An Anesthesiologist's View of Tumor Ablation in the Radiology Suite

Musculoskeletal oncology and thermal ablation: the current and emerging role of interventional radiology

The role of interventional radiology (IR) is expanding. With new techniques being developed and tested, this radiology subspecialty is taking a step forward in different clinical scenarios, especially in oncology. Musculoskeletal tumoral diseases would definitely benefit from a low-invasive approach that could reduce mortality and morbidity in particular. Thermal ablation through IR has already become important in the palliation and consolidation of bone metastases, oligometastatic disease, local recurrences, and treating specific benign tumors, with a more tailored approach, considering the characteristics of every patient. As image-guided ablation techniques lower their invasiveness and increase their efficacy while the collateral effects and complications decrease, they become more relevant and need to be considered in patient care pathways and clinical management, to improve outcomes. We present a literature review of the different percutaneous and non-invasive image-guided thermal ablation methods that are currently available and that could in the future become relevant to manage musculoskeletal oncologic diseases.

Establishing MRI-guided prostate intervention at a UK Centre

OBJECTIVES

To describe our preliminary experience in establishing an MRI suite capable to deliver targeted prostate biopsy and cryoablation.

METHODS

This article includes a description of the necessary infrastructure alterations, scanning sequence suggestions, anaesthetic advice, and practical procedural considerations. We aim to examine the anticipated issues most UK centres would encounter and offer our experience in overcoming them. During this process we will also explore some of the technical aspects of MRI-guided prostate biopsy and cryoablation.

RESULTS

The clinical indication, treatment rationale, intervention strategy, and initial clinical outcomes are described for our first series of patients.

CONCLUSION

MRI-guided prostate intervention provides many theoretical advantages over traditional TRUS guidance. This article demonstrates some of the complexities encountered in establishing this technique in a UK centre, and the proposed solutions.

ADVANCES IN KNOWLEDGE

This article gives an account of establishing the first MRI intervention suite in the UK. It demonstrates some of the logistical considerations, and offers the unit's early experience.