Download PDF
Semin Musculoskelet Radiol 2006; 10(2): 137-144
DOI: 10.1055/s-2006-939031
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Percutaneous Minimally Invasive Therapies in the Treatment of Bone Tumors: Thermal Ablation

Caroline J. Simon1 , Damian E. Dupuy1
  • 1Department of Diagnostic Imaging, Brown Medical School, Providence, Rhode Island
Further Information

Publication History

Publication Date:
05 April 2006 (online)

Also available at
    Permissions and Reprints

ABSTRACT

Many percutaneous image-guided ablative techniques have been utilized in the treatment of bone cancers. These techniques are fast becoming a focus in the treatment of patients with both benign and malignant forms of bone cancer. This article will review the principles of radiofrequency ablation including its use in combination with other therapies, cryoablation, and microwave ablation in the treatment of osteoid osteomas and bone metastases.

KEYWORDS

Radiofrequency ablation (RFA) - cryoablation - microwave ablation (MWA) - osteoid osteoma - bone metastasis

REFERENCES

  • 1 Jaffe H L. Osteoid osteoma: a benign osteoblastic tumor composed of osteoid and atypical bone.  Arch Surg. 1935;  31 709-728
    CrossrefPubMedGoogle Scholar
  • 2 Greenspan A. Benign bone-forming lesions: osteoma, osteoid osteoma, and osteoblastoma. Clinical, imaging, pathologic, and differential considerations.  Skeletal Radiol. 1993;  22 485-500
    CrossrefPubMedGoogle Scholar
  • 3 Simm R J. The natural history of osteoid osteoma.  Aust NZJ Surg. 1975;  45 412-415
    PubMedGoogle Scholar
  • 4 Haibach H, Farrell C, Gaines R W. Osteoid osteoma of the spine: surgically correctable cause of painful scoliosis.  CMAJ. 1986;  135 895-899
    PubMedGoogle Scholar
  • 5 Jackson R P. Recurrent osteoblastoma: a review.  Clin Orthop Relat Res. 1978;  131 229-233
    PubMedGoogle Scholar
  • 6 Rosenthal D I, Hornicek F J, Wolfe M W et al.. Percutaneous radiofrequency coagulation of osteoid osteoma compared with operative treatment.  J Bone Joint Surg Am. 1998;  80 815-821
    CrossrefPubMedGoogle Scholar
  • 7 Kneisl J S, Simon M A. Medical management compared with operative treatment for osteoid-osteoma.  J Bone Joint Surg Am. 1992;  74 179-185
    PubMedGoogle Scholar
  • 8 Sans N, Galy-Fourcade D, Assoun J et al.. Osteoid osteoma: CT-guided percutaneous resection and follow-up in 38 patients.  Radiology. 1999;  212 687-692
    CrossrefPubMedGoogle Scholar
  • 9 Skjeldal S, Lilleas F, Folleras G et al.. Real time MRI-guided excision and cryo-treatment of osteoid osteoma in os ischii: a case report.  Acta Orthop Scand. 2000;  71 637-638
    CrossrefPubMedGoogle Scholar
  • 10 Resnick R B, Jarolem K L, Sheskier S C et al.. Arthroscopic removal of an osteoid osteoma of the talus: a case report.  Foot Ankle Int. 1995;  16 212-215
    PubMedGoogle Scholar
  • 11 Adam G, Keulers P, Vorwerk D et al.. The percutaneous CT-guided treatment of osteoid osteomas: a combined procedure with a biopsy drill and subsequent ethanol injection [in German].  Rofo. 1995;  162 232-235
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Gangi A, Dietemann J L, Gasser B et al.. Interstitial laser photocoagulation of osteoid osteomas with use of CT guidance.  Radiology. 1997;  203 843-848
    CrossrefPubMedGoogle Scholar
  • 13 Rosenthal D I, Alexander A, Rosenberg A E, Springfield D. Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure.  Radiology. 1992;  183 29-33
    CrossrefPubMedGoogle Scholar
  • 14 Woertler K, Vestring T, Boettner F et al.. Osteoid osteoma: CT-guided percutaneous radiofrequency ablation and follow-up in 47 patients.  J Vasc Interv Radiol. 2001;  12 717-722
    PubMedGoogle Scholar
  • 15 Vanderschueren G M, Taminiau A H, Obermann W R, Bloem J L. Osteoid osteoma: clinical results with thermocoagulation.  Radiology. 2002;  224 82-86
    CrossrefPubMedGoogle Scholar
  • 16 Rosenthal D I, Hornicek F J, Torriani M et al.. Osteoid osteoma: percutaneous treatment with radiofrequency energy.  Radiology. 2003;  229 171-175
    CrossrefPubMedGoogle Scholar
  • 17 Nahum Goldberg S, Dupuy D E. Image-guided radiofrequency tumor ablation: challenges and opportunities - Part I.  J Vasc Interv Radiol. 2001;  12 1021-1032
    PubMedGoogle Scholar
  • 18 Goldberg S N, Gazelle G S, Solbiati L et al.. Radiofrequency tissue ablation: increased lesion diameter with a perfusion electrode.  Acad Radiol. 1996;  3 636-644
    CrossrefPubMedGoogle Scholar
  • 19 Regan M W, Galey J P, Oakeshott R D. Recurrent osteoid osteoma. Case report with a ten-year asymptomatic interval.  Clin Orthop Relat Res. 1990;  253 221-224
    PubMedGoogle Scholar
  • 20 American Cancer Society .Cancer Facts and Figures 2004. Atlanta, GA; American Cancer Society 2004
    Google Scholar
  • 21 Janjan N A. Radiation for bone metastases: conventional techniques and the role of systemic radiopharmaceuticals.  Cancer. 1997;  80(8 Suppl) 1628-1645
    CrossrefPubMedGoogle Scholar
  • 22 Janjan N. Bone metastases: approaches to management.  Semin Oncol. 2001;  28(4 Suppl 11) 28-34
    PubMedGoogle Scholar
  • 23 Bloomfield D J. Should bisphosphonates be part of the standard therapy of patients with multiple myeloma or bone metastases from other cancers? An evidence-based review.  J Clin Oncol. 1998;  16 1218-1225
    PubMedGoogle Scholar
  • 24 Tong D, Gillick L, Hendrickson F R. The palliation of symptomatic osseous metastases: final results of the Study by the Radiation Therapy Oncology Group.  Cancer. 1982;  50 893-899
    CrossrefPubMedGoogle Scholar
  • 25 Madsen E L. Painful bone metastasis: efficacy of radiotherapy assessed by the patients: a randomized trial comparing 4 Gy x 6 versus 10 Gy x 2.  Int J Radiat Oncol Biol Phys. 1983;  9 1775-1779
    PubMedGoogle Scholar
  • 26 Blitzer P H. Reanalysis of the RTOG study of the palliation of symptomatic osseous metastasis.  Cancer. 1985;  55 1468-1472
    CrossrefPubMedGoogle Scholar
  • 27 Price P, Hoskin P J, Easton D et al.. Prospective randomised trial of single and multifraction radiotherapy schedules in the treatment of painful bony metastases.  Radiother Oncol. 1986;  6 247-255
    PubMedGoogle Scholar
  • 28 Arcangeli G, Micheli A, Arcangeli G et al.. The responsiveness of bone metastases to radiotherapy: the effect of site, histology and radiation dose on pain relief.  Radiother Oncol. 1989;  14 95-101
    CrossrefPubMedGoogle Scholar
  • 29 Cole D J. A randomized trial of a single treatment versus conventional fractionation in the palliative radiotherapy of painful bone metastases.  Clin Oncol (R Coll Radiol). 1989;  1 59-62
    CrossrefPubMedGoogle Scholar
  • 30 Poulter C A, Cosmatos D, Rubin P et al.. A report of RTOG 8206: a phase III study of whether the addition of single dose hemibody irradiation to standard fractionated local field irradiation is more effective than local field irradiation alone in the treatment of symptomatic osseous metastases.  Int J Radiol Oncol Biol Phys. 1992;  23 207-214
    PubMedGoogle Scholar
  • 31 Arcangeli G, Giovinazzo G, Saracino B et al.. Radiation therapy in the management of symptomatic bone metastases: the effect of total dose and histology on pain relief and response duration.  Int J Radiol Oncol Biol Phys. 1998;  42 1119-1126
    CrossrefPubMedGoogle Scholar
  • 32 Ratanatharathorn V, Powers W E, Moss W T, Perez C A. Bone metastasis: review and critical analysis of random allocation trials of local field treatment.  Int J Radiol Oncol Biol Phys. 1999;  44 1-18
    CrossrefPubMedGoogle Scholar
  • 33 Dupuy D, Ahmed M, Rodrigues B, Safran H. Percutaneous radiofrequency ablation of painful osseous metastases: a phase II trial. Presented at the 37th Annual Meeting of the American Society of Clinical Oncology. May 12-15, 2001 San Francisco, CA; Abstract 1537
    Google Scholar
  • 34 Dupuy D E, Safran H, Mayo-Smith W W et al.. Radiofrequency ablation of painful osseous metastases.  Radiology. 1998;  209(suppl) 389
    PubMedGoogle Scholar
  • 35 Callstrom M R, Charboneau J W, Goetz M P et al.. Painful metastases involving bone: feasibility of percutaneous CT- and US-guided radio-frequency ablation.  Radiology. 2002;  224 87-97
    CrossrefPubMedGoogle Scholar
  • 36 Goetz M P, Callstrom M R, Charboneau J W et al.. Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study.  J Clin Oncol. 2004;  22 300-306
    CrossrefPubMedGoogle Scholar
  • 37 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;  200 525-530
    CrossrefPubMedGoogle Scholar
  • 38 Schaefer O, Lohrmann C, Herling M et al.. Combined radiofrequency thermal ablation and percutaneous cementoplasty treatment of a pathologic fracture.  J Vasc Interv Radiol. 2002;  13 1047-1050
    CrossrefPubMedGoogle Scholar
  • 39 Schaefer O, Lohrmann C, Markmiller M et al.. Combined treatment of a spinal metastasis with radiofrequency heat ablation and vertebroplasty.  AJR Am J Roentgenol. 2003;  180 1075-1077
    PubMedGoogle Scholar
  • 40 Nakatsuka A, Yamakado K, Maeda M et al.. Radiofrequency ablation combined with bone cement injection for the treatment of bone malignancies.  J Vasc Interv Radiol. 2004;  15 707-712
    CrossrefPubMedGoogle Scholar
  • 41 Gage A A. History of cryosurgery.  Semin Surg Oncol. 1998;  14 99-109
    CrossrefPubMedGoogle Scholar
  • 42 Silverman S G, Tuncali K, Adams D F et al.. MR imaging-guided percutaneous cryotherapy of liver tumors: initial experience.  Radiology. 2000;  217 657-664
    PubMedGoogle Scholar
  • 43 Shingleton W B, Sewell Jr P E. Percutaneous renal cryoablation of renal tumors in patients with von Hippel-Lindau disease.  J Urol. 2002;  167 1268-1270
    CrossrefPubMedGoogle Scholar
  • 44 Beland M D, Dupuy D E, Mayo-Smith W W. Percutaneous cryoablation of extra abdominal metastatic disease: preliminary results.  AJR Am J Roentgenol. 2005;  184 926-930
    PubMedGoogle Scholar
  • 45 Fan Q Y, Ma B A, Qlu X C et al.. Preliminary report on treatment of bone tumors with microwave-induced hyperthermia.  Bioelectromagnetics. 1996;  17 218-222
    CrossrefPubMedGoogle Scholar
  • 46 Murakami R, Yoshimatsu S, Yamashita Y et al.. Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation.  AJR Am J Roentgenol. 1995;  164 1159-1164
    PubMedGoogle Scholar
  • 47 Seki T, Tamai T, Nakagawa T et al.. Combination therapy with transcatheter arterial chemoembolization and percutaneous microwave coagulation therapy for hepatocellular carcinoma.  Cancer. 2000;  89 1245-1251
    CrossrefPubMedGoogle Scholar
  • 48 Lu M D, Chen J W, Xie X Y et al.. Hepatocellular carcinoma: US-guided percutaneous microwave coagulation therapy.  Radiology. 2001;  221 167-172
    CrossrefPubMedGoogle Scholar
  • 49 Shibata T, Iimuro Y, Yamamoto Y et al.. Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy.  Radiology. 2002;  223 331-337
    CrossrefPubMedGoogle Scholar

Damian E DupuyM.D. 

Director of Ultrasound, Department of Diagnostic Imaging, Brown Medical School, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903