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Insights into Imaging

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Open Access 01-06-2014 | Review

Percutaneous image-guided ablation of bone and soft tissue tumours: a review of available techniques and protective measures

Authors: Dimitrios K. Filippiadis, Sean Tutton, Argyro Mazioti, Alexis Kelekis

Published in: Insights into Imaging | Issue 3/2014

Abstract

Background

Primary or metastatic osseous and soft tissue lesions can be treated by ablation techniques.

Methods

These techniques are classified into chemical ablation (including ethanol or acetic acid injection) and thermal ablation (including laser, radiofrequency, microwave, cryoablation, radiofrequency ionisation and MR-guided HIFU). Ablation can be performed either alone or in combination with surgical or other percutaneous techniques.

Results

In most cases, ablation provides curative treatment for benign lesions and malignant lesions up to 3 cm. Furthermore, it can be a palliative treatment providing pain reduction and local control of the disease, diminishing the tumour burden and mass effect on organs. Ablation may result in bone weakening; therefore, whenever stabilisation is undermined, bone augmentation should follow ablation depending on the lesion size and location.

Conclusion

Thermal ablation of bone and soft tissues demonstrates high success and relatively low complication rates. However, the most common complication is the iatrogenic thermal damage of surrounding sensitive structures. Nervous structures are very sensitive to extremely high and low temperatures with resultant transient or permanent neurological damage. Thermal damage can cause normal bone osteonecrosis in the lesion’s periphery, surrounding muscular atrophy and scarring, and skin burns. Successful thermal ablation requires a sufficient ablation volume and thermal protection of the surrounding vulnerable structures.

Teaching points

• Percutaneous ablations constitute a safe and efficacious therapy for treatment of osteoid osteoma.

• Ablation techniques can treat painful malignant MSK lesions and provide local tumour control.

• Thermal ablation of bone and soft tissues demonstrates high success and low complication rates.

• Nerves, cartilage and skin are sensitive to extremely high and low temperatures.

• Successful thermal ablation occasionally requires thermal protection of the surrounding structures.

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Title: Percutaneous image-guided ablation of bone and soft tissue tumours: a review of available techniques and protective measures
Authors: Dimitrios K. Filippiadis
Sean Tutton
Argyro Mazioti
Alexis Kelekis
Publication date: 01-06-2014
Publisher: Springer Berlin Heidelberg
Published in: Insights into Imaging / Issue 3/2014
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1007/s13244-014-0332-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Percutaneous image-guided ablation of bone and soft tissue tumours: a review of available techniques and protective measures

Abstract

Background

Methods

Results

Conclusion

Teaching points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Teaching points

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