HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tuncali, K. Articles by Silverman, S. G. Search for Related Content PubMed PubMed Citation Articles by Tuncali, K. Articles by Silverman, S. G. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

MRI-Guided Percutaneous Cryotherapy for Soft-Tissue and Bone Metastases: Initial Experience

¹ Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115.
² Department of Radiology, University of Massachusetts Medical Center, Worcester, MA.
³ Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
⁴ Department of Radiology, St. Joseph's Hospital and Medical Center, Phoenix, AZ.

OBJECTIVE. We sought to determine the safety and feasibility of percutaneous MRI-guided cryotherapy in the care of patients with refractory or painful metastatic lesions of soft tissue and bone adjacent to critical structures.

MATERIALS AND METHODS. Twenty-seven biopsy-proven metastatic lesions of soft tissue (n = 17) and bone (n = 10) in 22 patients (15 men, seven women; age range, 24–85 years) were managed with MRI-guided percutaneous cryotherapy. The mean lesion diameter was 5.2 cm. Each lesion was adjacent to or encasing one or more critical structures, including bowel, bladder, and major blood vessels. A 0.5-T open interventional MRI system was used for cryoprobe placement and ice-ball monitoring. Complications were assessed for all treatments. CT or MRI was used to determine local control of 21 tumors. Pain palliation was assessed clinically in 19 cases. The mean follow-up period was 19.5 weeks.

RESULTS. Twenty-two (81%) of 27 tumors were managed without injury to adjacent critical structures. Two patients had transient lower extremity numbness, and two had both urinary retention and transient lower extremity paresthesia. One patient had chronic serous vaginal discharge, and one sustained a femoral neck fracture at the ablation site 6 weeks after treatment. Thirteen (62%) of the 21 tumors for which follow-up information was available either remained the same size as before treatment or regressed. Eight tumors progressed (mean local progression-free interval, 5.6 months; range, 3–18 months). Pain was palliated in 17 of 19 patients; six of the 17 experienced complete relief, and 11 had partial relief.

CONCLUSION. MRI-guided percutaneous cryotherapy for metastatic lesions of soft tissue and bone adjacent to critical structures is safe and can provide local tumor control and pain relief in most patients.

Keywords: interventional radiology • MRI • musculoskeletal system • oncology • percutaneous ablation

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				P. G. Fine and S. Brogan Interventional Approaches to Treating Cancer Pain ASCO Educational Book, January 1, 2009; 2009(1): 583 - 588. [Abstract] [Full Text] [PDF]