Skip to main content
Erschienen in: Skeletal Radiology 9/2019

02.02.2019 | Scientific Article

Cementoplasty of pelvic bone metastases: systematic assessment of lesion filling and other factors that could affect the clinical outcomes

verfasst von: Thomas P. Moser, Marta Onate, Katia Achour, Véronique Freire

Erschienen in: Skeletal Radiology | Ausgabe 9/2019

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To evaluate lesion filling and other factors that could affect the clinical outcomes of cementoplasty for pelvic bone metastases.

Methods

We retrospectively reviewed the files of 40 patients treated for 44 pelvic bone metastases, collected the parameters related to patients (pain relief evaluated on a visual analog scale, subsequent fractures, and need for surgery), lesions (size, cortical breach score, fracture, soft-tissue extension), and cementoplasty procedures (number of needles, volume of cement, percentage of lesion filling, cement leaks, residual acetabular roof defect), and performed a statistical analysis.

Results

The lesions were on average 43.2 mm in diameter and the mean cortical breach score was 2.5 out of 6, with a pathological fracture in 14 lesions. The number of needles inserted was one in 32 out of 44, two in 10 out of 44, and three in 2 out of 44. On average, the volume of cement injected per lesion was 10.3 ml and the filling was 54.8%. Mild or moderate asymptomatic cement leakage occurred in 20 lesions (45.5%). The mean pain score was 84.2 mm before the procedure (with no correlation with lesion size, cortical breach score or fracture) and 45.6 mm at follow-up. The pain relief of 38.6 mm was statistically significant (p < 0.001) and did not correlate with the filling percentage. There were no fractures of the treated lesions at a mean follow-up of 355 days.

Conclusions

Cementoplasty of pelvic bone metastases appears effective for providing pain relief and may prevent subsequent fractures. We were unable to demonstrate a correlation between the lesion filling and the degree of pain relief.
Literatur
1.
Zurück zum Zitat Cotten A, Duquesnoy B. Cimentoplastie percutanée des ostéolyses malignes du cotyle. Presse Med. 1995;24:1308–10.PubMed Cotten A, Duquesnoy B. Cimentoplastie percutanée des ostéolyses malignes du cotyle. Presse Med. 1995;24:1308–10.PubMed
2.
Zurück zum Zitat Weill A, Kobaiter H, Chiras J. Acetabulum malignancies: technique and impact on pain of percutaneous injection of acrylic surgical cement. Eur Radiol. 1998;8:123–9.CrossRefPubMed Weill A, Kobaiter H, Chiras J. Acetabulum malignancies: technique and impact on pain of percutaneous injection of acrylic surgical cement. Eur Radiol. 1998;8:123–9.CrossRefPubMed
3.
Zurück zum Zitat Cotten A, Deprez X, Migaud H, Chabanne B, Duquesnoy B, Chastanet P. Malignant acetabular osteolyses: percutaneous injection of acrylic bone cement. Radiology. 1995;197:307–10.CrossRefPubMed Cotten A, Deprez X, Migaud H, Chabanne B, Duquesnoy B, Chastanet P. Malignant acetabular osteolyses: percutaneous injection of acrylic bone cement. Radiology. 1995;197:307–10.CrossRefPubMed
4.
Zurück zum Zitat Papagelopoulos PJ, Mavrogenis AF, Soucacos PN. Evaluation and treatment of pelvic metastases. Injury. 2007;38:509–20.CrossRefPubMed Papagelopoulos PJ, Mavrogenis AF, Soucacos PN. Evaluation and treatment of pelvic metastases. Injury. 2007;38:509–20.CrossRefPubMed
6.
Zurück zum Zitat Harrington KD. The management of acetabular insufficiency secondary to metastatic malignant disease. J Bone Joint Surg Am. 1981;63:653–64.CrossRefPubMed Harrington KD. The management of acetabular insufficiency secondary to metastatic malignant disease. J Bone Joint Surg Am. 1981;63:653–64.CrossRefPubMed
7.
Zurück zum Zitat Anselmetti GC, Manca A, Ortega C, Grignani G, Debernardi F, Regge D. Treatment of extraspinal painful bone metastases with percutaneous cementoplasty: a prospective study of 50 patients. Cardiovasc Intervent Radiol. 2008;31:1165–73.CrossRefPubMed Anselmetti GC, Manca A, Ortega C, Grignani G, Debernardi F, Regge D. Treatment of extraspinal painful bone metastases with percutaneous cementoplasty: a prospective study of 50 patients. Cardiovasc Intervent Radiol. 2008;31:1165–73.CrossRefPubMed
8.
Zurück zum Zitat Basile A, Giuliano G, Scuderi V, et al. Cementoplasty in the management of painful extraspinal bone metastases: our experience. Radiol Med. 2008;113:1018–28.CrossRefPubMed Basile A, Giuliano G, Scuderi V, et al. Cementoplasty in the management of painful extraspinal bone metastases: our experience. Radiol Med. 2008;113:1018–28.CrossRefPubMed
9.
Zurück zum Zitat Botton E, Edeline J, Rolland Y, et al. Cementoplasty for painful bone metastases: a series of 42 cases. Med Oncol. 2012;29:1378–83.CrossRefPubMed Botton E, Edeline J, Rolland Y, et al. Cementoplasty for painful bone metastases: a series of 42 cases. Med Oncol. 2012;29:1378–83.CrossRefPubMed
10.
Zurück zum Zitat Iannessi A, Amoretti N, Marcy PY, Sedat J. Percutaneous cementoplasty for the treatment of extraspinal painful bone lesion, a prospective study. Diagn Interv Imaging. 2012;93:859–70.CrossRefPubMed Iannessi A, Amoretti N, Marcy PY, Sedat J. Percutaneous cementoplasty for the treatment of extraspinal painful bone lesion, a prospective study. Diagn Interv Imaging. 2012;93:859–70.CrossRefPubMed
11.
Zurück zum Zitat Marcy PY, Palussiere J, Descamps B, et al. Percutaneous cementoplasty for pelvic bone metastasis. Support Care Cancer. 2000;8:500–3.CrossRefPubMed Marcy PY, Palussiere J, Descamps B, et al. Percutaneous cementoplasty for pelvic bone metastasis. Support Care Cancer. 2000;8:500–3.CrossRefPubMed
12.
Zurück zum Zitat Hierholzer J, Anselmetti G, Fuchs H, Depriester C, Koch K, Pappert D. Percutaneous osteoplasty as a treatment for painful malignant bone lesions of the pelvis and femur. J Vasc Interv Radiol. 2003;14:773–7.CrossRefPubMed Hierholzer J, Anselmetti G, Fuchs H, Depriester C, Koch K, Pappert D. Percutaneous osteoplasty as a treatment for painful malignant bone lesions of the pelvis and femur. J Vasc Interv Radiol. 2003;14:773–7.CrossRefPubMed
13.
14.
Zurück zum Zitat Scaramuzzo L, Maccauro G, Rossi B, Messuti L, Maffulli N, Logroscino CA. Quality of life in patients following percutaneous PMMA acetabuloplasty for acetabular metastasis due to carcinoma. Acta Orthop Belg. 2009;75:484–9.PubMed Scaramuzzo L, Maccauro G, Rossi B, Messuti L, Maffulli N, Logroscino CA. Quality of life in patients following percutaneous PMMA acetabuloplasty for acetabular metastasis due to carcinoma. Acta Orthop Belg. 2009;75:484–9.PubMed
15.
Zurück zum Zitat Gupta AC, Hirsch JA, Chaudhry ZA, et al. Evaluating the safety and effectiveness of percutaneous acetabuloplasty. J Neurointerv Surg. 2012;4:134–8.CrossRefPubMed Gupta AC, Hirsch JA, Chaudhry ZA, et al. Evaluating the safety and effectiveness of percutaneous acetabuloplasty. J Neurointerv Surg. 2012;4:134–8.CrossRefPubMed
16.
Zurück zum Zitat Choi ES, Kim YI, Kang HG, Kim JH, Kim HS, Lin PP. Percutaneous cementoplasty for acetabulum in patients with bone metastasis. Acta Orthop Belg. 2017;83:480–7.PubMed Choi ES, Kim YI, Kang HG, Kim JH, Kim HS, Lin PP. Percutaneous cementoplasty for acetabulum in patients with bone metastasis. Acta Orthop Belg. 2017;83:480–7.PubMed
17.
Zurück zum Zitat Cotten A, Demondion X, Boutry N, et al. Therapeutic percutaneous injections in the treatment of malignant acetabular osteolyses. Radiographics. 1999;19:647–53.CrossRefPubMed Cotten A, Demondion X, Boutry N, et al. Therapeutic percutaneous injections in the treatment of malignant acetabular osteolyses. Radiographics. 1999;19:647–53.CrossRefPubMed
18.
Zurück zum Zitat Moser T, Cohen-Solal J, Breville P, Buy X, Gangi A. Pain assessment and interventional spine radiology. J Radiol. 2008;89:1901–6.CrossRefPubMed Moser T, Cohen-Solal J, Breville P, Buy X, Gangi A. Pain assessment and interventional spine radiology. J Radiol. 2008;89:1901–6.CrossRefPubMed
19.
Zurück zum Zitat Lee JS, Hobden E, Stiell IG, Wells GA. Clinically important change in the visual analog scale after adequate pain control. Acad Emerg Med. 2003;10:1128–30.CrossRefPubMed Lee JS, Hobden E, Stiell IG, Wells GA. Clinically important change in the visual analog scale after adequate pain control. Acad Emerg Med. 2003;10:1128–30.CrossRefPubMed
20.
Zurück zum Zitat Colman MW, Karim SM, Hirsch JA, et al. Percutaneous acetabuloplasty compared with open reconstruction for extensive periacetabular carcinoma metastases. J Arthroplast. 2015;30:1586–91.CrossRef Colman MW, Karim SM, Hirsch JA, et al. Percutaneous acetabuloplasty compared with open reconstruction for extensive periacetabular carcinoma metastases. J Arthroplast. 2015;30:1586–91.CrossRef
21.
Zurück zum Zitat Onate Miranda M, Moser TP. A practical guide for planning pelvic bone percutaneous interventions (biopsy, tumour ablation and cementoplasty). Insights Imaging. 2018;9:275–85.CrossRefPubMedPubMedCentral Onate Miranda M, Moser TP. A practical guide for planning pelvic bone percutaneous interventions (biopsy, tumour ablation and cementoplasty). Insights Imaging. 2018;9:275–85.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Cotten A, Dewatre F, Cortet B, et al. Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. Radiology. 1996;200:525–30.CrossRefPubMed Cotten A, Dewatre F, Cortet B, et al. Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. Radiology. 1996;200:525–30.CrossRefPubMed
23.
Zurück zum Zitat Belkoff SM, Mathis JM, Jasper LE, Deramond H. The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior. Spine (Phila Pa 1976). 2001;26:1537–41.CrossRef Belkoff SM, Mathis JM, Jasper LE, Deramond H. The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior. Spine (Phila Pa 1976). 2001;26:1537–41.CrossRef
24.
Zurück zum Zitat Liebschner MA, Rosenberg WS, Keaveny TM. Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty. Spine (Phila Pa 1976). 2001;26:1547–54.CrossRef Liebschner MA, Rosenberg WS, Keaveny TM. Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty. Spine (Phila Pa 1976). 2001;26:1547–54.CrossRef
25.
Zurück zum Zitat Kwon HM, Lee SP, Baek JW, Kim SH. Appropriate cement volume in vertebroplasty: a multivariate analysis with short-term follow-up. Korean J Neurotrauma. 2016;12:128–34.CrossRefPubMedPubMedCentral Kwon HM, Lee SP, Baek JW, Kim SH. Appropriate cement volume in vertebroplasty: a multivariate analysis with short-term follow-up. Korean J Neurotrauma. 2016;12:128–34.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Sun HB, Jing XS, Liu YZ, Qi M, Wang XK, Hai Y. The optimal volume fraction in percutaneous vertebroplasty evaluated by pain relief, cement dispersion, and cement leakage: a prospective cohort study of 130 patients with painful osteoporotic vertebral compression fracture in the thoracolumbar vertebra. World Neurosurg. 2018;114:e677–88.CrossRefPubMed Sun HB, Jing XS, Liu YZ, Qi M, Wang XK, Hai Y. The optimal volume fraction in percutaneous vertebroplasty evaluated by pain relief, cement dispersion, and cement leakage: a prospective cohort study of 130 patients with painful osteoporotic vertebral compression fracture in the thoracolumbar vertebra. World Neurosurg. 2018;114:e677–88.CrossRefPubMed
27.
28.
Zurück zum Zitat Deschamps F, de Baere T, Hakime A, et al. Percutaneous osteosynthesis in the pelvis in cancer patients. Eur Radiol. 2016;26:1631–9.CrossRefPubMed Deschamps F, de Baere T, Hakime A, et al. Percutaneous osteosynthesis in the pelvis in cancer patients. Eur Radiol. 2016;26:1631–9.CrossRefPubMed
29.
Zurück zum Zitat Pusceddu C, Fancellu A, Ballicu N, Fele RM, Sotgia B, Melis L. CT-guided percutaneous screw fixation plus cementoplasty in the treatment of painful bone metastases with fractures or a high risk of pathological fracture. Skeletal Radiol. 2017;46:539–45.CrossRefPubMed Pusceddu C, Fancellu A, Ballicu N, Fele RM, Sotgia B, Melis L. CT-guided percutaneous screw fixation plus cementoplasty in the treatment of painful bone metastases with fractures or a high risk of pathological fracture. Skeletal Radiol. 2017;46:539–45.CrossRefPubMed
Metadaten
Titel
Cementoplasty of pelvic bone metastases: systematic assessment of lesion filling and other factors that could affect the clinical outcomes
verfasst von
Thomas P. Moser
Marta Onate
Katia Achour
Véronique Freire
Publikationsdatum
02.02.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 9/2019
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-019-3156-0

Weitere Artikel der Ausgabe 9/2019

Skeletal Radiology 9/2019 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.