Abstract
Purpose
To prospectively evaluate the feasibility, safety, and clinical utility of bone radiofrequency (RF) ablation with real-time monitoring of the spinal canal temperature for the treatment of spinal tumors adjacent to the spinal cord.
Materials and Methods
Our Institutional Review Board approved this study. Patients gave informed consent. The inclusion criteria were (a) a painful spinal metastasis and (b) a distance of 1 cm or less between the metastasis and the spinal cord. The thermocouple was placed in the spinal canal under CT fluoroscopic guidance. When the spinal canal temperature reached 45°C, RF application was immediately stopped. RF ablation was considered technically successful when the procedure was performed without major complications. Clinical success was defined as a fall in the visual analogue scale score of at least 2 points.
Results
Ten patients with spinal tumors measuring 3–8 cm (mean, 4.9 ± 1.5 cm) were enrolled. The distance between the tumor and the spinal cord was 1–6 mm (mean, 2.4 ± 1.6 mm). All procedures were judged technically successful (100%). The spinal canal temperature did not exceed 45°C in 9 of the 10 patients (90%). In the remaining patient, the temperature rose to 48°C, resulting in transient neural damage, although RF application was immediately stopped when the temperature reached 45°C. Clinical success was achieved within 1 week in all patients (100%).
Conclusion
Bone RF ablation with real-time monitoring of the spinal canal temperature is feasible, safe, and clinically useful for the treatment of painful spinal metastases adjacent to the spinal cord.
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Livraghi T, Goldberg SN, Lazzaroni S et al (1999) Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology 210:655–661
Yamakado K, Nakatsuka A, Kobayashi S et al (2006) Radiofrequency ablation combined with renal arterial embolization for the treatment of unresectable renal cell carcinoma larger than 3.5 cm: initial experience. Cardiovasc Intervent Radiol 29:389–394
Yamakado K, Hase H, Matsuoka T et al (2007) Radiofrequency ablation for the treatment of unresectable lung metastases in patients with colorectal cancer: a multicenter study in Japan. J Vasc Interv Radiol 18:303–398
Akeboshi M, Yamakado K, Nakatsuka A et al (2004) Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response. J Vasc Interv Radiol 15:463–470
Gronemeyer DH, Schirp S, Gevargez A (2002) Image-guided radiofrequency ablation of spinal tumors: preliminary experience with an expandable array electrode. Cancer J 8:33–39
Callstrom MR, Charboneau JW, Goetz MP et al (2002) Painful metastases involving bone: feasibility of percutaneous CT- and US-guided radio-frequency ablation. Radiology 224:87–97
Toyota N, Naito A, Kakizawa H et al (2005) Radiofrequency ablation therapy combined with cementoplasty for painful bone metastases: initial experience. Cardiovasc Intervent Radiol 28:578–583
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 22:300–306
Nakatsuka A, Yamakado K, Maeda M et al (2004) Radiofrequency ablation combined with bone cement injection for the treatment of bone malignancies. J Vasc Interv Radiol 15:707–712
Kojima H, Tanigawa N, Kariya S, Komemushi A et al (2006) Clinical assessment of percutaneous radiofrequency ablation for painful metastatic bone tumors. Cardiovasc Intervent Radiol 29:1022–1026
Rhim H, Goldberg SN, Dodd GD III et al (2001) Essential techniques for successful radiofrequency thermal ablation of malignant hepatic tumors. Radiographics 21:S17–S39
Varghese T, Zagzebski JA, Chen Q et al (2002) Ultrasound monitoring of temperature change during radiofrequency ablation: preliminary in-vivo results. Ultrasound Med Biol 28:321–329
Froese G, Das RM, Dunscombe PB (1991) The sensitivity of the thoracolumbar spinal cord of the mouse to hyperthermia. Radiat Res 125:173–180
Yamane T, Tateishi A, Cho S et al (1992) The effects of hyperthermia on the spinal cord. Spine 17:1386–1391
Dupuy DE, Hong R, Oliver B et al (2000) Radiofrequency ablation of spinal tumors: temperature distribution in the spinal canal. AJR Am J Roentgenol 175:1263–1266
Diehn FE, Neeman Z, Hvizda JL et al (2003) Remote thermometry to avoid complications in radiofrequency ablation. J Vasc Interv Radiol 14:1569–1576
Zubrod CG, Schneiderman M, Frei E et al (1960) Appraisal of methods for the study of chemotherapy of cancer in man: comparative trial of nitrogen mustard and trimethylene triophoshoramide. J Chron Dis 11:7–33
Chen WT, Shih TTF, Chen RC et al (2002) Blood perfusion of vertebral lesions evaluated with gadolinium-enhanced dynamic MRI: in comparison with compression fracture and metastasis. J Magn Reson Imaging 15:308–314
Maeda M, Sakuma H, Maier SE et al (2003) Quantitative assessment of diffusion abnormalities in benign and malignant vertebral compression fractures by line scan diffusion-weighted imaging. AJR Am J Roentgenol 181:1203–1209
Goldberg SN, Grassi CJ, Cardella JF et al (2005) Image-guided tumor ablation: standardization of terminology and reporting criteria. Radiology 235:728–739
Boon JM, Abrahams PH, Meiring JH et al (2004) Lumbar puncture: anatomical review of a clinical skill. Clin Anat 17:544–553
Parnass SM, Schmidt KJ (1990) Adverse effects of spinal and epidural anesthesia. Drug Safety 5:179–194
Goldberg SN, Stein MC, Gazelle GS et al (1999) Percutaneous radiofrequency tissue ablation: optimization of pulsed-radiofrequency technique to increase coagulation necrosis. J Vasc Interv Radiol 10:907–916
Thiagalingam A, D’Avila A, McPherson C et al (2007) Impedance and temperature monitoring improve the safety of closed-loop irrigated-tip radiofrequency ablation. J Cardiovasc Electrophysiol 18:318–325
Antz M, Otomo K, Nakagawa H et al (2001) Radiofrequency catheter ablation with the split-tip electrode in the temperature-controlled mode. J Pacing Clin Electrophysiol 24:1765–1773
Lepetit-Coiffe M, Quesson B, Seror O et al (2006) Real-time monitoring of radiofrequency ablation of rabbit liver by respiratory-gated quantitative temperature MRI. J Magn Reson Imaging 24:152–159
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Nakatsuka, A., Yamakado, K., Takaki, H. et al. Percutaneous Radiofrequency Ablation of Painful Spinal Tumors Adjacent to the Spinal Cord with Real-Time Monitoring of Spinal Canal Temperature: A Prospective Study. Cardiovasc Intervent Radiol 32, 70–75 (2009). https://doi.org/10.1007/s00270-008-9390-9
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DOI: https://doi.org/10.1007/s00270-008-9390-9