Semin intervent Radiol 2014; 31(02): 167-179
DOI: 10.1055/s-0034-1373791
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Bone and Soft Tissue Ablation

Ryan C.B. Foster
1   Department of Radiology, Hospital for Special Surgery, New York, New York
,
Joseph M. Stavas
2   Department of Radiology, the University of North Carolina, Chapel Hill, North Carolina
› Author Affiliations
Further Information

Publication History

Publication Date:
21 May 2014 (online)

Abstract

Bone and soft tissue tumor ablation has reached widespread acceptance in the locoregional treatment of various benign and malignant musculoskeletal (MSK) lesions. Many principles of ablation learned elsewhere in the body are easily adapted to the MSK system, particularly the various technical aspects of probe/antenna design, tumoricidal effects, selection of image guidance, and methods to reduce complications. Despite the common use of thermal and chemical ablation procedures in bone and soft tissues, there are few large clinical series that show longitudinal benefit and cost-effectiveness compared with conventional methods, namely, surgery, external beam radiation, and chemotherapy. Percutaneous radiofrequency ablation of osteoid osteomas has been evaluated the most and is considered a first-line treatment choice for many lesions. Palliation of painful metastatic bone disease with thermal ablation is considered safe and has been shown to reduce pain and analgesic use while improving quality of life for cancer patients. Procedure-related complications are rare and are typically easily managed. Similar to all interventional procedures, bone and soft tissue lesions require an integrated approach to disease management to determine the optimum type of and timing for ablation techniques within the context of the patient care plan.

 
  • References

  • 1 Rosenthal DI, Alexander A, Rosenberg AE, Springfield D. Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure. Radiology 1992; 183 (1) 29-33
  • 2 Rosenthal DI, Hornicek FJ, Wolfe MW, Jennings LC, Gebhardt MC, Mankin HJ. Percutaneous radiofrequency coagulation of osteoid osteoma compared with operative treatment. J Bone Joint Surg Am 1998; 80 (6) 815-821
  • 3 Kurup AN, Callstrom MR. Image-guided percutaneous ablation of bone and soft tissue tumors. Semin Intervent Radiol 2010; 27 (3) 276-284
  • 4 Jaffe HL. Osteoid osteoma: a benign osteoblastic tumor composed of osteoid and atypical bone. Arch Surg 1935; 31: 708-728
  • 5 Greenspan A. Benign bone-forming lesions: osteoma, osteoid osteoma, and osteoblastoma. Clinical, imaging, pathologic, and differential considerations. Skeletal Radiol 1993; 22 (7) 485-500
  • 6 Rosenthal DI, Hornicek FJ, Torriani M, Gebhardt MC, Mankin HJ. Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology 2003; 229 (1) 171-175
  • 7 Rimondi E, Mavrogenis AF, Rossi G , et al. Radiofrequency ablation for non-spinal osteoid osteomas in 557 patients. Eur Radiol 2012; 22 (1) 181-188
  • 8 Gebauer B, Collettini F, Bruger C , et al. Radiofrequency ablation of osteoid osteomas: analgesia and patient satisfaction in long-term follow-up. Rofo 2013; 184 (10) 959-966
  • 9 Lanza E, Thouvenin Y, Viala P , et al. Osteoid osteoma treated by percutaneous thermal ablation: when do we fail? A systematic review and guidelines for future reporting. Cardiovasc Intervent Radiol 2013;
  • 10 Gangi A, Buy X. Percutaneous bone tumor management. Semin Intervent Radiol 2010; 27 (2) 124-136
  • 11 Gangi A, Dietemann JL, Gasser B , et al. Interstitial laser photocoagulation of osteoid osteomas with use of CT guidance. Radiology 1997; 203 (3) 843-848
  • 12 Witt JD, Hall-Craggs MA, Ripley P, Cobb JP, Bown SG. Interstitial laser photocoagulation for the treatment of osteoid osteoma. J Bone Joint Surg Br 2000; 82 (8) 1125-1128
  • 13 Gangi A, Alizadeh H, Wong L, Buy X, Dietemann JL, Roy C. Osteoid osteoma: percutaneous laser ablation and follow-up in 114 patients. Radiology 2007; 242 (1) 293-301
  • 14 Moser T, Giacomelli MC, Clavert JM, Buy X, Dietemann JL, Gangi A. Image-guided laser ablation of osteoid osteoma in pediatric patients. J Pediatr Orthop 2008; 28 (2) 265-270
  • 15 Etienne A, Waynberger É, Druon J. Interstitial laser photocoagulation for the treatment of osteoid osteoma: retrospective study on 35 cases. Diagn Interv Imaging 2013; 94 (3) 300-310
  • 16 Sequeiros RB, Hyvönen P, Sequeiros AB , et al. MR imaging-guided laser ablation of osteoid osteomas with use of optical instrument guidance at 0.23 T. Eur Radiol 2003; 13 (10) 2309-2314
  • 17 Streitparth F, Gebauer B, Melcher I , et al. MR-guided laser ablation of osteoid osteoma in an open high-field system (1.0 T). Cardiovasc Intervent Radiol 2009; 32 (2) 320-325
  • 18 Maurer MH, Gebauer B, Wieners G , et al. Treatment of osteoid osteoma using CT-guided radiofrequency ablation versus MR-guided laser ablation: a cost comparison. Eur J Radiol 2012; 81 (11) e1002-e1006
  • 19 Jaffe HL, Lichtenstein L. Benign chondroblastoma of bone: a reinterpretation of the so-called calcifying or chondromatous giant cell tumor. Am J Pathol 1942; 18 (6) 969-991
  • 20 Rajalakshmi P, Srivastava DN, Rastogi S, Julka PK, Bhatnagar S, Gamanagatti S. Bipolar radiofrequency ablation of tibial chondroblastomas: a report of three cases. World J Radiol 2012; 4 (7) 335-340
  • 21 Rybak LD, Rosenthal DI, Wittig JC. Chondroblastoma: radiofrequency ablation—alternative to surgical resection in selected cases. Radiology 2009; 251 (2) 599-604
  • 22 Christie-Large M, Evans N, Davies AM, James SL. Radiofrequency ablation of chondroblastoma: procedure technique, clinical and MR imaging follow up of four cases. Skeletal Radiol 2008; 37 (11) 1011-1017
  • 23 Petsas T, Megas P, Papathanassiou Z. Radiofrequency ablation of two femoral head chondroblastomas. Eur J Radiol 2007; 63 (1) 63-67
  • 24 Tins B, Cassar-Pullicino V, McCall I, Cool P, Williams D, Mangham D. Radiofrequency ablation of chondroblastoma using a multi-tined expandable electrode system: initial results. Eur Radiol 2006; 16 (4) 804-810
  • 25 Erickson JK, Rosenthal DI, Zaleske DJ, Gebhardt MC, Cates JM. Primary treatment of chondroblastoma with percutaneous radio-frequency heat ablation: report of three cases. Radiology 2001; 221 (2) 463-468
  • 26 Atalar H, Basarir K, Yildiz Y, Erekul S, Saglik Y. Management of chondroblastoma: retrospective review of 28 patients. J Orthop Sci 2007; 12 (4) 334-340
  • 27 Ramappa AJ, Lee FY, Tang P, Carlson JR, Gebhardt MC, Mankin HJ. Chondroblastoma of bone. J Bone Joint Surg Am 2000; 82-A (8) 1140-1145
  • 28 Lin PP, Thenappan A, Deavers MT, Lewis VO, Yasko AW. Treatment and prognosis of chondroblastoma. Clin Orthop Relat Res 2005; 438 (438) 103-109
  • 29 Suneja R, Grimer RJ, Belthur M , et al. Chondroblastoma of bone: long-term results and functional outcome after intralesional curettage. J Bone Joint Surg Br 2005; 87 (7) 974-978
  • 30 Burdío F, Güemes A, Burdío JM , et al. Large hepatic ablation with bipolar saline-enhanced radiofrequency: an experimental study in in vivo porcine liver with a novel approach. J Surg Res 2003; 110 (1) 193-201
  • 31 Corby RR, Stacy GS, Peabody TD, Dixon LB. Radiofrequency ablation of solitary eosinophilic granuloma of bone. AJR Am J Roentgenol 2008; 190 (6) 1492-1494
  • 32 Munk PL, Malfair D, Rashid F, Torreggiani WC. Radiofrequency ablation of solitary eosinophilic granuloma of bone. AJR Am J Roentgenol 2008; 191 (6) W320 , author reply W321
  • 33 Teichgräber V, Aubé C, Schmidt D , et al. Percutaneous MR-guided radiofrequency ablation of recurrent sacrococcygeal chordomas. AJR Am J Roentgenol 2006; 187 (2) 571-574
  • 34 Anis N, Chawki N, Antoine K. Use of radio-frequency ablation for the palliative treatment of sacral chordoma. AJNR Am J Neuroradiol 2004; 25 (9) 1589-1591
  • 35 Neeman Z, Patti JW, Wood BJ. Percutaneous radiofrequency ablation of chordoma. AJR Am J Roentgenol 2002; 179 (5) 1330-1332
  • 36 Kurup AN, Woodrum DA, Morris JM , et al. Cryoablation of recurrent sacrococcygeal tumors. J Vasc Interv Radiol 2012; 23 (8) 1070-1075
  • 37 Nielsen OS, Munro AJ, Tannock IF. Bone metastases: pathophysiology and management policy. J Clin Oncol 1991; 9 (3) 509-524
  • 38 Wu JS, Wong R, Johnston M, Bezjak A, Whelan T ; Cancer Care Ontario Practice Guidelines Initiative Supportive Care Group. Meta-analysis of dose-fractionation radiotherapy trials for the palliation of painful bone metastases. Int J Radiat Oncol Biol Phys 2003; 55 (3) 594-605
  • 39 Bang HJ, Littrup PJ, Currier BP , et al. Percutaneous cryoablation of metastatic lesions from non-small-cell lung carcinoma: initial survival, local control, and cost observations. J Vasc Interv Radiol 2012; 23 (6) 761-769
  • 40 Nazario J, Hernandez J, Tam AL. Thermal ablation of painful bone metastases. Tech Vasc Interv Radiol 2011; 14 (3) 150-159
  • 41 Dupuy DE, Hong R, Oliver B, Goldberg SN. Radiofrequency ablation of spinal tumors: temperature distribution in the spinal canal. AJR Am J Roentgenol 2000; 175 (5) 1263-1266
  • 42 Dupuy DE, Liu D, Hartfeil D , et al. Percutaneous radiofrequency ablation of painful osseous metastases: a multicenter American College of Radiology Imaging Network trial. Cancer 2010; 116 (4) 989-997
  • 43 Callstrom MR, Charboneau JW, Goetz MP , et al. Image-guided ablation of painful metastatic bone tumors: a new and effective approach to a difficult problem. Skeletal Radiol 2006; 35 (1) 1-15
  • 44 Gazis AN, Beuing O, Franke J, Jöllenbeck B, Skalej M. Bipolar radiofrequency ablation of spinal tumors: predictability, safety, and outcome. Spine J 2014; 14 (4) 604-608
  • 45 Pezeshki PS, Woo J, Akens MK , et al. Evaluation of a bipolar-cooled radiofrequency device for ablation of bone metastases: preclinical assessment in porcine vertebrae. Spine J 2014; 14 (2) 361-370
  • 46 Callstrom MR, Atwell TD, Charboneau JW , et al. Painful metastases involving bone: percutaneous image-guided cryoablation—prospective trial interim analysis. Radiology 2006; 241 (2) 572-580
  • 47 Munk PL, Rashid F, Heran MK , et al. Combined cementoplasty and radiofrequency ablation in the treatment of painful neoplastic lesions of bone. J Vasc Interv Radiol 2009; 20 (7) 903-911
  • 48 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 (6) 1165-1173
  • 49 Lane MD, Le HB, Lee S , et al. Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients. Skeletal Radiol 2011; 40 (1) 25-32
  • 50 Walczak BE, Rose PS. Desmoid: the role of local therapy in an era of systemic options. Curr Treat Options Oncol 2013; 14 (3) 465-473
  • 51 Molloy AP, Hutchinson B, O'Toole GC. Extra-abdominal desmoid tumours: a review of the literature. Sarcoma 2012; 2012: 578052
  • 52 Escobar C, Munker R, Thomas JO, Li BD, Burton GV. Update on desmoid tumors. Ann Oncol 2012; 23 (3) 562-569
  • 53 Okuno S. The enigma of desmoid tumors. Curr Treat Options Oncol 2006; 7 (6) 438-443
  • 54 Bonvalot S, Desai A, Coppola S , et al. The treatment of desmoid tumors: a stepwise clinical approach. Ann Oncol 2012; 23 (Suppl. 10) x158-x166
  • 55 Kujak JL, Liu PT, Johnson GB, Callstrom MR. Early experience with percutaneous cryoablation of extra-abdominal desmoid tumors. Skeletal Radiol 2010; 39 (2) 175-182
  • 56 Kolberg M, Høland M, Agesen TH , et al. Survival meta-analyses for >1800 malignant peripheral nerve sheath tumor patients with and without neurofibromatosis type 1. Neuro-oncol 2013; 15 (2) 135-147
  • 57 McCaughan JA, Holloway SM, Davidson R, Lam WW. Further evidence of the increased risk for malignant peripheral nerve sheath tumour from a Scottish cohort of patients with neurofibromatosis type 1. J Med Genet 2007; 44 (7) 463-466
  • 58 Cornelis F, Havez M, Labrèze C , et al. Percutaneous cryoablation of symptomatic localized venous malformations: preliminary short-term results. J Vasc Interv Radiol 2013; 24 (6) 823-827
  • 59 Freiberg AA, Loder RT, Heidelberger KP, Hensinger RN. Aneurysmal bone cysts in young children. J Pediatr Orthop 1994; 14 (1) 86-91
  • 60 Dormans JP, Hanna BG, Johnston DR, Khurana JS. Surgical treatment and recurrence rate of aneurysmal bone cysts in children. Clin Orthop Relat Res 2004; (421) 205-211
  • 61 Shiels II WE, Mayerson JL. Percutaneous doxycycline treatment of aneurysmal bone cysts with low recurrence rate: a preliminary report. Clin Orthop Relat Res 2013; 471 (8) 2675-2683
  • 62 Carrafiello G, Laganà D, Pellegrino C , et al. Percutaneous imaging-guided ablation therapies in the treatment of symptomatic bone metastases: preliminary experience. Radiol Med (Torino) 2009; 114 (4) 608-625
  • 63 Grieco CA, Simon CJ, Mayo-Smith WW, Dipetrillo TA, Ready NE, Dupuy DE. Image-guided percutaneous thermal ablation for the palliative treatment of chest wall masses. Am J Clin Oncol 2007; 30 (4) 361-367
  • 64 Catane R, Beck A, Inbar Y , et al. MR-guided focused ultrasound surgery (MRgFUS) for the palliation of pain in patients with bone metastases—preliminary clinical experience. Ann Oncol 2007; 18 (1) 163-167
  • 65 Liberman B, Gianfelice D, Inbar Y , et al. Pain palliation in patients with bone metastases using MR-guided focused ultrasound surgery: a multicenter study. Ann Surg Oncol 2009; 16 (1) 140-146
  • 66 Li C, Zhang W, Fan W, Huang J, Zhang F, Wu P. Noninvasive treatment of malignant bone tumors using high-intensity focused ultrasound. Cancer 2010; 116 (16) 3934-3942
  • 67 Chen W, Zhu H, Zhang L , et al. Primary bone malignancy: effective treatment with high-intensity focused ultrasound ablation. Radiology 2010; 255 (3) 967-978
  • 68 Napoli A, Anzidei M, Marincola BC , et al. MR imaging-guided focused ultrasound for treatment of bone metastasis. Radiographics 2013; 33 (6) 1555-1568
  • 69 Groenemeyer DH, Schirp S, Gevargez A. Image-guided percutaneous thermal ablation of bone tumors. Acad Radiol 2002; 9 (4) 467-477
  • 70 Ahrar K, Stafford RJ. Magnetic resonance imaging-guided laser ablation of bone tumors. Tech Vasc Interv Radiol 2011; 14 (3) 177-182
  • 71 Fini M, Tschon M, Ronchetti M , et al. Ablation of bone cells by electroporation. J Bone Joint Surg Br 2010; 92 (11) 1614-1620
  • 72 Marty M, Sersa G, Garbay JR , et al. Electrochemotherapy—an easy, highly effective and safe treatment of cutaneous and subcutaneous metastases: Results of ESOPE (European Standard Operating Procedures of Electrochemotherapy) study. Eur J Cancer, Suppl 2006; 4 (11) 3-13
  • 73 Mir LM, Gehl J, Sersa G , et al. Standard operating procedures of the electrochemotherapy: instructions for the use of bleomycin or cisplatin administered either systemically or locally and electric pulses delivered by the CliniporatorTM by means of invasive or non-invasive electrodes. Eur J Cancer, Suppl 2006; 4 (11) 14-25
  • 74 Fini M, Salamanna F, Parrilli A , et al. Electrochemotherapy is effective in the treatment of rat bone metastases. Clin Exp Metastasis 2013; 30 (8) 1033-1045
  • 75 Shimizu T, Nikaido T, Gomyo H , et al. Electrochemotherapy for digital chondrosarcoma. J Orthop Sci 2003; 8 (2) 248-251
  • 76 Littrup PJ, Bang HJ, Currier BP , et al. Soft-tissue cryoablation in diffuse locations: feasibility and intermediate term outcomes. J Vasc Interv Radiol 2013; 24 (12) 1817-1825
  • 77 McMenomy BP, Kurup AN, Johnson GB , et al. Percutaneous cryoablation of musculoskeletal oligometastatic disease for complete remission. J Vasc Interv Radiol 2013; 24 (2) 207-213
  • 78 Thacker PG, Callstrom MR, Curry TB , et al. Palliation of painful metastatic disease involving bone with imaging-guided treatment: comparison of patients' immediate response to radiofrequency ablation and cryoablation. AJR Am J Roentgenol 2011; 197 (2) 510-515
  • 79 Buy X, Tok CH, Szwarc D, Bierry G, Gangi A. Thermal protection during percutaneous thermal ablation procedures: interest of carbon dioxide dissection and temperature monitoring. Cardiovasc Intervent Radiol 2009; 32 (3) 529-534
  • 80 Goetz MP, Callstrom MR, Charboneau JW , et al. Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study. J Clin Oncol 2004; 22 (2) 300-306
  • 81 Thanos L, Mylona S, Galani P , et al. Radiofrequency ablation of osseous metastases for the palliation of pain. Skeletal Radiol 2008; 37 (3) 189-194
  • 82 Callstrom MR, Dupuy DE, Solomon SB , et al. Percutaneous image-guided cryoablation of painful metastases involving bone: multicenter trial. Cancer 2013; 119 (5) 1033-1041
  • 83 Tsoumakidou G, Buy X, Garnon J, Enescu J, Gangi A. Percutaneous thermal ablation: how to protect the surrounding organs. Tech Vasc Interv Radiol 2011; 14 (3) 170-176
  • 84 Callstrom MR, Charboneau JW, Goetz MP , et al. Painful metastases involving bone: feasibility of percutaneous CT- and US-guided radio-frequency ablation. Radiology 2002; 224 (1) 87-97