT-guided percutaneous cryoablation between May 2012 and June 2016 were enrolled in this retrospective study. All procedures were performed under local anesthesia. A visual analog scale (VAS) was used to evaluate pain before the procedure and at 1 day, 1 month, 3 months, and 6 months after the procedure. Complications during and after the procedure were recorded and graded by the Clavien-Dindo classification. The mean VAS pain score was 7.1 ± 1.1 (range, 4-10) before cryoablation. It was significantly lower at all timepoints after treatment: 2.1 ± 1.7 (P < 0.0001) at 1 day after treatment, 1.3 ± 1.8 (P < 0.0001) at 1 month, 1.6 ± 1.7 (P < 0.0001) at 3 months, and 1.8 ± 1.3 (P < 0.0001) at 6 months. The response rates were 91.7%, 94.4%, 91.7%, and 94.4%, respectively, at 1 day, 1 month, 3 months, and 6 months after cryoablation; the complete response rates were 22.2%, 41.7%, 36.1%, and 22.2%, respectively. Adverse events (skin frostbite, nerve injury, pathologic fracture) occurred in 3 patients. CT-guided percutaneous cryoablation under local anesthesia appears to be a safe and effective treatment for painful osteolytic bone metastases. Prospective clinical trials on large samples needed to confirm this conclusion.
Collapse
Affiliation(s)
- Yumei Yang
- Department of Ultrasound, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, 519000, China
| | - Yong Li
- Department of Interventional Radiology, Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, Shenzhen, 518020, China
| | - Yumin Wu
- Department of Interventional Therapy, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Shuibo Qiu
- Department of Interventional Therapy, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Chunlin Liu
- Department of Interventional Therapy, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Qiuyu Wang
- Department of Radiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, China
| | - Yuefei Hong
- Department of Interventional Therapy, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Jialing Lyu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Yanfang Zhang
- Department of Interventional Radiology, Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, Shenzhen, 518020, China.
| | - Duanming Du
- Department of Interventional Therapy, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518035, China.
| |
Collapse
|
12
|
Prud'homme C, Nueffer JP, Runge M, Dubut J, Kastler B, Aubry S. Prospective pilot study of CT-guided microwave ablation in the treatment of osteoid osteomas. Skeletal Radiol 2017; 46:315-323. [PMID: 28028574 DOI: 10.1007/s00256-016-2558-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 12/13/2016] [Accepted: 12/15/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE The aims of this work were to assess the feasibility and efficacy of CT-guided microwave ablation (MWA) in the treatment of osteoid osteomas (OOs). MATERIALS AND METHODS Thirteen consecutive patients (range 11-31 years old) presenting with OO were prospectively included and treated by CT-guided MWA. Power and duration of MWA were both recorded. The patient's pain was assessed using a numeric pain rating scale (NRS), and side effects were recorded during procedures, after 1 day, 7 days and 1 month. The nidus vascularization and the volume of necrosis induced by MWA were assessed using contrast-enhanced MRI. Success was defined as the complete relief of the patient's pain 1 month after the first procedure, associated with necrosis of the nidus on follow-up MRI. RESULTS The success rate was up to 92.3% (12/13). At 1 day, 7 days and 1 month, the median NRSs were respectively 5 [interquartile range (IQR) 2-5], 0 (IQR 0-1) and 0 (IQR 0-0). Side effects observed were one partial and self-resolving lesion of a sensory branch of the radial nerve and two skin burns. The median power of the MWA used was 60 W (IQR 50-60) with a 1.5-min duration (IQR 1-2), leading to MWA-induced necrosis measuring on average 23 × 15 × 16 mm. CONCLUSION CT-guided MWA of OO has a success rate that appears to be almost similar to that of laser or radiofrequency ablation, but care must be taken to prevent nerve or skin lesions.
Collapse
Affiliation(s)
- Clara Prud'homme
- Department of Musculoskeletal Imaging, University Hospital of Besancon, 25000, Besancon, France
| | - Jean-Philippe Nueffer
- Department of Musculoskeletal Imaging, University Hospital of Besancon, 25000, Besancon, France
| | - Michel Runge
- Department of Musculoskeletal Imaging, University Hospital of Besancon, 25000, Besancon, France
| | - Jonathan Dubut
- Department of Musculoskeletal Imaging, University Hospital of Besancon, 25000, Besancon, France
| | - Bruno Kastler
- Department of Musculoskeletal Imaging, University Hospital of Besancon, 25000, Besancon, France.,I4S Laboratory, INSERM EA4268, University of Franche-Comte, 25000, Besancon, France
| | - Sébastien Aubry
- Department of Musculoskeletal Imaging, University Hospital of Besancon, 25000, Besancon, France. .,Nanomedecine Laboratory, INSERM EA4662, University of Franche-Comte, 25000, Besancon, France.
| |
Collapse
|
13
|
Boas FE, Srimathveeravalli G, Durack JC, Kaye EA, Erinjeri JP, Ziv E, Maybody M, Yarmohammadi H, Solomon SB. Development of a Searchable Database of Cryoablation Simulations for Use in Treatment Planning. Cardiovasc Intervent Radiol 2017; 40:761-768. [PMID: 28050658 DOI: 10.1007/s00270-016-1562-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/26/2016] [Indexed: 01/20/2023]
Abstract
PURPOSE To create and validate a planning tool for multiple-probe cryoablation, using simulations of ice ball size and shape for various ablation probe configurations, ablation times, and types of tissue ablated. MATERIALS AND METHODS Ice ball size and shape was simulated using the Pennes bioheat equation. Five thousand six hundred and seventy different cryoablation procedures were simulated, using 1-6 cryoablation probes and 1-2 cm spacing between probes. The resulting ice ball was measured along three perpendicular axes and recorded in a database. Simulated ice ball sizes were compared to gel experiments (26 measurements) and clinical cryoablation cases (42 measurements). The clinical cryoablation measurements were obtained from a HIPAA-compliant retrospective review of kidney and liver cryoablation procedures between January 2015 and February 2016. Finally, we created a web-based cryoablation planning tool, which uses the cryoablation simulation database to look up the probe spacing and ablation time that produces the desired ice ball shape and dimensions. RESULTS Average absolute error between the simulated and experimentally measured ice balls was 1 mm in gel experiments and 4 mm in clinical cryoablation cases. The simulations accurately predicted the degree of synergy in multiple-probe ablations. The cryoablation simulation database covers a wide range of ice ball sizes and shapes up to 9.8 cm. CONCLUSION Cryoablation simulations accurately predict the ice ball size in multiple-probe ablations. The cryoablation database can be used to plan ablation procedures: given the desired ice ball size and shape, it will find the number and type of probes, probe configuration and spacing, and ablation time required.
Collapse
Affiliation(s)
- F Edward Boas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA.
| | | | - Jeremy C Durack
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Elena A Kaye
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Joseph P Erinjeri
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Etay Ziv
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Majid Maybody
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Hooman Yarmohammadi
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Stephen B Solomon
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| |
Collapse
|
14
|
Prospective 1-year follow-up pilot study of CT-guided microwave ablation in the treatment of bone and soft-tissue malignant tumours. Eur Radiol 2016; 27:1477-1485. [DOI: 10.1007/s00330-016-4528-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 07/08/2016] [Accepted: 07/21/2016] [Indexed: 12/12/2022]
|