Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 4/2017

01-04-2017 | Interventional

Prospective 1-year follow-up pilot study of CT-guided microwave ablation in the treatment of bone and soft-tissue malignant tumours

Authors: Sébastien Aubry, Jonathan Dubut, Jean-Philippe Nueffer, Loic Chaigneau, Chrystelle Vidal, Bruno Kastler

Published in: European Radiology | Issue 4/2017

Login to get access

Abstract

Purpose

The aims of this work were to assess the feasibility, efficacy, short-term outcome and safety of microwave ablation (MWA) in the treatment of malignant musculoskeletal tumours.

Materials and methods

Sixteen bone and soft-tissue malignant tumours were prospectively included and were treated by CT-guided MWA. The percentage and size of necrosis of the lesions were measured by contrast-enhanced MRI before the procedure and after 1, 3, 6 and 12 months. mRECIST criteria were used to assess tumour response. Procedural success was defined as ≥80 % necrosis. Patient pain (as assessed using a numeric visual scale (NVS)) and side effects were noted.

Results

Six osteolytic metastases, five osteoblastic metastases and five soft tissue sarcomas were treated. At 1 month, 40 % were treated completely, the percentage of necrosis was 85 ± 30.4 %, and the success rate was 80 %. At 3, 6 and 12 months the success rate was 80 %, 76.9 % and 63.6 %, respectively. At 12 months, four lesions (36.3 %) still had no recurrence. Mean NVS during the procedure was 3.5 ± 2.8. One patient had transitory sciatica without neurological deficit that was treated medically.

Conclusion

CT-guided MWA of bone and soft-tissue malignant tumours is efficient, well tolerated and has good short-term anti-cancer effects.

Key Points

• CT-guided MWA is efficient in treating musculoskeletal malignant tumours.
• This prospective pilot study showed MWA induces high percentages of tumour necrosis.
• MWA has good short-term anti-cancer effects.
• MWA has healing potential when lesions can be completely necrosed.
• CT-guided MWA under equimolar mixture of oxygen-nitrous oxide inhalation is well tolerated.
Literature
1.
Nordlinger B, De Sena G, Szawlowski A et al (1983) Surgical resection of hepatic metastases of cancers of the colon and rectum. Gastroentérologie Clinique Et Biologique 7:240–243PubMed
2.
Hellman S, Weichselbaum RR (1995) Oligometastases. J Clin Oncol Off J Am Soc Clin Oncol 13:8–10CrossRef
3.
Filippiadis DK, Tutton S, Mazioti A, Kelekis A (2014) Percutaneous image-guided ablation of bone and soft tissue tumours: a review of available techniques and protective measures. Insights Imaging 5:339–346CrossRefPubMedPubMedCentral
4.
Moser T, Buy X, Goyault G et al (2008) Image-guided ablation of bone tumors: review of current techniques. J Radiol 89:461–471CrossRefPubMed
5.
Xie C, Jeys L, James SLJ (2015) Radiofrequency ablation of chondroblastoma: long-term clinical and imaging outcomes. Eur Radiol 25:1127–1134CrossRefPubMed
6.
Kastler A, Alnassan H, Pereira PL et al (2013) Analgesic effects of microwave ablation of bone and soft tissue tumors under local anesthesia. Pain Med (Malden, Mass) 14:1873–1881CrossRef
7.
Goetz MP, Callstrom MR, Charboneau JW et al (2004) Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study. J Clin Oncol 22:300–306CrossRefPubMed
8.
Miguel R (2000) Interventional treatment of cancer pain: the fourth step in the World Health Organization analgesic ladder? Cancer Control 7:149–156PubMed
9.
de Baere T (2011) New techniques of tumor ablation (microwaves, electroporation). Journal De Radiologie 92:789–795CrossRefPubMed
10.
11.
Palussière J (2010) L’ablation tumorale percutanée: où en est-on ? Oncologie 12:213–218CrossRef
12.
Dupuy DE, Goldberg SN (2001) Image-guided radiofrequency tumor ablation: challenges and opportunities--part II. J Vasc Interv Radiol 12:1135–1148CrossRefPubMed
13.
Pusceddu C, Sotgia B, Fele RM, Melis L (2013) Treatment of bone metastases with microwave thermal ablation. J Vasc Interv Radiol 24:229–233CrossRefPubMed
14.
Yang X, Ye X, Zheng A et al (2014) Percutaneous microwave ablation of stage I medically inoperable non-small cell lung cancer: clinical evaluation of 47 cases. J Surg Oncol 110:758–763CrossRefPubMedPubMedCentral
15.
Fournier L, Ammari S, Thiam R, Cuénod C-A (2014) Imaging criteria for assessing tumour response: RECIST, mRECIST, Cheson. Diagn Interv Imaging 95:689–703CrossRefPubMed
16.
Llovet JM, Di Bisceglie AM, Bruix J et al (2008) Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst 100:698–711CrossRefPubMed
17.
18.
Kastler B, Boulahdour H, Barral FG et al (2005) Pain management in bone metastasis of pulmonary origin: new interventional and metabolic techniques. Revue Des Maladies Respiratoires 22:8S94–8S100CrossRefPubMed
19.
Dixmérias F, Palussière J (2011) Management of painful bone metastases. Journal De Radiologie 92:796–800CrossRefPubMed
20.
Yu J, Liang P, Yu X-L et al (2012) US-guided percutaneous microwave ablation of renal cell carcinoma: intermediate-term results. Radiology 263:900–908CrossRefPubMed
21.
Durick NA, Laeseke PF, Broderick LS et al (2008) Microwave ablation with triaxial antennas tuned for lung: results in an in vivo porcine model. Radiology 247:80–87CrossRefPubMed
22.
Kastler A, Alnassan H, Aubry S, Kastler B (2014) Microwave thermal ablation of spinal metastatic bone tumors. J Vasc Interv Radiol 25:1470–1475CrossRefPubMed
23.
Carrafiello G, Laganà D, Mangini M et al (2008) Microwave tumors ablation: principles, clinical applications and review of preliminary experiences. Int J Surg (London, England) 6:S65–S69CrossRef
24.
Cornélis F, Havez M, Lippa N et al (2013) Radiologically guided percutaneous cryotherapy for soft tissue tumours: a promising treatment. Diagn Interv Imaging 94:364–370CrossRefPubMed
25.
Kurup AN, Callstrom MR (2013) Ablation of musculoskeletal metastases: pain palliation, fracture risk reduction, and oligometastatic disease. Tech Vasc Interv Radiol 16:253–261CrossRefPubMed
26.
White ML, Atwell TD, Kurup AN et al (2016) Recurrence and survival outcomes after percutaneous thermal ablation of oligometastatic melanoma. Mayo Clin Proc 91:288–296CrossRefPubMed
27.
Tuncali K, Morrison PR, Winalski CS et al (2007) MRI-guided percutaneous cryotherapy for soft-tissue and bone metastases: initial experience. AJR Am J Roentgenol 189:232–239CrossRefPubMed
28.
Callstrom MR, Atwell TD, Charboneau JW et al (2006) Painful metastases involving bone: percutaneous image-guided cryoablation--prospective trial interim analysis. Radiology 241:572–580CrossRefPubMed
29.
Goldberg SN, Grassi CJ, Cardella JF et al (2005) Image-guided tumor ablation: standardization of terminology and reporting criteria. Radiology 235:728–739CrossRefPubMedPubMedCentral
30.
Cha CH, Lee FT, Gurney JM et al (2000) CT versus sonography for monitoring radiofrequency ablation in a porcine liver. AJR Am J Roentgenol 175:705–711CrossRefPubMed
31.
Belfiore MP, Ronza FM, Volpe Della T et al (2015) Long-term local disease control in a recurrent soft-tissue sarcoma of the thigh treated by radiofrequency ablation. J Surg Oncol 111:708–710CrossRefPubMed
32.
Xu J, Li J, Zhou X et al (2014) Cryotherapy for local recurrent dermatofibrosarcoma protuberans: experience in 19 patients. Cryobiology 68:134–138CrossRefPubMed
33.
Rosenthal D, Callstrom MR (2012) Critical review and state of the art in interventional oncology: benign and metastatic disease involving bone. Radiology 262:765–780CrossRefPubMed
34.
Kastler B, Jacamon M, Aubry S et al (2007) Combined bipolar radiofrequency and cementoplasty of bone metastases. J Radiol 88:1242–1247CrossRefPubMed
35.
36.
Kurup AN, Callstrom MR (2010) Image-guided percutaneous ablation of bone and soft tissue tumors. Semin Interv Radiol 27:276–284CrossRef
37.
Owen D, Laack NN, Mayo CS et al (2014) Outcomes and toxicities of stereotactic body radiation therapy for non-spine bone oligometastases. Pract Radiat Oncol 4:e143–e149CrossRefPubMed
38.
McDonald R, Probyn L, Poon I et al (2015) Tumor response after stereotactic body radiation therapy to nonspine bone metastases: an evaluation of response criteria. Int J Radiat Oncol Biol Phys 93:879–881CrossRefPubMed
39.
40.
Maybody M, Tang PQ, Moskowitz CS et al (2016) Pneumodissection for skin protection in image-guided cryoablation of superficial musculoskeletal tumours. Eur Radiol 1–9. doi:10.​1007/​s00330-016-4456-6
41.
Gangi A, Buy X (2010) Percutaneous bone tumor management. Semin Interv Radiol 27:124–136CrossRef
42.
Filippiadis DK, Tutton S, Kelekis A (2014) Percutaneous bone lesion ablation. La Radiologia Medica 119:462–469CrossRefPubMed
43.
Munk PL, Murphy KJ, Gangi A, Liu DM (2011) Fire and ice: percutaneous ablative therapies and cement injection in management of metastatic disease of the spine. Semin Musculoskelet Radiol 15:125–134CrossRefPubMed
44.
Deschamps F, Farouil G, Hakime A et al (2012) Percutaneous stabilization of impending pathological fracture of the proximal femur. Cardiovasc Intervent Radiol 35:1428–1432CrossRefPubMed
Metadata
Title
Prospective 1-year follow-up pilot study of CT-guided microwave ablation in the treatment of bone and soft-tissue malignant tumours
Authors
Sébastien Aubry
Jonathan Dubut
Jean-Philippe Nueffer
Loic Chaigneau
Chrystelle Vidal
Bruno Kastler
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4528-7

Other articles of this Issue 4/2017

European Radiology 4/2017 Go to the issue

Interventional

Transarterial chemoembolization of hepatocellular carcinoma with segmental portal vein tumour thrombus

Oncology

Advanced non small cell lung cancer: response to microwave ablation and EGFR Status

Magnetic Resonance

Characterizing amide proton transfer imaging in haemorrhage brain lesions using 3T MRI

Gastrointestinal

Compression of the superior mesenteric vein—a sign of acute internal herniation in patients with antecolic laparoscopic Roux-en-Y gastric bypass

Ultrasound

Added value of point shear-wave elastography in the diagnosis of acute cholecystitis

Computed Tomography

Prediction of presence of kidney disease in patients undergoing intravenous iodinated contrast enhanced computed tomography: a validation study